Improving Inclusivity, Equity, and Diversity in Oncology Clinical Trials: A European Perspective

Abstract

Historically, clinical trials in cancer medicine are, unfortunately, often poorly representative of the diverse populations who ultimately receive the intervention in real-world settings. This discrepancy could relate to age, extent of comorbidity, ethnicity, socioeconomic status (SES), and/or disability. This is particularly important, as medication efficacy and/or toxicity are known to be influenced by such variables. Many cancers also disproportionately affect individuals in underserved communities. If a highly selected cohort of individuals are recruited to a trial, theoretically, the findings should only be translated to equivalent cohorts in the community. Therefore, the more representative a trial cohort is of the target population, the more generalisable and applicable findings will be. If we aim to lessen disparities and improve equity, clinical trials must strive to become more inclusive, improving our knowledge of disease in these underserved groups, and therefore improving the care we provide to them in wider clinical practice. This review summarises the current European perspective on this topical issue, suggesting potential strategies to proactively improve inclusivity and diversity in cancer trials, by encouraging enthusiastic collaboration between the pharmaceutical industry, healthcare authorities, study sponsors, research networks, and clinicians.