Journal of Hepatocellular Carcinoma (Jul 2023)
Hispanic Individuals are Underrepresented in Phase III Clinical Trials for Advanced Liver Cancer in the United States
Abstract
Cecilia Monge,1 J Alberto Maldonado,1 Katherine A McGlynn,2 Tim F Greten1,3 1Gastrointestinal Malignancies Section, Thoracic and GI Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; 2Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; 3NCI CCR Liver Cancer Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Betheda, MD, USACorrespondence: Tim F Greten, Thoracic and GI Malignancy Section, TGMB NIH/NCI/CCR, Building 10 Rm 2B28B, 9000, Rockville Pike, Bethesda, MD, 20892, USA, Tel +1 240 760 6114, Email [email protected]: Hispanic individuals comprise the second-largest subpopulation after non-Hispanic White (NHW) individuals in the United States (US). We compared the relative contribution of Hispanic individuals to the ten most common causes of cancer-related deaths and studied enrollment of Hispanic patients in multinational phase III advanced liver cancer trials with the aim to investigate whether racial subpopulations are adequately represented in liver cancer trials.Methods: Relative cancer incidence rates in Hispanic individuals, NHW individuals, non-Hispanic black (NHB) individuals, and Asian individuals were obtained from both the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results Program and the Center for Disease Control and Prevention (CDC), United States Cancer Statistics (USCS) database. Searching PubMed, Embase, and Web of Science, we identified phase III clinical trials studying advanced liver cancer in the last ten years and collected enrollment for each race and ethnicity. Incidence rates of liver cancer and enrollment rates in phase III trials were compared by race and ethnicity.Results: The cancer type with the relatively highest contribution of Hispanic individuals was liver cancer. From 2015 to 2019, 15.1% of liver cancer cases occurred in Hispanic individuals compared to 12.5% in Asian individuals, 11% in NHB individuals, and 7.5% in NHW individuals. In the last ten years, Hispanic individuals made up 1.6% of patients and NHB individuals 1.3% of patients included in phase III multinational liver cancer trials, compared to 31% NHW individuals and 47% Asian individuals.Conclusion: Hispanic individuals are disproportionately underrepresented in multinational phase III clinical trials for liver cancer despite having the highest relative incidence rates among the four major racial or ethnic groups in the US.Keywords: liver cancer, hepatocellular carcinoma, intrahepatic cholangiocarcinoma, health care disparities, cancer care disparities, Hispanic individuals, non-Hispanic black individuals
