@article{490662eeb25c44e89603f5913d4b97f6,
title = "Undercutting efforts of precision medicine: roadblocks to minority representation in breast cancer clinical trials",
abstract = "Precision (or personalized) medicine holds great promise in the treatment of breast cancer. The success of personalized medicine is contingent upon inclusivity and representation for minority groups in clinical trials. In this article, we focus on the roadblocks for the African American demographic, including the barriers to access and enrollment in breast oncology trials, the prevailing classification of race and ethnicity, and the need to refine monolithic categorization by employing genetic ancestry mapping tools for a more accurate determination of race or ethnicity.",
keywords = "African Americans, Ancestry informative markers, Oncology trials, Race/ethnicity classification",
author = "Geetanjali Saini and Keerthi Gogineni and Kittles, {Rick A.} and Ritu Aneja",
note = "Funding Information: This study was supported by a grant from the National Cancer Institutes of Health (R01CA239120) to RA. Funding Information: A 2011 examination of data from the NIH IMPAC II grant database uncovered a lopsided relationship between race and award probability, with AA/Black applicants securing significantly less funding than their white peers despite comparable qualifications []. This report, by NIH{\textquoteright}s own admission, was a wake-up call, and subsequently, they set out to understand the factors driving racial gap in funding [] and gain insights into the wider issue of why little was changing on the ground, despite their efforts. One such NIH study found that over 20% of the differences in funding outcomes could be attributed to the applicants{\textquoteright} topic choice and how the subject was valued by the grant reviewers []. Applications from AA applicants are inclined to include research on health disparities and patient-focused interventions, subjects that are less favorably received []. This exposes a rather self-defeating process, wherein requisite research, fundamental to mitigating disparities across the continuum of healthcare, remains vastly underfunded. NIH has ramped up measures to narrow the funding gap and improve diversity, including programs such as the Distinguished Scholars Program (DSP; 2018) [] and Faculty Institutional Recruitment for Sustainable Transformation (FIRST; 2020) []; the long-term impact of these initiatives remains to be seen. Further, the looming cuts in NIH and NCI funding will aggravate competition for funding and may detract from a renewed focus on representation in research and researchers. US federal agencies, such as the Centers for Disease Control and Prevention (CDC) (e.g., OMHHE; Office of Minority Health and Health Equity) and Department of Health and Human Services HHS (e.g., NIH) have been committed towards increasing diversity in its biomedical workforce. Dedicated offices across NIH, such as the National Institute on Minority Health and Health Disparities (NIMHHD), are working on aspects of workforce diversity ( https://diversity.nih.gov/programs-partnerships/nih-diversity-offices ). These changes may help remedy minority representation in the biomedical workforce and ensure funding for research that may provide a basis for precision medicine for minority groups, research on health disparities, and patient-focused interventions. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2021",
month = jun,
doi = "10.1007/s10549-021-06264-x",
language = "English (US)",
volume = "187",
pages = "605--611",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "3",
}