Does recruitment to cancer clinical trials at the Leicester Royal Infirmary reflect the ethnic diversity of those receiving systemic anticancer therapy?


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Adrian Nicholson1,Mohammed Karolia1,Emily de Groot2,Sarah Nicholson1,Devinder Dhillon1,Lynne Howells3,Harriet Walter3,Anne Thomas3
1University Hospitals Leicester, Leicester, UK,2University of Leicester Medical School, Leicester, UK,3Leicester Cancer Research Centre, Leicester, UK

Abstract

Background

Participation in cancer clinical trials has been associated with improved outcome. However, specific barriers to participation exist within racial and ethnic minority populations. According to the 2011 census, Leicester has one of the most diverse population within the UK (8th highest). We sought to determine whether recruitment to cancer clinical trials reflects the racial and ethnic diversity of patients treated with systemic anticancer therapy (SACT) within the Leicester Cancer Centre (LCC).

Method

A retrospective review using the SACT Dataset of racial and ethnic diversity of patients (categorised using SACT codes) receiving treatment within a cancer clinical trial was compared to those receiving standard treatment from January 2016 to December 2018.

Results

From Jan 2016 - Dec 2018, 11,080 patients received SACT. 1,140 (10.3%) were treated within a clinical trial. Of patients receiving standard SACT: 7,788 (78.4%) were white, 871(8.8%) Asian/Asian British, 163 (1.6%) black/African/Caribbean/Black British, 39 (0.4%) Mixed/Multiple ethnic groups, 87 (0.9%) other and 992 (10.0%) not stated/unknown; versus 908 (79.6%), 96 (8.4%), 10 (0.9%), 5 (0.4%), 6 (0.5%) and 115 (10.1%) respectively treated in clinical trials. Of those treated in a Phase I trial 78.9% were white.

The male:female ratio of patients receiving SACT was 1:1. Of those receiving SACT, a greater percent of males received treatment within a clinical trial versus females (13.1% vs 7.46% p=<0.005). The median age of patients treated within a trial was 66 years (range 2-89) and standard SACT 67 years (range 1-100).

Conclusion

When compared to SACT, our results demonstrate higher recruitment to trials of white and Asian/Asian British patients. Interestingly, despite a diverse population, 78.5 % treated with SACT were white. Further work is required to identify whether recruitment barriers exist, which may have implications in terms of safety and efficacy of the trial.