Abstract 6374: Socio-demographic predictors of recruitment in neuroblastoma therapeutic clinical trials
Authors: DeVon Hunter-Schlichting, Jeannette Sample, Kate Knowles, David Van Riper, Logan Spector, Erin Marcotte
Journal: Cancer Research (2024)

Abstract The generalizability of clinical trial outcomes hinges upon the equitable access and enrollment of diverse patient populations. Yet, disparities persist that may influence enrollment patterns. In neuroblastoma, the impact of ethnicity, socioeconomic status (SES), distance to care, and age at diagnosis on enrollment in therapeutic trials remains underexplored. We aimed to investigate these factors in neuroblastoma patients to identify potential disparities in clinical trial participation. We utilized the Childhood Cancer Research Network data, selecting neuroblastoma cases from 2008-2015, excluding those &amp;gt;21 years old or with incomplete data. We focused on factors influencing enrollment in therapeutic trials (ANBL0032, ANBL0421, ANBL0531, ANBL0532, ANBL0621, ANBL0931, ANBL1021, ANBL1221, ANBL1232). Key predictors examined were ethnicity, age at diagnosis, SES (via Yost Index), and distance to care from home to treatment hospital. We employed Poisson regression to calculate adjusted risk ratios (aRR) and 95% confidence intervals for trial participation. Analyzing 3,148 neuroblastoma cases from the CCRN registry, the ethnic composition was as follows: 68% were non-Hispanic White, 14% Hispanic, and 10% NH Black and SES distribution was even across quintiles. Age at diagnosis was a significant factor in trial enrollment: children &amp;gt;2 years were 94% more likely to enroll than those under 2 years (p &amp;lt; 0.001). Race, ethnicity, SES, and distance to care showed no significant effect on enrollment, all with non-significant p-values. In CCRN, neuroblastoma patient's age at diagnosis was a determinant in therapeutic trial enrollment, providing insight into design strategies to encourage trial participation. While common barriers like race, ethnicity, SES, and distance to care did not impact enrollment in our cohort, the significant role of age highlights an area where focused efforts can ensure that all age groups have equitable access to the potential benefits of therapeutic trials. Category N aRR (95% CI) p-value Race and Ethnicity Non-Hispanic (NH) White 2139 ref Hispanic (All races) 436 0.93 (0.81, 1.08) 0.36 NH Black 320 1.07 (0.93, 1.23) 0.33 NH Asian/Pacific Islander 98 1.14 (0.89, 1.47) 0.30 NH American Indian/Alaska Native 17 0.95 (0.48, 1.88) 0.89 Other 138 0.94 (0.75, 1.17) 0.55 SES (Yost Index) Quintile 1 493 0.88 (0.75, 1.02) 0.09 Quintile 2 524 0.95 (0.83, 1.10) 0.53 Quintile 3 606 0.98 (0.86, 1.11) 0.71 Quintile 4 554 0.92 (0.80, 1.06) 0.24 Quintile 5 563 ref Age at Diagnosis &amp;lt;2 year 1790 ref &amp;gt;2 years 1354 1.94 (1.76, 2.12) &amp;lt;0.001 Distance to Care 0-25 miles 1520 ref &amp;gt;25-50 miles 535 1.05 (0.93, 1.18) 0.36 &amp;gt;50-100 miles 412 0.97 (0.85, 1.11) 0.91 &amp;gt;100-250 miles 239 0.99 (0.87, 1.13) 0.60 &amp;gt;250 miles 82 0.99 (0.77, 1.28) 0.97 Citation Format: DeVon Hunter-Schlichting, Jeannette Sample, Kate Knowles, David Van Riper, Logan Spector, Erin Marcotte. Socio-demographic predictors of recruitment in neuroblastoma therapeutic clinical trials [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6374.