April 2023
Orlando, Florida
By Adrian K. Barfield
Is AACR the key to overcoming cancer disparities?
After sitting through a sea of science and settling into a session on BEATING KRAS: A 30-YEAR OVERNIGHT SENSATION, chaired by Dr. Dafna Bar-Sagi, a worldly renowned cancer researcher our of NYC, I’ve come to conclude that if we are going to have effective therapy for all patients, the thought process must begin well before we see a candidate to move forward for testing in cancer patients! I’ve also come to realize the major large societies are serious about highlighting disparities in their annual meetings. Each day of the AACR meeting had multiple sessions on disparities including an NCI-NIH sponsored session on NCI funding opportunities for Diversity Training and Disparities research in cancer to promote health equity. Outside of the NCI-NIH session, there were at least 20 other presentations and posters on the topic.
What about the data?
Well, I’m not sure what was expected to be seen during the first two days as it relates to the data other than the fact that we have a long, long way to go! I know my colleagues on the manufacturing side have the intellect and resources to solve any problem on any level but this one is either very elusive or a very low priority. After seeing one of the first few large clinical trials which had a combined total of 36 non-white or asian patients out of 740 patients, I was left shaking my head once again. I must say the outcomes clearly show progress in lung cancer with, in this case, AEGEAN: A Phase 3 Trial of Neoadjuvant Durvalumab + Chemotherapy followed by Adjuvant Durvalumab in Patients with Resectable NSCLC, show encouraging interim results. If the data holds, per Dr. Heymachs conclusions, Perioperative durvalumab + neoadjuvant CT is a potential new treatment for patients with resectable NSCLC. This is certainly exciting news for patients and one can only hope that future trials will have a larger number as it relates to those patients not represented in this study. This study is not being highlighted due to its lack of diverse patients but merely as an example of what most, if not all, of the clinical trial patient populations looked like throughout the meeting. We also know that clinical trial participation is only one aspect of oncology disparities but it is the one barrier that most people feel can be overcome.
Where do we go from here?
I am not sure where to go from here, but I do believe that increased focus, incremental resources and the increased attention from the FDA and The President of the United States should accelerate our progress. Since President Bidens (then vice-president Biden) visit to ASCO several years ago, which focused primarily on the Cancer Moonshot initiative, the administration has shown a keen interest in Cancer Research. The moonshot initiative was highlighted again during this year’s AACR meeting. The most recent move by the administration relates to Clinical Trials Diversity and Modernization and was signed by the President at the end of 2022. Several sections within this Act will require sponsors to create diversity action plans which are specific to age, group, sex, racial and ethnic demographic characteristics. Depending on enforcement and associated penalties, this should make a difference for sure.
Upcoming Meetings
The American Society of Clinical Oncology (ASCO) meeting is rapidly approaching and is the center of where all hope resides. I know we will see an incredible body of medical breakthroughs and scientific advances, but I am eager to see the overall disparities score. I am hoping that we see more than a bunch of presentations highlighting the problems but that we see a few bold sponsors who dare to be different and invest in making a difference.