Fox Chase Researchers Explore Racial Disparities in Survival for Head and Neck Cancer Patients

“We show here that there is a measurable difference in survival after implementation of a multidisciplinary tumor board," said Dr. Liu.
“We decided to look at patients who were undergoing clinical trials. Clinical trials are unique in that once a patient is enrolled in a trial, their treatment is very uniform,” said Liu.

PHILADELPHIA (June 25, 2020)—Researchers at Fox Chase Cancer Center have presented findings from a study that found that survival rates for Black patients were worse than those for white patients being treated for head and neck cancer even when they had access to the same care. The researchers said the disparities could be explained by biological differences between the two groups.

“It’s been known for decades that there’s a disparity in both the incidence and survival of patients who develop this cancer between Blacks and whites. If you look at those groups, Blacks consistently do worse with this cancer than whites,” said Jeffrey Chang-Jen Liu, MD, FACS, the study’s lead author and attending surgeon for the Division of Head & Neck Surgery in the Department of Surgical Oncology at Fox Chase.

Liu presented the findings of the study, “Race Informs Survival Disparities in Head and Neck Cancer Clinical Trials,” at the AACR Virtual Annual Meeting II, held June 22-24.

Two factors that may play a large role in these survival disparities are lack of access to care and lower socioeconomic status, but Liu and his study collaborators wanted to determine what else could be affecting outcomes.

“We decided to look at patients who were undergoing clinical trials. Clinical trials are unique in that once a patient is enrolled in a trial, their treatment is very uniform,” something that would help control for lack of access to care and lower socioeconomic status, said Liu.

For each patient in the clinical trial reported as Black, a white patient was matched from within the same arm of that clinical trial as a control. Matching was performed by study arm, age, gender, and stages, including tumors, nodes, and metastasis.

“About 60 percent of the time, Blacks still did worse than their white control, even when they were in the exact same study arm receiving the exact same treatment,” said Liu. “The reason they seemed to do worse was because of regional/local control, which means their cancer was more likely to come back sooner than their white control,” he said.

Liu said the results indicate that there could be a biological explanation for some of the disparities in head and neck cancer. “This study gives us a very clear picture that there is something here to look at. We are on our second grant looking at some mechanisms that may explain this difference from a biological standpoint. It’s something that we’re actively investigating.”

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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