Edith P. Mitchell, MD, MACP, FCPP, FRCS, shared the inspiration behind the ECOG-ACRIN Health Equity Committee, and discusses ECOG-ACRIN’s efforts in addressing health disparities in cancer care.

The ECOG-ACRIN Cancer Research Group is working to provide collaborative efforts with Black physicians who are members of the National Medical Association, as well as collaborations to increase the accrual of Black patients to ECOG-ACRIN clinical trials, Mitchell says. Moreover, in 2017, efforts were put into a project to increase the number of Black providers who are in or plan to work in cancer medicine, including residents, fellows, and undergraduate medical students, Mitchell explains. This project as done with the goal of mentoring Black individuals who are preparing for a career in medicine, Mitchell adds. 

With these effots, it became possible to develop the in the ECOG-ACRIN Health Equity Committee, Mitchell continues. The committee consists of physicians, as well as clinical research assistants and individuals from various fields of cancer research. The goal is to have a comprehensive group of individuals involved and working together, Mitchell concludes.

Videos

Edith P. Mitchell, MD, MACP, FCPP, FRCS, shared the inspiration behind the ECOG-ACRIN Health Equity Committee, and discusses ECOG-ACRIN’s efforts in addressing health disparities in cancer care. 


Dr. Mitchell on ECOG-ACRIN’s Efforts in Addressing Health Disparities in Cancer Care 

Edith Mitchell, MD, FACP professor of Medicine and Medical Oncology at Thomas Jefferson University, Director of the Center to Eliminate Cancer Disparities at the Sidney Kimmel Cancer Center at Thomas Jefferson University, discusses racial disparities in breast and prostate cancer.

African Americans with cancer tend to have worse outcomes when compared to Caucasians. While many people assume this discrepancy is primarily due to a lack of assess to care, poverty, and other socioeconomic factors, there are distinct molecular differences in tumors between white and African American patients that often cause these disparities, explained Mitchell.

Triple-negative breast cancer, which has a higher mortality rate, occurs twice as frequency among African American woman. There is a lack of therapeutic options to treat this disease as drugs like tamaxifan and trituzimab, which have shown benefit in other breast cancer types, have no effectiveness in triple-negative breast cancer.

Prostate cancer also occurs earlier and has a higher mortality rate among African American men. More studies are needed to identify the risk factors based on race and to develop therapies to reduce disparities.

Edith Mitchell, MD, Prof of Medicine and Medical Oncology at Thomas Jefferson University, Director of the Center to Eliminate Cancer Disparities at the Sidney Kimmel Cancer Center at Thomas Jefferson University, discusses racial disparities in breast and prostate cancer.

Dr. Edith Mitchell on Cancer Disparities Among African American Patients 

Edith Mitchell, MD, FACP, clinical professor, director, Center to Eliminate Cancer Disparities Program Leader, Thomas Jefferson University, discusses an analysis of the VELOUR trial. This analysis looked at overall survival and safety during the course of the phase III trial comparing FOLFIRI and ziv-aflibercept or placebo in patients with metastatic colorectal cancer (mCRC) who progressed on prior oxaliplatin treatment.

With any new drug, Mitchell says, it takes time for physicians to learn about the toxicities and how to manage symptoms. Patients who remain on an agent can have side effects that are easier to manage and receive benefit.

This analysis showed that hazard ratio improved over time, consistent with survival curves that continue to separate past the median time point, which indicated that the magnitude of ziv-aflibercept treatment effect continues to increase over time. The analysis also showed that the majority of grade 3/4 adverse events occurred in early treatment (first 3-4 cycles) and the majority of grade 3/4 events were single-episode in nature.

Edith Mitchell, MD, FACP, clinical professor, director, Center to Eliminate Cancer Disparities Program Leader, Thomas Jefferson University, discusses an analysis of the VELOUR trial.

Dr. Mitchell on Survival and Safety of the VELOUR Trial

Edith Mitchell, MD, FACP, clinical professor, director, Center to Eliminate Cancer Disparities Program Leader, Thomas Jefferson University, talks about the growing number of drugs and regimens for patients with colorectal cancer.

Mitchell says the approval of aflibercept adds to the growing list of drugs for patients with colorectal cancer.

In 1996, Mitchell says, 5-gluorouracil was the only drug that showed benefit for patients with metastatic colorectal cancer. Now, as a variety of drugs are available to patients, doctors can strive for the best quality of life possible.

As the number of drugs has increased, so has the improvement of survival for patients with colorectal cancer, Mitchell says. 

Edith Mitchell, MD, FACP, clinical professor, director, Center to Eliminate Cancer Disparities Program Leader, Thomas Jefferson University, talks about the growing number of drugs and regimens for patients with colorectal cancer.


Dr. Mitchell on Colorectal Cancer Treatment Options

Edith Mitchell, MD, FACP, Clinical Professor, Director, Center to Eliminate Cancer Disparities Program Leader, Thomas Jefferson University, gives an overview of the North American subgroup analysis of the VELOUR trial.

The VELOUR trial evaluated ziv-aflibercept (ZALTRAP) versus placebo plus FOLFIRI in patients with metastatic colorectal cancer who are resistant to or progressed after an oxaliplatin-containing regimen. Mitchell says that the question of whether patients in different parts of the world responded to ziv-aflibercept equally -- regarding side effects and benefit -- was an important one to answer.

Bevacizumab has been approved in the U.S. as a first-line therapy option and is unavailable in this setting in other areas of the world. Mitchell says that this analysis was not so much comparing North America and the rest of the world as it was comparing available treatment options and the use of bevacizumab.

The analysis found that there were very few differences regarding toxicities and benefits in North America compared with other parts of the world.

Edith Mitchell, MD, FACP, from Thomas Jefferson University, gives an overview of the North American subgroup analysis of the VELOUR trial.

Edith Mitchell, MD, FACP

Articles

Dr. Mitchell on ECOG-ACRIN’s Efforts in Addressing Health Disparities in Cancer Care

Dr. Edith Mitchell on Cancer Disparities Among African American Patients

Dr. Mitchell on Survival and Safety of the VELOUR Trial

Dr. Mitchell on Colorectal Cancer Treatment Options

Dr. Mitchell on a Subgroup Analysis of the VELOUR Trial