Participation in clinical trials may help to overcome health disparities in the treatment of advanced or recurrent ovarian cancer, and minority patients should be encouraged to participate, said Khilen B. Patel, MD, Obstetrics & Gynecology Resident, Medical College of Georgia, Augusta University, at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer.
Dr Patel presented results of the study showing similar overall survival (OS) rates for white and minority patients who participated in clinical trials, which starkly contrasts with the survival rates for these 2 populations outside of clinical trials.
“Compared to those not enrolled in clinical trials, the evidence shows that the minority patients participating in clinical trials had increased overall survival. Our study is evidence that no one should be afraid of clinical trials, and that more attention should be placed on enrollment,” Dr Patel said.
Clinical trials enrollment remains very low, and patient enrollment in phase 3 gynecologic cancer trials declined by more than 90% between 2011 and 2016, Dr Patel said.
Dr Patel and colleagues evaluated the effect of clinical trial participation on overcoming health disparities, such as race and distance to a cancer treatment center, which are related to OS in patients with stage III or IV epithelial ovarian, fallopian tube, and peritoneal cancer.
This retrospective study identified patients diagnosed with advanced or recurrent epithelial ovarian cancer between January 2004 and June 2017 who received treatment at the Georgia Cancer Center at Augusta University. The 236 patients were divided into 2 groups based on clinical trial enrollment—145 patients had participated in clinical trials, and 91 patients had not. Of all 236 patients, 60.3% of minority patients and 61.8% of white patients participated in clinical trials.
White patients were more likely to live closer to a treatment center than minority patients, and in the general population, the OS was significantly greater for white patients who lived less than 25 miles from a treatment center.
However, among patients who participated in clinical trials, after controlling for age and distance from a treatment center, no significant difference was seen in survival, with 53 months for white patients and 50 months for minority patients; being white did not confer a survival benefit.
After the same controls were applied to patients not enrolled in clinical trials, being white was significantly associated with a survival benefit. Compared with minority patients, the OS was significantly greater for white patients who had not participated in trials: 24.5 months for minority patients versus 71.4 months for white patients.
Dr Patel cited the Georgia Cancer Center’s large minority patient population as a strength of the study. Approximately 40% to 45% of the center’s population are minority patients with gynecologic malignancies, with an average clinical trial participation rate of approximately 25% to 30% compared with the 6% to 7% national average.
Although a significant health disparity exists for minority patients in this patient population, the researchers suggest that participation in clinical trials can overcome this health barrier and improve outcomes for patients with ovarian cancer.
The potential survival benefit from clinical trial participation for minority patients with advanced or recurrent epithelial ovarian cancer warrants further research, according to Dr Patel and colleagues.