Dr Mikhael on Unmet Needs in Cancer Care for Patients With Multiple Myeloma

Joseph Mikhael, MD, professor, Applied Cancer Research and Drug Discovery Division, the Translational Genomics Research Institute, affiliate, City of Hope Cancer Center; chief medical officer, The International Myeloma Foundation; consultant hematologist, director, Myeloma Research, HonorHealth Research Institute; councilor, American Society of Hematology Executive, discusses the importance of closing gaps in care for patients with multiple myeloma from underserved populations, highlighting the unmet needs that remain for these populations regarding clinical trial enrollment. 

Health equity is not just phase or a movement; it is the cornerstone of effective cancer care and requires a concerted effort to achieve, Mikhael begins. Stark racial/ethnic disparities in outcomes exists for patients with multiple myeloma, which are exemplified by the double mortality rate seen in African American vs White patients, he states. This issue is both personally and professionally important to Mikhael, he says, given his own identity as an African American. 

As a community, it is imperative to comprehend the complex nature of racial/ethnic disparities, he explains. Inequalities in cancer care are rooted in systemic racism, which isingrained in the healthcare system, as well as social determinants of health, Mikhael states. In myeloma, oncologists can see the ramifications of delayed diagnosis and restricted access to various therapeutic options. Notably, triplet regimens, transplant, clinical trials, and CAR T-cell therapy are key approaches for improving myeloma survival rates, Mikhael emphasizes. However, these avenues are often less accessible to diverse populations within the community, including African American, Latino, and Hispanic patients, he notes.

This calls for dedication at the regulatory and industry levels, as well as from the broader community, Mikhael continues. Healthcare providers should commit to the delivery of culturally sensitive care, advocate for patients, and ensure patients can access the critical treatments outlined above, Mikhael explains. Notably, patients of African American descent typically make up less than 5% of clinical trial populations, marking a significant disparity that must be resolved, he states.

Oncologists’ commitment to promoting health equity should extend beyond verbal affirmations; a commitment to daily action in the clinic and broader advocacy for patients is necessary to bridge these gaps, Mikhael concludes.