CancerLinQ Discovery Improves Understanding of Clinical Trial Enrollment and Prostate Cancer Survival
By: Thomas Flaig, MD
It was so great to be back in person for this year’s ASCO Annual Meeting to see many long-time colleagues and meet a few new ones as well. For my entire career, the ASCO Annual Meeting has been an opportunity to learn and share new findings on ways we can improve the care we provide. At this year’s meeting, I had the great opportunity to join with colleagues from University of Colorado (CU) School of Medicine on a study evaluating racial disparities in clinical trial enrollment and survival in advanced prostate cancer patients using CancerLinQ Discovery data.
Our potential to understand and improve the treatment of cancer is on an upward trajectory, in part because of the growing availability of real-world evidence (RWE). I have been working with Simon Kim, MD and colleagues at CU, using RWE from a variety of sources to investigate genitourinary cancer questions. We have recently started working with the CancerLinQ Discovery, which provides curated sets of timely, aggregated, de-identified data on a variety of cancer types that can be studied. Ten years ago, this data was simply unavailable.
Now that we have access to these data, we have been able to investigate questions not readily evaluable in other ways. We used this approach to explore racial disparities in clinical trial enrollment in advanced prostate cancer. Many patient populations, including African-Americans, have been historically underrepresented in trials, including prostate cancer studies. Using CancerLinQ Discovery data, we investigated this disparity in enrollment in academic and community oncology clinics across the United States. In addition, we also examined the overall survival rates for prostate cancer patients who participated in clinical trials compared to those who did not.
The CancerLinQ Discovery team provided us with a data set of 160,888 patients with regional or metastatic prostate cancer. Only 2,368 (or 1.5%) were enrolled in a clinical trial and African-American men participated in clinical trials at a lower rate than white men after adjusting for other covariates.
There were two major finding from this analysis and abstract presented by Dr. Kim at the annual meeting. First, for the entire cohort, when controlling for multiple factors, there was worse overall survival in African-American prostate cancer patients compared to other racial groups. Second, clinical trial enrollment correlated with higher survival rates. We specifically found in our analysis of patients enrolled in clinical trials that the overall survival of African-American and white patients was similar in this setting. This suggests that when patients receive very similar care through enrollment in a clinical trial, historic and ongoing racial disparities in prostate cancer outcomes can be improved. This further demonstrates the critical need to increase our efforts to address barriers to communication and access to clinical trials recognizing the need for diverse and representative patient populations in clinical trials.
One way we can continue to improve our understanding disparities in clinical trial enrollment and other issues facing cancer care is through more real-world data. CancerLinQ is a great source of real-world data to both improve cancer care within participating practices and also contribute deidentified data for research that can improve care. To give you perspective on how this can help, the data set of nearly 161,000 advanced prostate cancer patients was a large enough pool for us to focus on a smaller subset and take away clinically meaningful findings from those participating in a clinical trial, which was less than 2% of the entire cohort. Imagine what we could do with larger data sets for all cancers, including rare ones.
For researchers who have not yet explored CancerLinQ Discovery, I encourage you to do so and learn more about this ASCO-supported resource. The CancerLinQ staff brings a team approach to getting new researchers up-to-speed so not utilizing these data sets could be a missed opportunity for your research.
I also suggest visiting CancerLinQ Discovery’s scientific publications center, where you can see some of the work that has been published using this data. Dr. Kim and I, along with our other colleagues, look forward to continuing our work using CancerLinQ Discovery as it is an invaluable resource whose impact on oncology research will only continue to grow.
Dr. Flaig is vice chancellor of research and Robert Rifkin Professor of Medicine at the CU Denver and CU Anschutz Medical Campus. @TomFlaigMD