Young people of color with a higher income more likely to participate in cancer clinical trials

People of color, those with a higher income and younger individuals are more likely to participate in clinical trials during their cancer treatment according to a new study from the University of Missouri School of Medicine.

Clinical trials are research studies that involve people who volunteer to take part in tests of new drugs, current approved drugs for a new purpose or medical devices.

The study analyzed data collected from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System Survey, which is an annual national telephone survey designed to collect health-related data from U.S. adults. Survey years selected included the question, "Did you participate in a clinical trial as part of your cancer treatment?" The analysis of 20,053 respondents revealed an average overall clinical trial participation rate of 6.51%. Among 17,600 white respondents, participation was 6.24%; among 445 Hispanic respondents, participation was 11%; and among 943 Black respondents, participation was 8.27%.

This study informs our understanding of who is participating in cancer clinical trials. We found people of color were more likely to participate in cancer clinical trials than white cancer patients when controlling for other demographic factors. It could be that in previous studies, the effects of income, sex or age were muddling the true picture."

Lincoln Sheets, MD, PhD, Assistant Research Professor, MU School of Medicine

Sheets said the analysis also indicated people who earn more than the national median household income of $50,000 annually and the young were more likely to participate in clinical trials during cancer treatment.

"Taken in total, the results of this study help confirm that there are sociodemographic disparities in cancer clinical trials, indicating there are deficiencies in the system as it stands now," Sheets said. "We must lessen financial barriers to participation, improve logistical accessibility of cancer clinical trials and loosen restrictions on the enrollment of patients with comorbidities."

Sheets said improving access to transportation, childcare and health insurance would remove some of the structural and logistical barriers that prevent people from participating in cancer clinical trials.

Sheets collaborated on the study with MU School of Medicine student Shelby Meyer.

Source:

University of Missouri-Columbia

Journal reference:

Meyer, S., et al. (2021) Sociodemographic diversity in cancer clinical trials: New findings on the effect of race and ethnicity. Contemporary Clinical Trials Communications. doi.org/10.1016/j.conctc.2021.100718.

Posted in: Medical Research News | Medical Condition News | Healthcare News

Tags: Cancer, Cancer Treatment, Clinical Trial, Drugs, Health Insurance, Medicine, Research

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Cognitive outcomes in survivors of childhood cancers have been largely understudied

In a new study led by Yale Cancer Center, researchers report many survivors of childhood cancers receive systemic therapies associated with cognitive effects and chronic health conditions that may impact long-term cognitive outcomes with downstream effects on education, employment, and income. The results were published online today in the Journal of Clinical Oncology (JCO).

Cognitive outcomes in survivors of childhood cancers have been largely understudied. In this study, we wanted to explore cognitive functioning after specific extracranial solid tumor and lymphoma diagnoses to discuss possible associated risk factors and highlight research gaps to help provide clinical guidance for affected survivors."

Nina S. Kadan-Lottick, MD, MSPH, Study Senior Author and Associate Professor of Pediatrics (Hematology/Oncology) and Disease Aligned Research Team (DART), Leader for Pediatric Cancer at Yale Cancer Center

Researchers examined previous studies that investigated long-term (>2 years off-therapy and/or 5 years from diagnosis) cognitive outcomes in survivors of childhood (diagnosed <21 years) extracranial solid tumors and lymphomas with at least 10 patients within the diagnostic subcategory back to 1990.

The studies suggested survivors of osteosarcoma, neuroblastoma, Wilms tumor, non-Hodgkin lymphoma, Hodgkin lymphoma, and Langerhans cell histiocytosis have increased risk of cognitive impairment. Co-morbid health conditions were frequently associated with cognition. For pediatric survivors of Ewing Sarcoma, Retinoblastoma, and soft tissue sarcomas, the data was less convincing for similar impairment.

"Given the older age at diagnosis of many childhood extracranial solid tumors and lymphomas as well as toxicities associated with certain therapies, we concluded patients may benefit from vocational services, occupational therapy, physical therapy, and/or hearing or visual rehabilitation in addition to surveillance for cognitive difficulties," added Kadan-Lottick. "However, larger prospective studies are needed that better delineate the severity of cognitive impairment, contributory risk factors, and effective interventions to reduce impairment."

Source:

Yale Cancer Center

Posted in: Child Health News | Medical Research News | Medical Condition News

Tags: Cancer, Cancer Prevention, Cancer Treatment, Cell, Chronic, Diagnostic, Education, Ewing Sarcoma, Hematology, Hodgkin Lymphoma, Hospital, Langerhans Cell Histiocytosis, Lymphoma, Mortality, Neuroblastoma, Non-Hodgkin Lymphoma, Occupational Therapy, Oncology, Osteosarcoma, Pediatrics, Physical Therapy, Research, Retinoblastoma, Sarcoma, Tumor, Wilms Tumor

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A region within GLI1 gene could potentially be targeted as cancer treatment

Scientists from the Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago found that a region within the DNA of the cancer-promoting GLI1 gene is directly responsible for regulating this gene's expression. These findings, published in the journal Stem Cells, imply that this region within GLI1 could potentially be targeted as cancer treatment, since turning off GLI1 would interrupt excessive cell division characteristic of cancer.

From previous research, we know that GLI1 drives the unrelenting cell proliferation that is responsible for many cancers, and that this gene also stimulates its own expression. We established in living human embryonic stem cells that removing the GLI1 regulatory region eliminated GLI1 expression and halted its activity. These findings are promising and could point to a therapeutic target for cancer."

Philip Iannaccone, MD, PhD, Co-Senior Author, Professor Emeritus at the Manne Research Institute, Lurie Children's and Northwestern University Feinberg School of Medicine

Dr. Iannaccone and colleagues used CRISPR gene editing technology to delete the binding region of the GLI1 DNA in human embryonic stem cells. They found that without this region, GLI1 remained turned off, which interfered with the gene's normal activity of driving embryonic development of blood, bone, and nerve cells.

"A surprising aspect of this work was that turning GLI1 off affected stem cell differentiation to all three embryonic lineages," says first author Yekaterina Galat, BS, Research Associate at the Manne Research Institute at Lurie Children's.

"The developmental function of GLI1 ends after birth, so if we manage to stop its expression in the context of cancer, it should not have negative consequences to normal biology," explains Dr. Iannaccone.

GLI1 expression is associated with about a third of all human cancers. In addition to promoting cell proliferation, GLI1 expression increases tumor cell migration and is associated with resistance to chemotherapy drugs.

"Our team plans to study GLI1 associated proteins that assist in regulation of GLI1 expression through its binding region," says Dr. Iannaccone. "Targeting these proteins as a means to stop GLI1 activity could prove to be a fruitful treatment strategy for cancer."

Source:

Ann & Robert H. Lurie Children's Hospital of Chicago

Posted in: Medical Science News | Medical Research News | Medical Condition News

Tags: Blood, Bone, Cancer, Cancer Treatment, Cell, Cell Division, Cell Migration, Cell Proliferation, Chemotherapy, Child Health, Children, CRISPR, DNA, Drugs, Embryonic Development, Embryonic Stem Cells, Gene, Hospital, Medicine, Nerve, Proliferation, Research, Stem Cells, Tumor

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