With the Right Support, Latina Breast Cancer Patients More Likely to Enroll in Clinical Trials

Patricia Chalela, DrPH

Researchers have identified a new way to boost the enrollment of Latina patients with breast cancer in clinical trials via a culturally sensitive video, a tailored booklet, and the help of a patient navigator.

Together, these approaches were found to increase the proportion of this underrepresented population who were actively pursuing a clinical trial, from approximately 38% to 75%, according to findings of a study announced this week at a meeting of the American Association of Cancer Research (AACR). Abstract A5

“Latinos represent 17% of the US population but only 5.6% of participants in National Cancer Institute treatment clinical trials,” noted Patricia Chalela, DrPH, in a statement. “Underrepresentation of minorities in clinical trials results in disparities of cancer outcomes and limits generalizability of the findings because researchers cannot study how minority patients respond to new treatments.”

Chalela and her colleagues at The University of Texas Health Science Center at San Antonio, where she is an assistant professor of epidemiology and biostatistics at the Institute for Health Promotion Research (IHPR), randomly assigned Latina patients with breast cancer who were eligible for a breast cancer clinical trial (BCCT) to receive either the intervention or usual care clinical trial information. To date, the study, in its last year of recruitment, has enrolled 71 eligible patients for randomization.

The intervention was comprised of a computer-based, culturally sensitive, and individually tailored BCCT video; a bilingual, low-literacy booklet, and navigator support. The intervention yielded higher awareness of clinical trials, including their purpose, requirements, the benefits and risks of participation, and an understanding of their potential as an appropriate treatment course.

Significant changes were observed in the group receiving the intervention compared with patients in the control group. The percentage of women in the intervention cohort found to be “in preparation” for clinical trial participation rose from a baseline level of 26.4% to 62.3% after the intervention. The proportion of those “in action” increased from 35.8% at baseline to 67.9% postintervention.

“Our results showed that intervention participants had significantly higher awareness of clinical trials than control participants,” said Chalela, who is part of the study team led by Amelie G. Ramirez, DrPH, director of the IHPR. “We hope that computer-based videos specifically tailored for Latinos will provide an effective strategy to increase Latina breast cancer patients’ knowledge, understanding, and participation in clinical trials, although this needs confirming in larger studies.”

“These results are encouraging,” Chalela continued. “We would like to assess the intervention at a larger scale and make the intervention available not only to all breast cancer patients, but expand it to all cancer patients in general.”

The AACR Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medical Underserved conference is being held November 9-12, 2014 in San Antonio.