Undercutting efforts of precision medicine: roadblocks to minority representation in breast cancer clinical trials

Saini, Geetanjali; Gogineni, Keerthi; Kittles, Rick A.

doi:10.1007/s10549-021-06264-x

Cited by 4 publications

(2 citation statements)

References 64 publications

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“…There has been an exponential expansion of drug development in oncology. 74 Upon the identification of potential druggable targets by molecular proﬁling, access to the corresponding targeted therapies should be optimized by encouraging patient participation in clinical trials and compassionate programs. Additionally, off-label use of targeted therapies should be systemically monitored.…”

Section: Resultsmentioning

confidence: 99%

Consensus Statements on Precision Oncology in the China Greater Bay Area

Lam,

Cho,

et al. 2023

JCO Precision Oncology

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BACKGROUND Next-generation sequencing comprehensive genomic panels (NGS CGPs) have enabled the delivery of tailor-made therapeutic approaches to improve survival outcomes in patients with cancer. Within the China Greater Bay Area (GBA), territorial differences in clinical practices and health care systems and strengthening collaboration warrant a regional consensus to consolidate the development and integration of precision oncology (PO). Therefore, the Precision Oncology Working Group (POWG) formulated standardized principles for the clinical application of molecular profiling, interpretation of genomic alterations, and alignment of actionable mutations with sequence-directed therapy to deliver clinical services of excellence and evidence-based care to patients with cancer in the China GBA. METHODS Thirty experts used a modified Delphi method. The evidence extracted to support the statements was graded according to the GRADE system and reported according to the Revised Standards for Quality Improvement Reporting Excellence guidelines, version 2.0. RESULTS The POWG reached consensus in six key statements: harmonization of reporting and quality assurance of NGS; molecular tumor board and clinical decision support systems for PO; education and training; research and real-world data collection, patient engagement, regulations, and financial reimbursement of PO treatment strategies; and clinical recommendations and implementation of PO in clinical practice. CONCLUSION POWG consensus statements standardize the clinical application of NGS CGPs, streamline the interpretation of clinically significant genomic alterations, and align actionable mutations with sequence-directed therapies. The POWG consensus statements may harmonize the utility and delivery of PO in China's GBA.

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Section: Resultsmentioning

confidence: 99%

Consensus Statements on Precision Oncology in the China Greater Bay Area

Lam,

Cho,

et al. 2023

JCO Precision Oncology

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“…Similar to findings in this review, this has been a persistent challenge in the larger world of clinical trials [ 95 ], including in rehabilitation medicine [ 96 ]. This lack of inclusion for historically or socially marginalized groups may undermine personalized medicine efforts and contribute to the persistence of health inequities [ 97 ]. The results described in our analysis indicate that there are challenges to translation in clinical care settings beyond individuals with breast cancer and individuals outside of economically developed nations and socially marginalized populations.…”

Section: Discussionmentioning

confidence: 99%

The influence of telehealth-based cancer rehabilitation interventions on disability: a systematic review

et al. 2022

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Purpose To characterize delivery features and explore effectiveness of telehealth-based cancer rehabilitation interventions that address disability in adult cancer survivors. Methods A systematic review of electronic databases (CINAHL Plus, Cochrane Library: Database of Systematic Reviews, Embase, National Health Service’s Health Technology Assessment, PubMed, Scopus, Web of Science) was conducted in December 2019 and updated in April 2021. Results Searches identified 3,499 unique studies. Sixty-eight studies met inclusion criteria. There were 81 unique interventions across included studies. Interventions were primarily delivered post-treatment and lasted an average of 16.5 weeks ( SD = 13.1). They were most frequently delivered using telephone calls (59%), administered delivered by nursing professionals (35%), and delivered in a one-on-one format (88%). Risk of bias of included studies was primarily moderate to high. Included studies captured 55 measures of disability. Only 54% of reported outcomes had data that allowed calculation of effect sizes ranging -3.58 to 15.66. Conclusions The analyses suggest small effects of telehealth-based cancer interventions on disability, though the heterogeneity seen in the measurement of disability makes it hard to draw firm conclusions. Further research using more diverse samples, common measures of disability, and pragmatic study designs is needed to advance telehealth in cancer rehabilitation. Implications for Cancer Survivors Telehealth-based cancer rehabilitation interventions have the potential to increase access to care designed to reduce disability across the cancer care continuum. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-022-01181-4.

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