Clinical trial enrollment in a Hispanic-majority NCI-designated cancer center: The Mays Cancer Center experience over 10 years.

Abstract

e18551 Background: There is a perpetual lack of representation in clinical trial enrollment among minorities. In 2013, the former Cancer Therapy and Research Center (CTRC) at the University of Texas Health Science Center at San Antonio implemented the Minority Accrual Plan (MAP) to address the challenge of deliberately enrolling minority subjects in clinical trials (CT). The objective of the present study was to describe the racial and ethnic minority representation in CT conducted, at the now Mays Cancer Center (MCC), from years 2012-2021. The MCC is an NCI designated cancer center, that serves a Hispanic (HI) enriched catchment area of 5.1 million people of South Texas. Methods: This is a descriptive analysis of patients enrolled in CT at the MCC from years (y) 2012 to 2021. Patients were enrolled in either interventional treatment (IT), interventional non-treatment (INT), or non-interventional/observational (NI) CT. Variables analyzed included ethnicity, payment class, disease site, and county of origin. Results: We identified a total of 14661 patients with various tumor types who were enrolled in CT at the MCC. A total of 7019 patients (48%) were HI, 6590 patients (45%) were Non-Hispanics (NH), and 1062 (7%) patients did not report ethnicity data. The majority of patients were enrolled on NI (67%), followed by INT (18%) and IT (15%) CT. Overall, the highest enrolled disease sites were genitourinary (40%), breast (11%) and pediatric (7%) cancers. Most patients were self-pay (27%) or had Medicare (27%), whereas 19% of patients had commercial insurance and 7% had CareLink. Enrollment of HI has fluctuated over the years; 4333 HI patients were enrolled from 2012-2016, this decreased to 2686 in the following 2017-2021 period. Overall, 26% of patients were from rural locations, while 74% were from urban locations. The number of rural CT participants was greater in Val Verde (298), Kerr (272), Uvalde (163), and Frio (103) counties. Conclusions: HI continue to be disproportionately enrolled in CT. In 2012, and prior to the implementation of the MAP, 45% of the patients enrolled in clinical trials were HI. In the past 10 years, over 7000 HI patients have participated in CT, even though there have been some fluctuations in accruals rates over the past years, such as in the 2017-2021 period where the COVID-19 pandemic affected enrollment rates. This study validates the notion that better, and perhaps different approaches are needed to improve minority enrollment in CT. Finally, we conclude that the uniqueness of our geographic location did not positively impact HI enrollments. [Table: see text]