Improved enrolment of ethnic minorities is needed to accurately reflect the myeloma patient population in clinical trials.

A recent study by a team at University College London Hospitals NHS Foundation Trust has highlighted an under-representation of ethnic minority participants in myeloma clinical trials. This study investigated whether these disparities existed even though access to treatments across the NHS should be equitable.

The study examined demographic data from the National Cancer Registration and Analysis Service (NCRAS), and the demographic and outcomes of over 7000 myeloma patients enrolled on UK academic trials (Myeloma IX, X, XI, XII and XIV). The range of trials enrolled transplant eligible and transplant-ineligible patients at first-line and second-line.

The data

In 2015, the National Cancer Registration and Analysis Service (NCRAS) reported that the incidence of myeloma by ethnicity in England over 10 years was 85.5% for white patients, 5.4% Black, 3.6% Asian, and 1.9% other.

The study found that the ethnic distribution of myeloma clinical trials was 93.8% white, 2.2% Black, 1.8% Asian, and 0.6% other. The distribution of enrolment based on ethnicity was consistent over 18 years, despite an increase in ethnic minority groups in the UK. The researchers noted that the skew of White patient enrolment was more apparent in transplant-ineligible trial arms.

Understanding and addressing the causes of this inequality is a priority for the UK Myeloma Research Alliance (UKMRA), who want to ensure that all patients can potentially benefit from clinical trials and that trial results represent the UK population.

Dr Rakesh Popat, Consultant Haematologist and Chair of the UKMRA, said:

Photograph of Dr Rakesh Popat, staged outdoors with blurred background“Enrolment of ethnic minorities into academic clinical trials in the UK was below that expected despite enrolling from over 100 geographically spread sites and intended equitable access to healthcare.

All ethnic groups had an overall survival benefit from novel agents within trials that were not routinely available; however, a substantial proportion of ethnic minorities were not enrolled, thereby limiting their survival gains.”

Dr Popat presented the data at the 2021 American Society of Hematology (ASH) Annual Meeting.