MP13-09: Underrepresentation of Minorities and Women in 20 years of Genitourinary Cancer Clinical Trials.

Juan Javier-DesLoges*, Arman Walia, Margaret Meagher, John Perry, San Diego, CA, Mimi Nguyen, San Diego , CA, Rekha Narasimhan, San Diego, CA, Madison Chakoumakos, San Diego , CA, Ava Saidian, Brent Rose, Maria Elena Martinez, James D. Murphy, Ithaar Derweesh, San Diego, CA

Introduction: To determine the representation of minorities and women in bladder, kidney, and prostate cancer National Cancer Institute (NCI) clinical trials.

Methods: This is an analysis in the NCI Clinical Data Update System, which is a database that contains enrollment information about clinical trial participants.  We evaluated patients in bladder, kidney, and prostate cancer trials between 2000-2019.  We determined the representation in a trial by race/ethnicity and sex compared to cancer incidence. Cancer incidence was determined using US Cancer Statistics.  The US Cancer Statistics includes cancer incidence data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program combined with the Center for Disease Control and Prevention’s National Program of Cancer Registries, together capturing roughly 100% of incident cancer cases. Lastly, we evaluated the change in trial participation by multivariable analysis between 2000-2004 and 2005-2019 adjusting for age, sex, and race/ethnicity.

Results: The cohort included 46,325 participants.  In the timeframe of 2015-2019, Blacks and Hispanics were underrepresented in bladder cancer trials, Odds Ratio (OR) 0.71, 95% Confidence Interval (CI).57-0.88, p=0.002)] and (OR 0.69, 95%CI 0.54-0.88, p=0.003), respectively.  Similarly, for kidney cancer, Black and Hispanic patients were underrepresented (OR 0.42, OR 0.33-0.54, p<0.001) and (OR 0.68, 95% CI 0.55-0.83, p<0.001), respectively.  Lastly, Blacks and Hispanics were underrepresented in prostate cancer trials (OR 0.85, 95% CI 0.79-0.92, p<0.001) and (OR 0.58, 95% CI 0.51-0.66, p<0.001).   Women were underrepresented in kidney (OR 0.80, 95% CI 0.72-0.89) and bladder cancer trials (OR 0.72, 95% CI 0.64-0.81, p<0.001).  

For bladder cancer trials, the odds of participation in 2015-2019 for Blacks was unchanged compared to 2000-2004 (OR 1.04, p=0.814) as was the participation of women (OR 1.03, p=0.741).  Similarly, for kidney cancer trials, the participation of Blacks (OR 1.17, p=0.293) and women (OR 1.03, p=0.663) were also unchanged. Participation increased for Blacks and Hispanics in prostate cancer trials (OR 1.14, 95% CI 1.04-1.26, p<0.001) and (OR 1.70, 95%CI 1.42-2.04, p=0.005) respectively.

Conclusions: In this study, we identified that Blacks, Hispanics, and Women remain underrepresented in trials, but in recent years participation of minorities increased for prostate cancer but not for kidney or bladder cancer.   These findings indicate that further efforts are needed to enroll minorities and women in genitourinary cancer trials.

Source of Funding: N/A