Race/ethnicity reporting and representation in clinical trials presented at the American Society of Clinical Oncology (ASCO) presidential plenaries from 2014 to 2024.

Abstract

11043 Background: The lack of appropriate racial and ethnic representation in life saving innovative trials has been linked to poor outcomes. To address this, ASCO published an Equity, Diversity, and Inclusion Action Plan in 2021 which aimed to improve clinical trial diversity. This study evaluates the frequency of race reporting and proportional race representation in trials presented at ASCO plenary sessions. Methods: We reviewed ASCO plenary sessions from 2014 through 2024 to identify clinical trial presentations. These clinical trials were then identified using the National Institutes of Health trials registry (ClinicalTrials.gov). Trial characteristics and race reporting were abstracted from primary report publications or ClinicalTrials.gov if race reporting was not included in the primary report. When an ASCO plenary session involved multiple trials, each trial was included in the analysis. US population-based cancer estimates were calculated using data from National Cancer Institute-Surveillance, Epidemiology, and End Results and US Census databases. Age-standardized incidence and mortality rates adjusted to the year 2000 standard US population by race were used to calculate estimated 5-year average incidence and mortality rates from 2017 to 2021. Results: Between 2014-2024, 46 clinical trials with a total 67496 participants were presented at ASCO plenary sessions. Race was reported in 31 (67%) trials and both race and ethnicity were reported in 15 (33%) trials. Between 2014 and 2019 vs 2021 and 2024, the proportion of trials reporting race or both race and ethnicity increased 57% to 83% and 25% to 44%, respectively. Overall, White, Asian, Black, and Hispanic patients represented 78.8%, 8.3%, 6.8%, and 6.3% of the trial participants, respectively. Between 2014 and 2019 vs 2021 and 2024, Black (19.7% vs. 18.1% of expected) and Hispanic (40.3% vs. 46.6% of expected) patients remained underrepresented compared to White (113.8% vs 76.3% of expected) and Asian (209.7% vs. 719.1% of expected) patients. Conclusions: Since the ASCO 2021 Equity Action Plan, there has been an increase in reporting race and ethnicity of clinical trial participants with no significant effect on Black and Hispanic patients enrolled on trials. This study shows a need for policy revision and meaningful intervention to address underrepresented population enrollment in trials to ensure equitable access and consistent outcomes for all patients.