Study Identifies Ways to Increase Representation of Black Patients in Breast Cancer Clinical Trials

By Kerri Fitzgerald - Last Updated: June 14, 2022

A study identified 4 actionable steps to increase clinical trial participation among Black patients, noting that all stakeholders have a role to play in increasing representation in this patient population. The results were presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting.

Despite the fact that Black patients comprise 15% of US patients with cancer, only 4% to 6% of clinical trial participants are Black, which impacts real-world effectiveness of treatments across different populations.

The BECOME (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement) project, sponsored by the Metastatic Breast Cancer Alliance, a consortium of representatives from nonprofit organizations, pharmaceutical/biotech companies, and patient advocates, many of whom live with metastatic breast cancer, seeks to understand barriers to clinical trial participation by Black patients with metastatic breast cancer. Based on findings from a literature review and key informant interviews, a survey was developed and completed by 424 US adults living with metastatic breast cancer, 24% of whom (n=102) self-identified as Black.

Although 92% of Black patients reported interest in learning about clinical trials and 83% said they were somewhat or very likely to consider trial participation, 40% reported that their care team had not discussed trials as an option and 64% reported difficulty finding trials. Reasons for not participating in a trial included concerns about side effects (73%) and effectiveness (63%).

Black respondents were more likely than non-Black respondents to believe unstudied treatments may be harmful (57% vs 31%), and Black respondents were less likely to indicate trust in clinical trials (73% vs 91%), as well as trust that people of all races/ethnicities get fair treatment in trials (32% vs 56%).

Compared with non-Black respondents, Black respondents valued receiving clinical trial information from someone with the same racial/ethnic identity (67% vs 10%), who has had breast cancer (73% vs 44%) or metastatic breast cancer (73% vs 51%), or who has been in a clinical trial (72% vs 48%). Black respondents indicated they were more likely to be motivated to participate in a trial to ensure benefit for their racial/ethnic counterparts (83%) compared with non-Black participants (51%).

The researchers outlined 4 actionable steps to increase trial participation among Black patients:

  1. Improve awareness about trials by informing patients, increasing education, training healthcare providers to deliver patient-friendly information in an unbiased manner, and providing messaging from people of shared racial/ethnic identity and health experience
  2. Build trust through clear communication
  3. Address concerns about side effects, effectiveness, harm, and fair treatment
  4. Help patients find and access trials


Walker S, Carlson M, While CD, Howell J, Felder TM. Increasing Black patient participation in metastatic breast cancer clinical trials: The BECOME (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement) project. Abstract #1014. Presented at the 2022 American Society of Clinical Oncology Annual Meeting; June 3-7, 2022; Chicago, IL.

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