Black Disparities in Targeted Therapy Clinical Trials – A Call for Future Reset

Studies show marked disparities in the relative risk of cancer death between Black Americans and White Americans even after adjusting for the stage at diagnosis and age. This may be explained by disparities in different aspects of cancer care including providing equal screening opportunities, availability of proper treatment options and inclusivity in clinical trials. To our knowledge, our study is the first descriptive study on Black disparities in targeted therapy clinical trials. We collected data on Black inclusivity from pivotal clinical trials as well as trials of special interest involving targeted therapies in some of the commonly encountered cancers. Our results show that most targeted therapy trials included in our review were multinational including some participating countries with very few or no Blacks and therefore had very poor Black representation with an average of around 1-3%. Also, some trials lacked transparent data on the racial demographics raising concerns on the generalizability of data when extrapolated to treat the Black population. We have reviewed existing literature on differences in cancer biology and host biology depending on the race and end with suggestions to improve Black inclusivity in clinical trials.