Why Does Representation in Prostate Cancer Clinical Trials Matter?

Deandre White:

So Dr. Burnham, why is it so important that new prostate cancer treatments and clinical trials intentionally including men from high-risk populations, and what do we lose without this resource when they don’t? And can you provide activation tips for patients who may want to be a part of trials, even if they have to be the ones to initiate these conversations?

Dr. Leanne Woods-Burnham:

Well, my [ACTIVATION tip for this question is to pursue genetic and genomic testing if you can. Pursue clinical trials if you can, because we don’t know what works in the biomedical field if we’ve never tested whether it works or not. Science is definitely not like a mind-reader activity, it is very much evidence-based, within the cancer cell there’s genetic pathways that certain treatments can target those genetic pathways. And this differs by individual, it differs by populations many times. 

So it’s an issue if let’s say, you are a man who’s more at risk for aggressive prostate cancer, so let’s say if you are a Black man and you have a family history of prostate cancer, there might be some sort of genetic variant that you all share that makes you more likely to get prostate cancer and then a drug is developed, where during the drug development process, we maybe enrolled 100 men in a clinical trial to test that drug and we only had one Black man in the trial. We really don’t get a full picture of how this drug works in all populations.

Unfortunately, in the history of drug development, what we know is that populations who are highest risk for worse outcomes are very much so not likely to be included in clinical trials. There is an effort to reverse this disturbing reality, but we don’t always hit a home run all the time. There’s a lot of reasons for that. 

My activation tip would be to pursue a clinical trial and don’t be scared of it. If you’re asked about it, just realize that for a drug to get to a level of a clinical trial, it means that there’s been a lot of evidence before that suggesting that there’s good reason that this medication will work and you’re going to receive additional touchpoints with your provider, compared to patients who do not participate in clinical trials, and you are going to receive some sort of helpful treatment, it’s not that you will, it’s not oh, we are going to either try this therapy or you’re not going to be treated. 

The option is going to be your going to receive a treatment that we would give to a typical patient with your set of clinical criteria or you have the option to try this that we think there is very good reason to believe that it will work better. So these are the types of things we want to think about. You can always go to a website it’s called ClinicalTrials.gov, so ClinicalTrials.gov and you can put in the particular disease you’re interested in, the particular stage, the state, the city that you live in and you can see what sort of trials match to where you are in your health journey and see if its something you would want to participate in. 

And not everything is a drug treatment, there are clinical trials with natural products, a lot of times people think “oh the pharmaceutical industry and they want us to do clinical trials.” I had my Dad participate in a clinical trial, he has prostate cancer as I mentioned where he was taking white mushroom powder, ok this is like a natural, this is not a drug, so there are natural products that are available on ClinicalTrials.gov as well. 

And there are also mental health clinical trials, there are support for clinical trials, there’s clinical trials to really track and gauge what is working best for patients at each stage and even survivorship, even after you can think you’re cancer free. Maybe it’s the nerd in me, but I just think it’s a cool website to go and search around sometimes. 

Deandre White:

Yes, and I definitely wanted to add that, clinical trials they may seem scary and I’ve had patients, minority patients, that there aren’t that many on the trial and you might want to introduce a study to them that they might be eligible for and they get taken aback and they get scared, you mentioned the phrase “Tuskegee” and everything that goes along with that unfortunately, like you were saying, research is getting better, from a federal level we have made improvements in terms of how studies have to be conducted and it just provides another opportunity for the patient to have another treatment in their line of treatments.

Dr. Leanne Woods-Burnham:

Every drug that we have, every treatment that we have that works, for example, me having the type of blood cancer that I had in chemotherapy worked, it was curative that was because somebody participated in a clinical trial for me that was able to show that. Even when we go to the store and we buy advil or we buy robutussion or whatever, this is something that has gone through a clinical trial and has shown to work and that’s why we are able to just buy it over the counter today so in order to find out what works we have to be willing to participate if offered the opportunity.