WCLC 2025 - Posters & ePosters-P1.17.02 Socioecological Factors Associated With Lung Cancer Clinical Trial Enrollment: Real-World California Cancer Registry Data

P1.17.02 Socioecological Factors Associated With Lung Cancer Clinical Trial Enrollment: Real-World California Cancer Registry Data

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This study examined factors influencing enrollment in lung cancer clinical trials (CTs) among patients in Los Angeles County from 2002 to 2021, focusing on socioecological domains and racial/ethnic disparities. Despite overall efforts, racial/ethnic minorities and Medicaid-insured patients remain underrepresented in CTs. Using multivariable logistic regression adjusted for age, sex, marital status, cancer stage, comorbidities, insurance, socioeconomic status, treatment, and facility designation, researchers found that patients with more comorbidities were less likely to enroll. Enrollment was higher at healthcare facilities with designations such as CoC, NCI, and NCCN, suggesting that specialized centers improve clinical trial access.<br /><br />The study revealed significant racial/ethnic differences related to insurance status: Medicaid-insured patients had lower odds of CT participation across all racial/ethnic groups compared to Medicare-insured patients. Privately insured Non-Hispanic White and Hispanic patients also showed significantly lower CT enrollment compared to their Medicare counterparts, with a stronger effect among Hispanics (60% reduction) than Non-Hispanic Whites (47% reduction). Hispanic and Non-Hispanic Black patients had notably lower CT enrollment rates (3.2% and 4.8%, respectively) compared to Non-Hispanic Whites (5.6%). CT enrollment rates declined during the COVID-19 pandemic and showed no significant change after the FDA's 2014 action plan aimed at increasing diversity.<br /><br />Findings emphasize the role of patient comorbidities in limiting trial eligibility and highlight the need to reassess restrictive criteria to enhance inclusivity. The significant impact of healthcare facility designation underscores opportunities to boost trial participation through partnerships between specialized centers and community practices. The persistently lower participation among Medicaid recipients calls for targeted interventions and further research. Overall, addressing access disparities and structural barriers is critical to improving equitable enrollment in lung cancer clinical trials.

Asset Subtitle

Angel Arizpe

Meta Tag

Speaker Angel Arizpe

Topic Global Health, Health Services, and Health Economics

Keywords

lung cancer

clinical trials

enrollment factors

racial disparities

ethnic disparities

Medicaid insurance

comorbidities

healthcare facility designation

COVID-19 impact

trial eligibility criteria