Mind the Gap: Precision Oncology and Its Potential to Widen Disparities

Huey, Ryan; Hawk, Ernest T.

doi:10.1200/jop.19.00102

Cited by 36 publications

(28 citation statements)

References 33 publications

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“…Increasing the participation of underrepresented groups in genetic research (GR) is critical to ensuring its benefits apply to diverse subgroups of the population (Landry, Ali, Williams, Rehm, & Bonham, 2018). Failure to increase diversity in GR may in fact exacerbate existing health disparities by limiting benefits from scientific advances, including development of genetically targeted cancer treatments and diagnostic tools (Hindorff, Bonham, & Ohno-Machado, 2018;Huey, Hawk, & Offodile, 2019).…”

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confidence: 99%

Understanding Diverse Perspectives on Genetic Research Through Focus Group Talk

Ridgeway

Albertie

Pantoja

et al. 2019

International Journal of Qualitative Methods

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While genetic research (GR) is fueling discoveries in fields like precision medicine, there is a growing concern that underrepresentation of racial and ethnic populations in GR will limit access to its benefits and subsequently worsen health disparities. This study aimed to understand GR perceptions among members from underrepresented communities by studying discourse and language use in focus group discussions. Nine focus groups were conducted with adults from three populations: African American, Hispanic/Latino, and Native American; 53 women and 15 men participated. Data were analyzed using methods of discourse and content analysis. Discourse analysis highlighted how conceptualization of science and family—rooted in historical experiences—can influence views on GR risks and benefits to self and others. The use of focus group discourse in particular provided an opportunity for group sense making around the science and ethics of GR. Content analysis highlighted differences between the language use of focus group moderators, who spoke about scientific discovery and research oversight, and that of participants, whose talk highlighted ancestral bloodline, personal risk, and ethical concerns. The findings can inform efforts to bolster GR participation, including recruitment and educational campaigns. However, they also challenge researchers to consider areas of discordance between their own and community members’ conceptualization of the risks and benefits of GR participation, including the notion of future and family benefit.

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confidence: 99%

Understanding Diverse Perspectives on Genetic Research Through Focus Group Talk

Ridgeway

Albertie

Pantoja

et al. 2019

International Journal of Qualitative Methods

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“…However, several logistical and financial challenges are still present. In this context, similar to other fields of precision medicine, international networks championing the use of organoids in the clinic are crucial to disseminate the technology and to avoid creating disparities in cancer care [40].…”

Section: Discussionmentioning

confidence: 99%

Patient-Derived Organoids: Promises, Hurdles and Potential Clinical Applications

Hedayat

Valeri

2020

Clinical Oncology

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“…Some speculate that using molecular information to target cancer treatment potentially provides a solution to current treatment inequalities [8]. Others argue that novel cancer therapies, because of their cost, disproportionately favor those with more resources and, therefore, may widen inequalities further [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Are there socio-economic inequalities in utilization of predictive biomarker tests and biological and precision therapies for cancer? A systematic review and meta-analysis

Norris

Dew

Sharp

et al. 2020

BMC Med

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Background Novel biological and precision therapies and their associated predictive biomarker tests offer opportunities for increased tumor response, reduced adverse effects, and improved survival. This systematic review determined if there are socio-economic inequalities in utilization of predictive biomarker tests and/or biological and precision cancer therapies. Methods MEDLINE, Embase, Scopus, CINAHL, Web of Science, PubMed, and PsycINFO were searched for peer-reviewed studies, published in English between January 1998 and December 2019. Observational studies reporting utilization data for predictive biomarker tests and/or cancer biological and precision therapies by a measure of socio-economic status (SES) were eligible. Data was extracted from eligible studies. A modified ISPOR checklist for retrospective database studies was used to assess study quality. Meta-analyses were undertaken using a random-effects model, with sub-group analyses by cancer site and drug class. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed for each study. Pooled utilization ORs for low versus high socio-economic groups were calculated for test and therapy receipt. Results Among 10,722 citations screened, 62 papers (58 studies; 8 test utilization studies, 37 therapy utilization studies, 3 studies on testing and therapy, 10 studies without denominator populations or which only reported mean socio-economic status) met the inclusion criteria. Studies reported on 7 cancers, 5 predictive biomarkers tests, and 11 biological and precision therapies. Thirty-eight studies (including 1,036,125 patients) were eligible for inclusion in meta-analyses. Low socio-economic status was associated with modestly lower predictive biomarker test utilization (OR 0.86, 95% CI 0.71–1.05; 10 studies) and significantly lower biological and precision therapy utilization (OR 0.83, 95% CI 0.75–0.91; 30 studies). Associations with therapy utilization were stronger in lung cancer (OR 0.71, 95% CI 0.51–1.00; 6 studies), than breast cancer (OR 0.93, 95% CI 0.78–1.10; 8 studies). The mean study quality score was 6.9/10. Conclusions These novel results indicate that there are socio-economic inequalities in predictive biomarker tests and biological and precision therapy utilization. This requires further investigation to prevent differences in outcomes due to inequalities in treatment with biological and precision therapies.

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Mind the Gap: Precision Oncology and Its Potential to Widen Disparities

Cited by 36 publications

References 33 publications

Understanding Diverse Perspectives on Genetic Research Through Focus Group Talk

Understanding Diverse Perspectives on Genetic Research Through Focus Group Talk

Patient-Derived Organoids: Promises, Hurdles and Potential Clinical Applications

Are there socio-economic inequalities in utilization of predictive biomarker tests and biological and precision therapies for cancer? A systematic review and meta-analysis

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