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Why Breast Cancer Clinical Trials Need More Diversity

In order to improve breast cancer outcomes, clinical trials need more women from racial and ethnic minorities.

In order to continue to improve the ways that breast cancer is detected and the ways it can be treated, clinical trials need more participants from racial and ethnic minorities.

Breast cancer has a long history. It has been described in medical literature for thousands of years. Physicians have been performing surgeries to treat breast cancer for well over a century.

In the most recent decades, there has been rapid progress in the understanding of what’s happening in the body when a person has breast cancer, leading to the introduction of what is called precision oncology—new categories of anti-cancer treatments, including targeted therapies and immunotherapies.

While there has been much progress, there is still more work to be done. In order to continue to improve the ways that breast cancer is detected and the ways it can be treated, there is a need for women with breast cancer to participate in clinical trials.

And there is especially a need for participants from racial and ethnic minorities—groups that have for too long been underrepresented in breast cancer research.

What is a clinical trial?
A clinical trial is a medical research study involving people. A clinical trial is generally trying to answer two questions—is a specific therapeutic approach safe, and is it effective?

Clinical trials can study many different things. One might look at a brand-new treatment option. Another might study if an existing therapy works more effectively when used at a higher dose. Another might look at the efficacy of existing therapies used in combination with one another.

Clinical trials may offer people access to new therapies that are not yet available and access to better healthcare (as all participants in a clinical trial are closely monitored). They also offer the opportunity to contribute to a better future for people with the same disease you are living with.

Why better representation is needed
The need for more clinical trial participants from racial and ethnic minorities is widely recognized. This is true of clinical trials where the focus is breast cancer—as well as clinical trials where the focus is other forms of cancer and clinical trials for other diseases.

Black or African American people and Hispanic or Latino people accounted for only 8.7 percent and 4.8 percent of participants in clinical trials for cancer therapies between 2000 and 2019. Though participation has increased in recent years, both groups are still underrepresented.

People with different racial and ethnic backgrounds may be affected differently by disease and may respond differently to treatment. Breast cancer is no exception. For example, Black women overall have a lower lifetime risk of developing breast cancer. However, Black women with breast cancer are more often diagnosed at younger ages, with more aggressive types of cancer, and are more likely to die because of breast cancer.

More participants from racial and ethnic minorities will lead to a better understanding of these differences—and will allow healthcare providers to work toward better treatment outcomes for women that represent racial and ethnic minorities.

Applying to a clinical trial
There are a number of barriers that can prevent a person from participating in a clinical trial. The time, travel, and out-of-pocket costs to participate in a clinical trial are barriers for many people. Many others lack trust in the healthcare system. And many people are not aware that clinical trials are available or that they may qualify to participate.

If you or a loved one is interested in participating in a clinical trial, there are a few ways to get started. One of the best ways is by speaking with a healthcare provider that treats breast cancer. A healthcare provider may be able to help you find a clinical trial, help you apply, and answer any questions you have.

You can also seek out potential clinical trials on your own. Upcoming clinical trial opportunities are listed at ClinicalTrials.gov.

Medically reviewed in January 2022.

Article sources open article sources

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Ritu Lakhtakia. "A Brief History of Breast Cancer." Sultan Qaboos University Medical Journal, 2014. Vol. 14, No. 2.
National Cancer Institute. "Advances in Breast Cancer Research."
U.S. Food & Drug Administration Oncology Center of Excellence. "Understanding Precision Medicine."
American Cancer Society. "Targeted Drug Therapy for Breast Cancer."
American Cancer Society. "Immunotherapy for Breast Cancer."
Luther T.Clark, Laurence Watkins, et al. "Increasing Diversity in Clinical Trials: Overcoming Critical Barriers." Current Problems in Cardiology, 2019. Vol. 44, No. 5.
Narjust Duma, Jesus Vera Aguilera, et al. "Representation of Minorities and Women in Oncology Clinical Trials: Review of the Past 14 Years." JCO Oncology Practice, 2018. Vol. 14, No. 1.
BreastCancer.org. "Clinical Trials for Metastatic Breast Cancer."
National Cancer Institute. "Deciding to Take Part in a Clinical Trial."
Christopher M. Aldrighetti, Andrzej Niemierko, et al. "Racial and Ethnic Disparities Among Participants in Precision Oncology Clinical Studies." JAMA Network Open, 2021. Vol. 4, No. 11.
Jonathan M. Loree, Seerat Anand, et al. "Disparity of Race Reporting and Representation in Clinical Trials Leading to Cancer Drug Approvals From 2008 to 2018." JAMA Oncology, 2019. Vol. 5, No. 10.
Juan Javier-DesLoges, Tyler J. Nelson, et al. "Disparities and trends in the participation of minorities, women, and the elderly in breast, colorectal, lung, and prostate cancer clinical trials." Cancer, 2022. Vol. 128, No. 4.
U.S. Food & Drug Administration. "Clinical Trial Diversity."
Breast Cancer Research Foundation. "Black Women and Breast Cancer: Why Disparities Persist and How to End Them."
BreastCancer.org. "Racial, Ethnic Minorities Underrepresented in Cancer Research."
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