Distrust Among Black Patients With mBC Impacts Participation in Clinical Trials

Although Black patients with metastatic breast cancer have the highest death rate and shortest survival outcomes when compared with other racial and ethnic groups in the United States, they are far less likely to be included in clinical trials that investigate newer treatments.

Findings from a recently completed survey demonstrated that although 83% of Black patients with metastatic breast cancer would be interested in participating in clinical trials, only 40% reported their provider having a conversation with them about a trial.

The results of the survey, which were presented during a press briefing ahead of the 2022 ASCO Annual Meeting, show that action needs to be taken to address these barriers and ensure more Black patients with metastatic breast cancer are included in clinical trials.

According to the presenter, only when a trial population represents the diversity of the general population can oncologists truly evaluate how a treatment works across different populations.

The purpose of the survey, which is a part of the BECOME initiative, was to better understand the barriers Black patients with metastatic breast cancer face in regard to participating in clinical trials. It was administered via social media, as well as by members of the Metastatic Breast Cancer Alliance and included 424 patients with metastatic breast cancer, 102 who self-identified as Black.

Black respondents trust and satisfaction rates with their oncology team were high, above 90%, and 83% of Black respondents were somewhat or very likely to consider participation in a clinical trial. However, 40% reported that their care team had not discussed clinical trials with them.

Additionally, Black respondents were more likely than non-Black respondents to believe unstudied treatments may be harmful (57% versus 31%) and were less likely to trust trials (73% versus 91%).

Other reasons for not participating in a clinical trial included worry about side effects (73%) and effectiveness (63%), as well as logistics such as travel and added cost.

Black respondents were also less likely than non-Black respondents to trust that people of all race and ethnicities would be given fair treatment in a trial (32% versus 56%) and would be more motivated to participate if there were assurance people of their race would benefit (83%).

Furthermore, Black respondents were more likely than non-Black respondents to value information on clinical trials if given by someone who is same race or ethnicity (67% versus 10%), has had breast cancer (73% versus 44%) or metastatic breast cancer (73% versus 51%).

Regarding forward steps, the presented said that all stakeholders have a role to play in increasing participation. This includes expanding the survey-respondent base, meaning investigators hope to reach a broader group of people to better represent the Black patient experience. Members of the BECOME initiative will also meet with other groups to share results and create strategies to improve care, she said.

_Reference:

_{Walker S, Carlson M, White C et al. Increasing Black patient participation in metastatic breast cancer clinical trials: The BECOME (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement) project. Presented at the 2022 ASCO Annual Meeting. May 26, 2022.}