Black Patients Show Shorter Survival in Ovarian Cancer Trials

Although progression-free survival was similar across racial groups, overall survival was shorter for Black patients with advanced epithelial ovarian cancer enrolled in first-line randomized clinical trials, according to a cohort study published in JAMA Network Open.

In an interview with CURE, Dr. Alex Francoeur, an oncology fellow at the University of California Irvine and study author, explained what may account for this difference and what could be happening after patients leave a clinical trial.

She explained that patients participating in trials typically have more frequent visits to monitor toxicities, as well as regimented time points for imaging and lab work, all built into a preset protocol. Because the protocol is structured, there is less deviation and less room for providers to make changes.

Based on these findings, Francoeur and her colleagues hypothesized that while patients are enrolled in clinical trials, there may be more of a leveling of the playing field in terms of disparities that have been highlighted in other studies related to outcomes. However, once patients come off trials, those disparities may become more pronounced again.

Transcript

Progression-free survival was similar across racial groups, but overall survival was shorter for Black patients. How do you explain that difference and what might be happening after patients leave a trial?

I think this was a really interesting finding that we unearthed in this study. Our conclusion and hypothesis based on this result is that when patients are enrolled in a clinical trial, there is a higher degree of oversight and strict protocols that have to be followed by the body running the trial. Patients generally have more frequent visits to check on toxicities, very regimented time points for imaging and lab work and everything is built into the trial protocol. The protocol is preset, so there is less deviation and less room for providers to make changes because of how trials are designed.

When patients’ disease progresses, they come off the trial. After that, they may return to their regular cancer doctor, especially if they traveled somewhere else to participate in the trial. If they were already being treated by their doctor, then the next steps are really up to that physician.

Our hypothesis from this result was that while patients are on clinical trials, we may see more of a leveling of the playing field in terms of disparities that have been highlighted in other studies related to patient outcomes. But once patients come off trials, those disparities may become more pronounced again. I think this really highlights the importance of enrolling a representative patient population in clinical trials and encouraging a diverse group of participants to join.

Transcript has been edited for clarity and conciseness.

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