Coming Together for Equitable Cancer Care

Author: Daniel A. Saez, MSc, Manager, LungMATCH Navigation Program

One of the priorities of GO2 for Lung Cancer, alongside many other ally organizations, is to ensure that people diagnosed with lung cancer receive optimal care regardless of their background, socioeconomic status, race or ethnicity. Collectively, we’re working to break down barriers to equitable cancer care, which was a hot topic at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting. Our team was on the ground to bring you the latest news on this front.

Lack of Diversity in Clinical Trials

The goal of clinical trials is to find new treatments that work better than, or give new options outside of, existing FDA approved treatments. To do this, clinical trials enroll patients they anticipate would benefit from the treatment they are testing. If patients benefit from the clinical trial treatment, the results suggest that the treatment being researched might be better than what is currently available.

One of the glaring issues with clinical trials is the lack of diversity. A disproportionate number of clinical trial participants identify as white while only 1% of patients in immunotherapy trials identify as Black. Presenters at ASCO provided an overview of how some of the lack of diversity in trials may have come about, including factors like limited physician communication and physician bias. Other barriers to diversity in clinical trials include accessibility and trial eligibility.

Presenters also provided potential solutions to the lack of diversity in clinical trials including more equitable screening and eligibility criteria. They also highlighted the vital need for easier access to join a clinical trial. Many patients in rural areas do not join clinical trials simply because none are offered at treatment centers located within a reasonable distance from their home.  not join clinical trials simply because none are offered at treatment centers located within a reasonable distance from their home.

Together, we are all working towards better representation for all people with lung cancer in clinical trials to ensure every patient who could benefit from treatments is given the opportunity to be seen and heard.

Going Beyond Race and Ethnicity: Special Populations in Lung Cancer

Diversity in lung cancer extends beyond race and ethnicity, those living in rural areas and the elderly. ASCO 2022 helped shine a light on what equity means for these populations in the “Including the Excluded” session.

This session took a deep dive into how clinical trials could include patients with brain metastases and the elderly, as well as barriers to accessing optimal treatment in different countries. Data presented in this session demonstrated that an emerging targeted therapy for one of the most common mutations in non-small cell lung cancer, KRAS G12C, has a positive effect on cancer that has spread to the brain. Many studies exclude this population of patients, therefore it is difficult to know if the treatments are effective because of the lack of representation. Similarly, trial data for an already approved immunotherapy, Tecentriq (atezolizumab), showed a positive effect on cancer that has spread to the brain.

The importance of including these presentations goes beyond showing that these treatments have positive effects. It creates the possibility for more trials to allow patients with untreated brain metastases to participate. This representation could change the landscape of lung cancer clinical trial accessibility—a step in the right direction toward equitable cancer care.