Dr. Johnson on the Importance of Diverse Representation in Breast Cancer Clinical Trials

Nathalie McDowell Johnson, MD, FACS, surgical oncologist, medical director, Legacy Cancer Institute, Legacy Breast Health Centers, president, the American Society of Breast Surgeons, discusses the importance of diverse representation in breast cancer clinical trials.

It is important to continue to include underrepresented minorities, such as African American women, in clinical trials for breast cancer, Johnson begins. This area of unmet need was underscored in data borne out by the phase 3 TAILORx (NCT00310180) and RxPONDER (NCT01272037) trials, which showed that African American women didn’t do as well as their White counterparts, Johnson emphasizes.

In the RxPONDER trial, one of the questions that researchers aimed to address was whether African American women were adherent to their endocrine therapy, Johnson continues, adding that it was hypothesized that this was the reason for the differences in outcomes. However, with further investigation into the data from the trial, investigators found that African American women were the most adherent to therapy on the study, yet they still had worse outcomes, Johnson explains. Additionally, investigators saw that some of these outcomes may be associated with metabolic syndrome or obesity, Johnson adds.

Because investigators had enough women enrolled from underserved populations in both trials, it was possible to obtain this information for clinicians to do better for their patients moving forward, Johnson says. Based on these outcomes, another area to look at is metabolic syndrome and obesity in these women. Further investigation into this topic may address whether clinicians are able to help patients with physical exercise and weight loss and if that can ultimately affect outcomes, Johnson notes. These areas of further investigation are all exciting and the better that clinicians do at enrolling different groups, the better oncologists will understand and begin to reduce disparate outcomes, Johnson concludes.