Abstract C056: Evaluating minority clinical trial participation and the impact of COVID-19 on enrollment in a large integrated academic satellite

Abstract Purpose/Objectives: Social distancing and healthcare rationing during the COVID-19 pandemic exacerbated cancer disparities worldwide and it is important to understand its impact on ethnic representation in clinical trials. For this reason, we investigated how the COVID-19 pandemic influenced racial/ethnic representation in radiation oncology trials in a large integrated academic satellite network, by interrogating sociodemographic factors associated with trial participation pre-COVID-19, during COVID-19, and post-COVID-19 pandemic as defined by the World Health Organization (WHO), hypothesizing that the pandemic significantly affected minority participation in clinical trial. Materials/Methods: We conducted an IRB-approved retrospective analysis of subjects ≥ 18 years who enrolled in radiation oncology trials from March 2018 to August 2024 in a five-campus integrated academic satellite. Subjects were classified by WHO definitions into pre-COVID-19 (3/10/2018-3/11/2022), during COVID-19 (3/12/2020-5/5/2023), and post-COVID-19 (5/6/2023-8/31/2024). Chi-square testing was used to compare ethnic/racial differences in trial participation and sociodemographic variables across the three periods. Statistical significance was considered for p-values 0.05. Results: There were 1,702 subjects who enrolled in radiation oncology trials. These include 531 (31.2%) pre-COVID-19, 843 (49.5%) during COVID-19, and 328 (19.3%) post-COVID-19. The average age of participants was 61. Racial/ethnic makeup was 79% white, and 21% non-White. Most subjects enrolled in Phase 2 trials (53.6%), were treated for breast cancer (48.6%) and had private primary insurance (58%). Racial and ethnic minority enrollment increased during the COVID-19 period (24.2%) compared to pre-COVID-19 (17.3%) and post-COVID-19 (18.9%), though this is not statistically significant (p = 0.06). The average distance from participants’ homes to the treatment centers was lower during the COVID-19 period (122 miles) compared to both pre-COVID-19 (174 miles) and post-COVID-19 (187 miles) periods (p 0.01). Conclusions: The findings of this study yield valuable insights into minority participation during COVID-19. Despite an abundance of literature suggesting the exacerbation of racial disparities in clinical trials during the pandemic, we observed an increase in minority representation. Travel restrictions and regionally focused recruitment efforts may have played a crucial role, where subjects who resided closer to study sites were minorities. This merits deeper exploration into the drivers of trial participation. Future research should explore barriers to minority participation in clinical trials. Expanding outreach initiatives with patient navigation, integrating telehealth, and improving patient education can enhance participation across diverse populations. By prioritizing equitable access to clinical trials, we can facilitate a more inclusive research landscape, improving cancer care for all patients, enhancing the distribution of benefits and risks, and generalizability of research findings. Citation Format: Chidinma P. Anakwenze, Jovita Echere, Oladipo K. Alfolayan, Molly Tate, Qatalina Hubbard, Shalin J. Shah, Stephen G. Chun. Evaluating minority clinical trial participation and the impact of COVID-19 on enrollment in a large integrated academic satellite abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C056.