Research has established that there is an increasing recognition that the incidence of ALL among Hispanic individuals living in the U.S. surpasses the incidence among non-Hispanic populations, especially in adolescents and young adult patients (AYA).
According to findings from a secondary analysis recently published in the journal Blood Advances, in the CALGB 10403 trial of adolescents and young adults with ALL, patients of Hispanic ethnicity demonstrated comparable outcomes as patients who were non-Hispanic white (NHW). The CALBG 10403 is a prospective, phase II clinical trial conducted by U.S. adult cancer cooperative groups to test the feasibility, safety, and efficacy of delivering an intensive pediatric ALL regimen to newly diagnosed AYAs in the adult cancer treatment setting.
In this analysis, researchers assessed data from 295 AYA patients with ALL aged 17 to 39 years enrolled in the phase II CALGB 10403 trial, which assessed an intensive pediatric regimen in an AYA population. Data from the Surveillance, Epidemiology, and End Results (SEER) registries were examined for U.S. estimates of ALL outcomes.
Within the CALGB 10403 cohort, patients who were of Hispanic descent demonstrated lower household income, had a greater frequency of CRLF2 aberrations, and higher rates of protocol completion compared with non-Hispanic Whites.
Hispanic patients had greater rates of protocol completion (P = .05) compared with NHW, and enrollments on CALGB 10403 differed relative to the distribution of Hispanic AYA ALL in the U.S., with enrollment being greatest in the Midwest at 15%; however, the overall enrollment of Hispanic AYAs was 19%, which was meaningfully lower than the 46% of Hispanic AYAs in the SEER cohort (P <.001).
The 3-year overall survival (OS) in the CALGB cohort was comparable between Hispanic and NHW patients, with rates of 75% and 74%, respectively. In the SEER cohort, 3-year OS was 61% among Hispanic patients compared with 71% among NHW patients (P <.001).
The authors concluded, “Although Hispanic AYAs under-enrolled on CALGB 10403, Hispanic trial participants experienced favorable survival. Inequity in cancer clinical trial enrollment is a critically important issue that will require a multipronged approach to resolve. As a start, clinical trialists should make every effort to ensure that their clinical trial population aligns with the regional or national epidemiology of the disease they are studying. This is particularly the case in ALL, where there is tremendous opportunity to not only improve enrollment of Hispanic patients but to greatly advance their outcomes.”
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