Lack of racial diversity in cancer drug trials

Issue: BCMJ, vol. 61, No. 8, October 2019, Page 315 News

New research published in JAMA Oncology has found a lack of racial and ethnic diversity in clinical trials for cancer drugs.

The study—conducted by researchers from UBC, the University of Texas MD Anderson Cancer Center, the Fred Hutchinson Cancer Center in Seattle, and Baylor University in Texas—raises concerns about the effectiveness of cancer drugs in some patients, especially since genetic differences may affect how well a patient responds to a drug.

The researchers found that fewer than 8% of cancer drug trials reported participation from the four major races in the United States—white, Asian, black, and Hispanic—between 2008 and 2018. Black and Hispanic patients were particularly underrepresented at 22% and 44%, respectively, considering their populations’ incidence of cancer. The findings show that the science might not be applicable to the population that’s going to receive the medications. The researchers found that both reporting about race in trials and enrolment rates had changed minimally over the decade.

For this study, Dr Jonathan Loree (assistant professor, UBC Department of Medicine, Division of Medical Oncology) and colleagues reviewed all reported trials supporting US Food and Drug Administration oncology drug approvals granted between July 2008 and June 2018. They scrutinized 230 trials with a total of 112 293 participants. They calculated the US population-based cancer estimates by race using National Cancer Institute and US census data.

Although the researchers used US data, Dr Loree says the findings are relevant in Canada, as well. Pharmaceutical companies typically apply for drug approvals through the FDA first, because it serves the largest market, and then submit to the European Medicines Agency and Health Canada. The trials considered in the approvals are usually the same.

Dr Loree also notes that they weren’t able to analyze the participation of Indigenous people in trials because there were only 13 patients reported out of a total of 112 000 participants.

The researchers are now looking at whether clinical trials represent the same gender ratio as the general population to ensure the drugs are effective in all people.

. Lack of racial diversity in cancer drug trials. BCMJ, Vol. 61, No. 8, October, 2019, Page(s) 315 - News.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply