Access and Representation: A Narrative Review of the Disparities in Access to Clinical Trials and Precision Oncology in Black men with Prostate Cancer

Esdaille, Ashanda; Ibilibor, Christine; Holmes, Arturo; Palmer, Nynikka R.

doi:10.1016/j.urology.2021.09.004

Cited by 11 publications

(7 citation statements)

References 70 publications

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“…For both phases, the two reviewers will discuss decisions and any discrepancies to reach consensus. When consensus cannot be reached, outstanding conflicts will be resolved by a third reviewer (NRP or TMF) who has extensive experience in conducting reviews relevant to cancer care [ 45 – 50 ]. Reasons for exclusion will be documented, and all selection procedures will conform to the PRIMSA-ScR guidance [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

Navigation programs relevant for African American men with prostate cancer: a scoping review protocol

et al. 2022

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Background The excess incidence and mortality due to prostate cancer that impacts African American men constitutes the largest of all cancer disparities. Patient navigation is a patient-centered healthcare system intervention to eliminate barriers to timely, high-quality care across the cancer continuum and improves health outcomes among vulnerable patients. However, little is known regarding the extent to which navigation programs include cultural humility to address prostate cancer disparities among African American men. We present a scoping review protocol of an in-depth examination of navigation programs in prostate cancer care—including navigation activities/procedures, training, and management—with a special focus on cultural context and humility for African American men to achieve health equity. Methods We will conduct comprehensive searches of the literature in PubMed, Embase, Web of Science, and CINAHL Complete, using keywords and index terms (Mesh and Emtree) within the three main themes: prostate cancer, patient navigation, and African American men. We will also conduct a search of the gray literature, hand-searching, and reviewing references of included papers and conference abstracts. In a two-phase approach, two authors will independently screen titles and abstracts, and full-text based on inclusion/exclusion criteria. All study designs will be included that present detailed data about the elements of navigation programs, including intervention content, navigator training, and/or management. Data will be extracted from included studies, and review findings will be synthesized and summarized. Discussion A scoping review focused on cultural humility in patient navigation within the context of eliminating disparities in PCa care among African American men does not yet exist. This review will synthesize existing evidence of patient navigation programs for African American prostate cancer patients and the inclusion of cultural humility. Results will inform the development and implementation of future programs to meet the unique needs of vulnerable prostate cancer patients in safety net settings. Systematic review registration PROSPERO 2021 CRD42021221412

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Section: Methodsmentioning

confidence: 99%

Navigation programs relevant for African American men with prostate cancer: a scoping review protocol

et al. 2022

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“…In a study analyzing 72 prostate cancer trials with start dates between 1987 and 2016, EAM accounted for 96% of all trial participants 81 . With the advancement of precision medicine, it is imperative to improve representation in trial enrollment in order to ensure properly validated biomarkers, and subsequently, an appropriate treatment decision for the general population, especially for those from marginalized and high‐risk backgrounds 82 . Here we identify clinical trials started after 2016 that investigated personalized therapy for prostate cancer in order to examine the representation of AAM across prostate cancer precision therapy trials.…”

Section: Germline and Somatic Testingmentioning

confidence: 99%

“… 81 With the advancement of precision medicine, it is imperative to improve representation in trial enrollment in order to ensure properly validated biomarkers, and subsequently, an appropriate treatment decision for the general population, especially for those from marginalized and high‐risk backgrounds. 82 Here we identify clinical trials started after 2016 that investigated personalized therapy for prostate cancer in order to examine the representation of AAM across prostate cancer precision therapy trials. We carried out a literature search on clinical trial registries (ClinicalTrials.gov) using the keywords: PDL‐1, Pembrolizumab, Nivolumab, Cemiplimab, Durvalumab, PARPi, Veliparib, Olaparib, Niraparib, Rucaparib, Talazoparib, Lutetium, and 177Lu.…”

Section: Germline and Somatic Testingmentioning

confidence: 99%

Racial disparity in the genomics of precision oncology of prostate cancer

Le,

Rojas,

Fakunle

et al. 2023

Cancer Reports

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BackgroundSignificant racial disparities in prostate cancer incidence and mortality have been reported between African American Men (AAM), who are at increased risk for prostate cancer, and European American Men (EAM). In most of the studies carried out on prostate cancer, this population is underrepresented. With the advancement of genome‐wide association studies, several genetic predictor models of prostate cancer risk have been elaborated, as well as numerous studies that identify both germline and somatic mutations with clinical utility.Recent FindingsDespite significant advances, the AAM population continues to be underrepresented in genomic studies, which can limit generalizability and potentially widen disparities. Here we outline racial disparities in currently available genomic applications that are used to estimate the risk of individuals developing prostate cancer and to identify personalized oncology treatment strategies. While the incidence and mortality of prostate cancer are different between AAM and EAM, samples from AAM remain to be unrepresented in different studies.ConclusionThis disparity impacts the available genomic data on prostate cancer. As a result, the disparity can limit the predictive utility of the genomic applications and may lead to the widening of the existing disparities. More studies with substantially higher recruitment and engagement of African American patients are necessary to overcome this disparity.

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“…Similar trends are seen in prostate cancer. 45 It is also important to consider that single-gene testing, while less costly, more accessible, and more often ordered by physicians, may be less effective at identifying molecular targets, especially for diseases in which multiple potential targets have been elucidated. 44 Socioeconomic status also influences rates of somatic molecular testing due to associated actual, perceived, and indirect costs.…”

Section: Extrinsic Factors Influencing Precision Oncology Disparitiesmentioning

confidence: 99%

Health Disparities and Precision Oncology in Foregut Malignancies

Dowell

Wang

2023

Foregut: The Journal of the American Foregut Society

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Health disparities exist in incidence, treatment, and survival of esophageal and gastric cancer based on socioeconomic and minority racial/ethnic group status. How socioeconomic and minority status affect access and utilization of precision oncology in foregut malignancies is not well understood. Based on other cancer types, multiple intrinsic and extrinsic factors influence utilization of cancer genetic testing, participation in precision oncology clinical trials, and access to molecularly targeted therapies. As precision oncology becomes more common in the treatment of foregut malignancies, health equity will require ongoing identification of sources of disparities and proposal of practical solutions.

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Access and Representation: A Narrative Review of the Disparities in Access to Clinical Trials and Precision Oncology in Black men with Prostate Cancer

Cited by 11 publications

References 70 publications

Navigation programs relevant for African American men with prostate cancer: a scoping review protocol

Navigation programs relevant for African American men with prostate cancer: a scoping review protocol

Racial disparity in the genomics of precision oncology of prostate cancer

Health Disparities and Precision Oncology in Foregut Malignancies

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