Dr. Duma said research already has revealed some differences:
- Blacks appear to metabolize some chemotherapy drugs more quickly, meaning they might need larger doses than other groups.
- The female hormone estrogen plays a significant role in how well tumors respond to cancer drugs.
- Elderly patients are more likely to suffer crippling side effects from their cancer treatment, and rebound from them less easily.
America’s history of unethical experimentation on minority groups prompts many to avoid participation in clinical trials, particularly blacks, Dr. Florez and Li said.
They cited the Tuskegee Study, started in 1932, in which black men were denied treatment for syphilis over four decades so researchers could observe the long-term effects of the venereal disease.
“Our country is still living with the legacy of things like Tuskegee,” Li said. Fears associated with being involved in research keep certain people from participating in clinical trials, he noted.
To overcome these concerns, the leaders of clinical trials need to provide more access to their studies through community-based hospitals, rather than the collegiate research hospitals where most trials are conducted, Li said.
Researchers also should recruit spokespeople from various racial and ethnic groups “who have participated in research trials who can talk with other members of their community in ways they can trust,” Li added.
Dr. Florez said clinical trials could provide more support to elderly participants—perhaps helping them keep their medications organized and providing money to those living on a fixed income.
And medical journals can help promote diversity by refusing to publish trials unless researchers provide tables indicating the race, age and sex of all participants, along with any reasons why certain groups are underrepresented, Dr. Florez said.
The findings were presented Monday at an American Association for Cancer Research meeting, in Atlanta. Until published in a peer-reviewed medical journal, research presented at meetings is usually considered preliminary.