Tag Archive for: Hispanic

Potential Impact of Artificial Intelligence on Stomach Cancer Detection and Care

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Potential Impact of Artificial Intelligence on Stomach Cancer Detection and Care from Patient Empowerment Network on Vimeo.

What role might artificial intelligence take in stomach cancer detection and care? Expert Dr. Joo Ha Hwang from Stanford Medicine shares his perspective on how AI might be most impactful in stomach cancer detection and care, how the FDA will be involved in AI use, and protections that must be put in place to safeguard patient interests.

See More from [ACT]IVATED Gastric Cancer

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How Biomarkers Might Impact Future Stomach Cancer Care

How Biomarkers Might Impact Future Stomach Cancer Care

 Stomach Cancer Screening | How Asian and Latinx Patients Can Self-Advocate

Stomach Cancer Screening | How Asian and Latinx Patients Can Self-Advocate

 Can Stomach Cancer Risk Be Reduced by Treatment and Lifestyle Changes?

Can Stomach Cancer Risk Be Reduced by Treatment and Lifestyle Changes?

Transcript:

Lisa Hatfield:

Dr. Hwang, what is the current role of artificial intelligence or AI in gastric cancer care? And how do you envision the role of AI in the future management of gastric cancer?

Dr. Joo Ha Hwang:

Yeah, it’s a great question, very early day for AI but AI is really the hot topic, in the field of medicine, and AI will definitely play a role in, the detection of gastric cancer on probably many fronts, obviously the most straightforward one is during endoscopy, we can use AI to help identify early gastric cancer, and one of the issues in the United States is, since gastric cancer is a relatively rare finding, and it can be very subtle on endoscopy, a lot of endoscopists can miss an early gastric cancer or a precancerous lesion, and so we’re hoping to use AI to better identify, these lesions, since they’re not super common, and we’re really not taught to look for these lesions, this is an area that AI can be helpful. But the other, probably easier implementations of AI would be through just medical records and just using AI to help identify people who are at high risk.

And then flagging these patients for physicians to say, “Hey, this patient should be considered for H. pylori testing, this patient should be considered for endoscopic screening.” So I think that’s actually a simpler implementation of AI. So I think that AI will definitely help, it should help with outcomes, the challenge really is, working with the FDA to allow AI to be implemented in the clinical setting, that’s not a really simple task, because AI can also potentially be used for nefarious reasons and so we certainly have to protect patients’ identities, we have to protect patients’ information.

And so, there’s a lot of steps and a lot of responsibility that comes with AI. But I would say stay tuned, it will definitely, you’ll see more and more AI implementation over the years to come, and overall it should be very positive for patients for all disease processes, including gastric cancer.

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What Stomach Cancer Care Obstacles Do Asian and Latinx Patients Face?

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What Stomach Cancer Care Obstacles Do Asian and Latinx Patients Face? from Patient Empowerment Network on Vimeo.

What kind of gastric cancer care barriers do some patient groups face? Expert Dr. Joo Ha Hwang from Stanford Medicine discusses key factors that impact gastric cancer care access, and recommendations for patients and providers to reduce disparities.

[ACT]IVATION TIP

“…if you have any influence with the members of Congress, kind of bring up the issues related to minority health and access to healthcare. I know there’s a, within the Department of Health and Human Services, there is a Department of Minority Health, this is something that I think that they’re working on, which is access to healthcare, but it’s a real problem.”

See More from [ACT]IVATED Gastric Cancer

Related Resources:

How Biomarkers Might Impact Future Stomach Cancer Care

How Biomarkers Might Impact Future Stomach Cancer Care

 What Are Key Risk Factors for Stomach Cancer?

What Are Key Risk Factors for Stomach Cancer?

 Can Stomach Cancer Risk Be Reduced by Treatment and Lifestyle Changes?
Can Stomach Cancer Risk Be Reduced by Treatment and Lifestyle Changes?

Transcript:

Lisa Hatfield:

Dr. Hwang, what are the challenges faced by the Asian and Hispanic populations in accessing timely and appropriate treatment for stomach cancer? And what strategies could be implemented to address these challenges?

Dr. Joo Ha Hwang:

There are several questions or several challenges. Number one, I think, is patient awareness is educating these communities that they actually are at higher risk of developing gastric cancer. Number two, their access to healthcare oftentimes, is difficult sometimes because of language barriers, sometimes due to cultural issues, sometimes just due to regional geographic issues, and access to healthcare also insurance. A lot of the immigrant population, they even if they’re very successful and work quite a bit, oftentimes they’re, small business owners and they have high deductible, insurance plans. I had a friend who was an immigrant from Asia, and I told him you’re at high risk for developing gastric cancer, and you should have an endoscopy, we did an endoscopy on him and this was at a county hospital in Seattle.

He got a bill for $6,000 for his endoscopy, and I was personally appalled at that, and that’s actually kind of what got me into this field, was because I felt that that was very unfair, that this person who worked very hard and had insurance, but had a high copay, because he had high deductible insurance, was being treated like this when someone with Medicare, we’re charging only $200 for an endoscopy. And then if we had screening guidelines from the USPSTF such as for colon cancer, breast cancer, it would be completely free. And so there’s a huge disparity, and it is the Hispanic, it’s the Asian population, it’s the immigrant population that are at higher risk for gastric cancer.

And this is completely uncovered, and so, these are all inequities, in the system that we’re trying to address, what I would say, is that, if my activation tip for this would be, if you have any influence with the members of Congress, kind of bring up the issues related to minority health and access to healthcare. I know there’s a, within the Department of Health and Human Services, there is a Department of Minority Health, this is something that I think that they’re working on, which is access to healthcare, but it’s a real problem. The other side of it also is the education side and the empowerment side, and I think that we have to do a better job in terms of educating the populations who are at high risk for gastric cancer to go see their primary care physician to talk to them about what they need to do.

The other challenge really, actually is on the physician side, because, and I’ve been working at this as well, physicians don’t know, we’re taught in medical school that gastric cancer is rare, and it’s almost like an afterthought and we spend very little time on gastric cancer, but gastric cancer isn’t rare, and there are high risk populations, and there is something that we can do about it. So we really have a long way to go, but the good news is there is progress to be made, so if we just put in the effort, we can make a huge dent in outcomes for gastric cancer.

Lisa Hatfield:

Are there any efforts underway right now to develop guidelines for those communities in the U.S. to do screening? Do you know?

Dr. Joo Ha Hwang:

Yeah. We’re actively involved on a national level to work with societies and working with societies to make guidelines. This helps educate providers and whatnot, the challenge really in terms of getting insurers to cover this. This is really cost-effective, but oftentimes when insurers look at something they need to see an immediate return, they want to say within one year, this is cost beneficial, where this is a long….Gastric cancer prevention, any cancer prevention is really a long-term, outlook and that’s why the USPSTF plays such an important role because their guidelines have immediate implications on insurers and what they need to pay for, and so really we need, guidelines from the USPSTF, to make a true impact on the outcomes of gastric cancer.

But this is proving to be challenging because, the population that’s affected is a relatively small population in the United States. But again, in this era of precision medicine and equitable medicine, my view is it shouldn’t matter, in terms of the size of the population, that’s at risk, it should be data that says these particular patients are at high risk, and this intervention should work to decrease the risk of gastric cancer, and so I think we need to start having dialogue and changing the way we think about, patient care and make this more personalized, precision individualized medicine as opposed to population-based medicine.

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Empowered Care: A Patient’s Guide to Navigating Endometrial Cancer

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Empowered Care: A Patient’s Guide to Navigating Endometrial Cancer from Patient Empowerment Network on Vimeo.

Meet Sharon, a 61-year-old endometrial cancer survivor who knows firsthand the importance of being an active participant in her healthcare. After a two-year struggle with misdiagnosed symptoms and a dismissive doctor, she took charge and found the right medical support, leading to a diagnosis of endometrial cancer.

Sharon’s journey, from diagnosis to treatment and recovery, highlights the vital role of self-advocacy and patient activation. Her story is a beacon for others, especially women of color facing similar challenges, emphasizing the power of being informed, asking questions, and seeking support.

Download Guide | Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions

Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions

 How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

 How Can Gynecologic Oncology Racial Disparities Be Addressed

How Can Gynecologic Oncology Racial Disparities Be Addressed

Transcript:

Being activated is a critical part of endometrial cancer care, especially for patients like me. 

My name is Sharon, I’m 61, and my diagnosis came after a two-year struggle with unidentified symptoms. Sharing my experience is my way of reaching out, hoping it might provide guidance to others facing similar challenges.

My symptoms began with abnormal vaginal bleeding, but my periods had ended over 10 years ago. That had me worried, and my sister encouraged me to see a doctor after I told her about the bleeding. I scheduled an appointment, but my doctor dismissed my symptoms. I felt like he wasn’t really listening to me and decided to find a doctor who looks more like me and would be more likely to listen to me. I found a Black female doctor who was concerned about my symptoms, which had worsened by then. I was also feeling pelvic pain. My new doctor scheduled an endometrial biopsy, and I was diagnosed with papillary serous carcinoma shortly afterward.

With an aggressive type of cancer, my oncologist scheduled a laparoscopic hysterectomy to remove my uterus along with my ovaries, fallopian tubes, and sentinel lymph nodes. I had the surgery within a few days, which was quickly followed by radiation to help ensure any remaining cancer cells were wiped out. My recovery went smoothly, and I continue to live a full life while getting regular scans to ensure I remain cancer-free.

After my cancer experience, I want to educate other women about what I’ve learned about endometrial cancer. Black women have nearly twice the death rate from endometrial cancer compared to white women. Hispanic, Black, and Asian women are not represented in clinical trials at equal rates to white women. And Black women are also diagnosed more frequently with rare but aggressive endometrial cancer forms. Remember that you shouldn’t have to suffer with your pain, and you can advocate for yourself and ask about patient advocates to advocate on your behalf.

Here are my activation tips for patients facing an endometrial cancer diagnosis:

  1. Ask your care team questions to learn about the status of your endometrial cancer, treatment options, and what to expect during and after treatment.
  2. Join a patient support group to offer and receive emotional support.
  3. Last but not least, inquire if a clinical trial may be a potential treatment option for your endometrial cancer.

Remember, stay activated by being informed, empowered, and engaged in your cancer care.

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How Can Variable Patient Groups Be Addressed in CAR T?

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How Can Variable Patient Groups Be Addressed in CAR T? from Patient Empowerment Network on Vimeo.

Can CAR T-cell therapy address variable patient groups? Expert Dr. Krina Patel from The University of Texas MD Anderson Cancer Center discusses variances in different myeloma patient groups, the KarMMa-3 study, and proactive advice for patients.

[ACT]IVATION TIP

“…if you are in a area, let’s say rural America where you don’t have access or you are in a minority population, African American, Hispanic, etcetera, or older, frail patients who are older that are considered vulnerable as well, absolutely make sure to talk to your doctors about these novel therapies because you still can get them safely and they will work. They can work. You just have to go to a center where they know how to adjust those types of therapies to make sure you get the best options out there as well.”

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See More from [ACT]IVATED CAR T

Related Resources:

What Patient Types Are Good Candidates for CAR-T Therapy?

What Patient Types Are Good Candidates for CAR T-Cell Therapy?

 Are CAR-T Clinical Trials Studying Use As a Frontline Therapy?

Are There Myeloma Trials Investigating CAR T for Frontline Therapy?

 A Look at Promising Strategies to Improve CAR T-Cell Therapy Access

A Look at Promising Strategies to Improve CAR T-Cell Therapy Access

Transcript:

Lisa Hatfield:

Dr. Patel, how might the heterogeneity of patient populations impact the standardization and reproducibility of CAR T therapy outcomes across different clinical settings, and what initiatives are in place to address this variability?

Dr. Krina Patel:

Yeah, I think that’s a great question because again, this is a personalized therapy. So it depends on what your myeloma is like, the genomics, the genetics of your myeloma, how aggressive is it, plus your T cells, right? And so everybody’s genetic ancestry, etcetera, is very different. So the idea of a personalized medicine, more than just even across groups of people, it’s at the individual level. And I think when you talk about different races or ethnicities, we have seen some differences in our real-world data, in very relapsed/refractory patients, where people can get great response rates still.

So, for instance, Caucasian patients versus African American patients, our response rates are still high in the 80s and 90 percent, but the toxicity is a little bit higher in our African American patients. It’s still not high grade. It’s not anything that makes me say, I’m not going to give this, but the baseline inflammatory markers are a little bit higher. And so once we get the CAR T, our patients tend to get a little bit more CRS.

They end up in the hospital a little bit longer. Now, again, this is a multivariate analysis and we couldn’t find any other difference, but when we look at KarMMa-3, which is one of our big studies that led to ide-cel (idecabtagene vicleucel) [Abecma] being approved early, we actually had an outcomes of African American patients only that we looked at and that we presented just this past TCT, and response rates were actually a little bit better.

Again, you can’t compare them because the numbers aren’t there to power that to compare, but numerically the numbers were better in terms of response rate, in terms of progression-free survival, it was actually more months that it beat the standard of care and we didn’t see more toxicity.

And so I think we do need to look at these things and make sure there’s not one group of patients has a lower efficacy for some reason, and why is that and how can we improve that? And so far, we don’t really see that. And the other is the toxicity piece, to make sure that these therapies that do cause some strange toxicities that we’re watching and seeing who might be more vulnerable to those toxicities, who do we need to maybe even prevent, do prevention strategies for, but so far we haven’t seen it.

And then I think coming back to the individual, right?So again, all of us have these different T cells that have different mutations in them, and some folks, for some reason, even with less myeloma, their T cells just expand really fast and other folks, they don’t. And so in the future to get best outcomes, we need to see how we can turn the volume lower for those folks who have really sensitive T cells.

And for those who don’t, how do we, what else can we add in combination to actually increase those T cells so that they’re actually doing a better job at killing the myeloma, right? And including the microenvironment too. So I think there’s a lot of translational work as well as the epidemiology side of things to say, okay, how do we first diagnose the problem, find the problems, and then how do we figure out how to intervene to then improve outcomes for all our patients? I think the activation tip here is that if you are in a area, let’s say rural America where you don’t have access or you are in a minority population, African American, Hispanic, etcetera, or older, frail patients who are older that are considered vulnerable as well, absolutely make sure to talk to your doctors about these novel therapies because you still can get them safely and they will work. They can work. You just have to go to a center where they know how to adjust those types of therapies to make sure you get the best options out there as well.

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Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions

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Addressing Disparities in Gynecologic Oncology | Key Challenges and Solutions from Patient Empowerment Network on Vimeo.

What are key challenges and solutions to gynecologic oncology research disparities? Expert Dr. Charlotte Gamble from MedStar Health shares specific factors that show up in research disparities and proactive advice to healthcare providers and researchers to help close the disparity gaps.

[ACT]IVATION TIP

“…for healthcare providers and researchers, is that we have to think about action and what, the evidence-based strategies are to help directly affect the disparate outcomes we see in America for our patients with cancers and to center patients and their concerns within these research questions.”

Download Guide | Descargar Guía en Español

See More from [ACT]IVATED Endometrial Cancer

Related Resources:

Navigating Advanced Endometrial Cancer | Treatment, Prognosis, and Lifestyle Strategies

Navigating Advanced Endometrial Cancer | Treatment, Prognosis, and Lifestyle Strategies

 How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

How Is Gynecological Cancer Care Impacted by Social Determinants of Health?

 How Can Gynecologic Oncology Racial Disparities Be Addressed

How Can Gynecologic Oncology Racial Disparities Be Addressed

Transcript:

Lisa Hatfield:

Dr. Gamble, what are the key challenges regarding the current paradigm of disparities research and gynecologic oncology, and what steps are proposed to overcome these challenges? And what is the role of the patient? 

Dr. Charlotte Gamble:

I love this question. This is such a great question because this is like my happy space and where I live, when I’m not taking care of patients directly and kind of where my research interests lie. So to take each question, each question, each part of this question, what are the key challenges regarding the current paradigm of what’s called disparities research? So I think a couple of challenges. One, historically disparities research just meant like looking and seeing what these patient outcomes were and who lived longer and, oh, no, it looks like Black patients are not living as long as white patients, and it looks like poor patients aren’t living as long as rich patients.

And it looks like patients who are living rurally don’t live as long as patients who live in the cities. And so just finding differences and seeing kind of how, again, this critical race practice and how the systems and structures in the United States have contributed or might contribute to these differences that we’re seeing, has classically and historically been easy low hanging fruit.

You look at these large cancer databases, you look at the SEER database, the National Cancer database as well, and can get, pull all these statistics and come up with pretty graphs that just show really wide disparities in Black versus white and versus Hispanic versus non-Hispanic and just say, hey, there are differences and people who are historically marginalized or vulnerable just don’t do as well, which is, okay, fine and good and maybe necessary to have that data to know where we’re starting from. But a challenging in that is that just shows some associations. There is not necessarily causation. There is no attempt to fix the system. It’s merely just stating these are where, this is where we’re at. And at this point, frankly, in 2024 and honestly for the past 15 to 20 years, it’s not anything new. It’s nothing that’s surprising.

 Like these have been trends that have been pretty ingrained in this social system and healthcare system that we have in the United States. And so doing kind of disparities that just discusses these differences is a little bit outdated at this point. I think, to answer the second part of that question, what are steps proposed to overcome these challenges? Really moving into, okay, so these differences are there, what are we going to do? So what are these solutions? What are the evidence-based solutions to these differences in how we overcome? So that spans anything from looking at sometimes the molecular tumor makeup that might be different based on ancestry or maybe based on exposure to racism. How does exposure to racism and or stress and over a lifetime influence cancer biology?

If someone has been minoritized and has been exposed to stress because of this for their entire lives, does that change their cancer risk or change the type of cancer they have or change how when they are diagnosed with cancer, how they respond to treatment. None of this has really been very aggressively studied within the gynecologic cancer space.  Some of this within the breast cancer space has been looked at, but not very much with the gynecologic cancers.

But then also importantly in this space that I love to live in is, okay, so like, how are we going to overcome the barriers that we discussed earlier? How do we get patients into the healthcare system a little bit earlier when they have abnormal symptoms? How do we get them to a subspecialist if they have transportation barriers, insurance barriers, health system barriers, and how do we actually address what we already know is the problem if they face delays in care, how do we shorten those intervals so they get timely care? And those are harder questions.

It’s harder to publish, it’s harder to get these studies done. They’re really messy. And I think that, there’s a lot of need to actually look at how the system is working or not working for patients and actually doing evidence-based strategies that we know, ie for example, care navigation to help improve the timeliness of care that patients receive.

To answer, and this dovetails well into the third part of the question, which is what is the role of the patient? This is critical because as we start thinking about actually designing interventions to work or to address these barriers, to care, to influence disparities and outcomes, of, patients with these cancers, patients are the center of what we do, and they have to be the center of the research, and they cannot be consulted on the back end after someone has come up with a very pretty project that sounds really nice and like can get funded easily.

 They have to be at the center at the start of the project. And so I think it’s really important to center voices of patients in designing research protocols, center them in designing clinical trials, center them in designing community-based outreach programs. This has to, not only come from patients, but feel like it is a patient almost run program. And, I think Kemi Doll really in the gynecologic cancer space, has, been a fierce advocate for, including patients and centering patients and, having patients lead as opposed to follow, as opposed to being adjacent to the project, but being really central to it and to its functioning.

And so when we think about the interventions, when we think about the research questions that are yet unanswered, oftentimes these answers as well as the, logistics of how to get these programs done lies within patients, their communities, their loved ones themselves, and failure to involve them early in the process is a failure of the research project in general. I think my activation to this question is actually for healthcare providers and researchers, is that we have to think about action and what, the evidence-based strategies are to help directly affect the disparate outcomes we see in America for our patients with cancers and to center patients and their concerns within these research questions.

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How Are Cultural and Language Barriers to CAR T Therapy Being Addressed?

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How Are Cultural and Language Barriers to CAR T Therapy Being Addressed? from Patient Empowerment Network on Vimeo.

How are CAR T therapy barriers of cultural and language nature being addressed? Expert Dr. Sikander Ailawadhi from Mayo Clinic discusses research study results on access barriers and ways to create solutions that address language and cultural issues.

[ACT]IVATION TIP

“…having a culturally sensitive discussion and a system that approaches the patients for complex treatments like CAR T or clinical trials. And personally, I’ve seen that it makes a big difference to the patient’s consideration of those treatment options.”

Download Guide | Descargar Guía

See More from [ACT]IVATED CAR T

Related Resources:

How Can CAR T-Cell Therapy Be Explained to Patients and Families?

How Can CAR T-Cell Therapy Be Explained to Patients and Families?

 Reducing CAR T-Cell Therapy Barriers for Relapsed/Refractory Myeloma

Reducing CAR T-Cell Therapy Barriers for Relapsed/Refractory Myeloma

 Roadblocks for Black and Latinx Patients From CAR T Trial Access

Roadblocks for Black and Latinx Patients From CAR T Trial Access

Transcript:

Lisa Hatfield:

Dr. Ailawadhi, we know cultural or language barriers may hinder access to information about CAR T-cell therapy. How are you and your colleagues addressing this barrier?

Dr. Sikander Ailawadhi:

It’s very important to think about cultural or language barriers and how they may affect our way we deliver the care and the way the patients consume that healthcare. A few years ago we had done a study looking at just electronic medical record usage and how patients participate in their EMRs, for example. And we realized that for patients who are non-white, language barrier was a big issue because frankly, majority of our EMRs are English. They don’t provide a lot of Spanish or other language support.

Similarly, clinical trials and education material for CAR T, et cetera, they are very frequently in English. There is an increasing number of Spanish documents that are becoming available. So how we try to overcome these barriers, I think we have started, utilizing an approach in our institution where our research staff, we are trying to hire a diverse population.

There is data that based on studies, it has been very clearly shown before that, a patient is more likely to consider favorably a clinical trial or a treatment if it is being offered by someone who look and speak like them. So an African American patient is more likely to accept or consider a treatment, I would say, not even accept, but consider a treatment if it is being offered by an African American physician, an African American clinical research coordinator, et cetera.

While I’m not African American, I can’t change that, but we have African American, Hispanic, Asian clinical research coordinators in our teams, and we have noticed a clear difference in the patient’s understanding their ability to ask questions, their willingness to ask questions and clear out their barriers if it is given to them in a culturally sensitive, culturally appropriate manner.  So my activation tip for this question would be, having a culturally sensitive discussion and a system that approaches the patients for complex treatments like CAR T or clinical trials. And personally, I’ve seen that it makes a big difference to the patient’s consideration of those treatment options.

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Why Is Multiple Myeloma Diagnosed Much Later in BIPOC Patients?

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Why is Multiple Myeloma Diagnosed Much Later in BIPOC Patients? from Patient Empowerment Network on Vimeo. 

How do multiple myeloma diagnosis and treatment differ in BIPOC communities? Expert Dr. Joseph Mikhael details some statistics on BIPOC myeloma patients, factors that can impact myeloma survival rates, and myeloma clinical trial participation rates of African Americans.

See More From the Myeloma TelemEDucation Empowerment Resource Center

Related Resources:

 
Is MGUS More Prevalent in BIPOC Communities?

Is MGUS More Prevalent in BIPOC Communities?

 

 Will Telemedicine Mitigate Financial Toxicity for Myeloma Patients?

Will Telemedicine Mitigate Financial Toxicity for Myeloma Patients?

 How Can We Address Noted Disparities in Multiple Myeloma?

How Can We Address Noted Disparities in Multiple Myeloma?
 

Transcript:

Dr. Joseph Mikhael:

We know that multiple myeloma is a unique disease in the African American, in the Black community, really for many reasons, primarily the disease is twice as common in Blacks than it is in Caucasians, we don’t fully understand all of the rationale and the understanding of that, the science behind that, but we know it’s just twice as prevalent.  What’s perhaps most disturbing is that despite knowing that it is twice as common, it is often not recognized and not recognized in time. The average time to diagnosis from the onset of symptoms to an accurate diagnosis is significantly longer in the African American community than it would be in the Caucasian community, and that’s an unfortunate reality. And that along with the treatment that individuals have access to, we’ve learned, unfortunately, that African Americans are less likely to receive triplet therapies or the combinations of chemotherapy that are so important, transplant that we know is stem cell transplants are very important in the treatment of myeloma, and access to clinical trials. African Americans constitute somewhere between 17 percent to 20 percent of all myeloma patients in this country, but actually, only reflect about 5 percent to 6 percent of clinical trial participation, and all of that has led unfortunately to an inferior survival rate in African Americans compared to Caucasians.

We’ve seen huge advances in survival in myeloma over the last decade, but for every 1.3 years gained by Caucasian patients, we’ve only seen 0.8 years gained in Black patients, so this is a disparity that is disturbing and that we need to address.

The disparity in multiple myeloma is honestly, not only confined to the African American community, we see this in many other vulnerable communities, in particular, the Hispanic community, where we know that the disease is diagnosed at a younger age than we would typically see in the Caucasian community. Also reflective of the healthcare system in our country where many patients of the Hispanic background have less access to healthcare, and this clearly influences outcomes, and so as we study this more and appreciate it more, we come to understand that there are many vulnerable populations by virtue of race, by virtue of insurance status, by virtue of a documented status, all of these things, unfortunately, have a significant impact in a patient’s survival with multiple myeloma. COVID-19 has really affected so many things in the medical community. But thankfully, one of the things that we have not significantly seen, apart from for a period of time, reduced access to clinical trials, we have been able to maintain the supply of our key agents and treatments that we use in multiple myeloma. So I’m very thankful that I have not had to delay or cancel my patients’ treatments by virtue of a supply chain issue, we’re very grateful that that supply chain has pretty well been maintained after out the pandemic, and we trust will continue to be maintained.