In this MD Newsline exclusive interview with cancer researcher Dr. Hadiyah-Nicole Green, Ph.D., we discuss how to increase recruitment and enrollment of diverse groups in cancer clinical trials.
Dr. Hadiyah-Nicole Green, Ph.D.:
“I think in order to improve and increase the recruitment and enrollment of diverse groups in clinical trials, it is important to rebuild a level of trustworthiness in the medical community. Often, I hear my colleagues say that African Americans don’t want to participate in clinical trials, and that simply is not true.
When I speak with African Americans who seek out my research—which has only demonstrated efficacy in mice, and we have not yet begun human clinical trials—they are not being invited by their oncologists to participate in clinical trials. So I think it’s important for oncologists to invite their African American patients and inform them about clinical trials.
On the other hand, I think it’s very important to understand the sensitivities and the scars that are present because of what happened with the Tuskegee experiment, with Henrietta Lacks, and with so many other African American families and families from diverse backgrounds.
And there’s a communication gap between technical, medical terms and the understanding of the average person who did not go to medical school or may not have even a college degree. So it’s also important to be able to communicate at a level that’s plain English, where patients can understand what’s being said to them.
Overall, having a level of transparency about what the clinical trial is and what the potential risks are upfront will help. The people in my family and my community prefer transparency over a long period of time to help build trust. But when there’s something that’s not shared upfront, but then it’s shared later, it gives us a feeling of being extremely uncomfortable, and it makes us immediately not trust something. These instincts have allowed us to survive but also can interfere with our willingness to participate in a clinical trial.
For example, there’s a huge mistrust of the COVID-19 vaccine, and people are perplexed about why more African Americans aren’t taking the vaccine, but no one’s addressing why African Americans who aren’t taking the vaccine don’t trust the vaccine. And the reason for that mistrust is there is a long track record of untrustworthy activities committed by the medical community.
That track record needs to be addressed and addressed in a way that offers reassurances. And transparency is needed to educate people about what’s happening in the trial and what risks are involved. The other thing that matters is having a presence in the African American community. If we don’t know you, we can’t trust you.
So some of the foundations that your pharmaceutical partners may have, encourage them to invest in community-based organizations and nonprofits in the communities where they would like to recruit people for clinical trials so that there’s not such a gap between them and who’s recruiting them to participate in the trial. There are legitimate fears that potential clinical trial participants have to overcome, and that can only happen when trust is reestablished, and familiarity is gained.”
Responses have been condensed and lightly edited.