News in brief: Precision oncology studies lack diversity; Rudd backs oncology trial collaboration to stop cold war; One in four patients wait too long for essential procedures

Precision oncology studies lacking in diversity

Precision oncology studies for breast, lung, prostate, and colorectal cancers underrepresent racial and ethnic minority populations relative to their cancer incidence in the population, a US study has shown.

Analysis of 93 studies involving 5867 cancer patients found that participants were predominantly white, whereas Black participants were significantly underrepresented (ratio, 0.49) as were Hispanic participants (ratio, 0.24), and American Indian and Alaskan Native participants (ratio, 0.43).

The study authors said precision oncology studies could be missing crucial findings that could be benefiting traditionally marginalised groups, “and it is unclear whether current precision medicine breakthroughs can be broadly applicable to, or safe for, our diverse cancer population.

“All relevant stakeholders should implement strategies to increase diverse clinical study enrolment to address this disparity,” they wrote in JAMA Network Open.

Rudd backs oncology trial collaboration to stop cold war

Former PM Kevin Rudd is helping to steer a US-China oncology therapy clinical trial collaboration that he hopes will help improve relations between the fractious superpowers.

As head of the Asia Society, Mr Rudd is supporting the Bloomberg International Cancer Coalition, which will be launched in Singapore later this month, with input from Australian oncology groups.

The Coalition will bring together the Memorial Sloan Kettering Cancer Center and leaders from Chinese and international pharma companies to foster clinical trial collaboration between the US and China “with the goal of accelerating development, access and approvals of cancer treatments that could save millions of lives.”

As well as pharma industry involvement, the Coalition will also encourage diagnostic companies to facilitate trial enrolment and regulatory authorities to commit to expand existing cross-regional efforts on regulatory harmonisation to avoid data redundancy and filing delays.

When it was first proposed two years ago, the alliance between the Memorial Sloan Kettering Cancer Center and the Chinese Thoracic Oncology Group (CTONG) sought policy advise support from leaders from the Australasian Lung Cancer Trials Group (ALTG) – now the Thoracic Oncology Group Australasia (TOGA).

Mr Rudd compared the collaboration to US President Richard Nixon’s attempt in the 1970s to thaw relations between the US and China using table tennis.

“The US-China relationship has got so bad that we at the Asia Society have formed a view that cancer treatment trials may well become the next iteration of ping-pong diplomacy, to get this relationship back on the rails,” he told the Financial Times.

He said the Coalition was looking to the FDA’s Project Orbis as a model of cross-border collaboration on clinical trials and harmonisation of regulatory approvals.

One example of this is the trialling and registration of sotorasib (Lumykras), Amgen’s first in class oncology drug for KRAS G12C-mutated advanced NSCLC, which was approved recently in the UK via Project Orbis.

One in four patients wait too long for essential procedures: AMA Report Card

The AMA’s latest hospital report card shows that nationally only 75% of patients classified as Category 2 for elective surgery received treatment within the recommended timeframe.

Federal AMA President, Dr Omar Khorshid said the hospital system was already overwhelmed before the COVID-19 pandemic hit in 2020, due to an relentless decline in the number of beds available per head of population.

“While called ‘elective’ surgery, this really is essential surgery that includes serious conditions like heart valve replacements and cancer investigations,” he said.

“In reality, what this means is that 25% of people will wait longer than 90 days for surgeries, which in this category can include treatment for an unruptured brain aneurism, decompression of a spinal cord and treatment for ovarian cysts or unhealed fractures.

Dr Khorshid said the problem was particularly bad for patients in states such as Tasmania where more than a 63% are waiting longer than the recommended period for essential surgery.

The report card showed that the ratio of beds available for people over the age of 65 (the most intensive users of public hospital beds) has been on a downward trend for 27 years, halving from 33 to just over 15 per 1000 people.

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