Emphasizing the Need for More Diversity in Cancer Clinical Trials

Kimberly (Cary) Demirhan, a registered nurse and assistant director of Education Programs at the Association of Cancer Care Centers (ACCC), sat down for an interview with CURE to discuss the need for more diversity and inclusivity in clinical trials for patients with cancer.

“Where you live, the color of your skin, or who your doctor is shouldn't determine the type of treatment you receive. We want to ensure that everyone has access to the best available treatments, and often those treatments are found in clinical trials,” she emphasized during the discussion.

Demirhan also went on to discuss the importance of personalized care, as well as the impact of decentralized clinical trials and digital healthcare tools. In an earlier interview, she expanded on the importance of clinical trial accessibility.

CURE: For patients who are new to clinical trial research, how does greater diversity and inclusivity in trial design improve treatment effectiveness and support more personalized care?

Demirham: Diversity in participation is truly important for having tailored and equitable care in clinical trials. We don't want a clinical trial to only include one type of person because then the trial lacks generalizability to real-world patient populations. Where you live, the color of your skin, or who your doctor is shouldn't determine the type of treatment you receive. We want to ensure that everyone has access to the best available treatments, and often those treatments are found in clinical trials.

Restricting someone from a clinical trial based on where they live, their age, race, or comorbidities is a barrier. It's imperative that we include all of those people in our research. When we announce that a drug is effective for a particular disease, we want that to be true for all patient populations, across the US and the world, not just for one type of person.

Including diverse populations helps build the scientific integrity of our work and public trust in the trial. We're not saying, “This works, but maybe not in your case”; instead, we can confidently say that the treatment is effective across the board.

With decentralized clinical trials and digital tools like remote visits and home-delivered medications becoming more common, what changes might patients experience? How could these make participating in clinical trials easier?

We are at the renaissance of decentralized trials and even digital tools. I believe we are at the beginning of a great and exciting future that will increase access to the ability to participate in clinical trials.

A breakdown of decentralized trials means that while there might be a primary care site (maybe that's an academic center in a large city) there are other ways that you can participate in that trial besides getting everything you need at a singular center. This might include telehealth visits, so you don't have to drive six hours to your clinical trial site. You can do telehealth visits with your physician, nurse, or anyone on the cancer care team from the comfort of your home. It also means you can do blood draws close to your house instead of at the primary clinical trial site. It's e-consent, so you don't have to drive all the way in just to consent. You can sign those forms electronically.

Decentralized trials also give us an opportunity to remotely monitor patients. We have wearable devices that monitor your heart rate and blood pressure. We also have apps where you can record your daily symptoms and how you feel at different times of the day. This data automatically transfers to your trial manager, so they know in real time what is happening with you and can intervene more quickly.

All of these are additions to the regular clinical trial process. The goal is to make communication and tracking easier and to allow more patients to enroll. You don't have to be in the hospital for constant monitoring because you now have a heart monitor at home. This provides another way to increase access to clinical trials.

How do you see digital tools and patient-centered technologies shaping the future of clinical trial participation and improving the patient experience?

In my personal opinion, this is just the beginning. There are a million things we can do, and a ton of different digital tools and resources are being created to help improve the patient experience. We are encouraging our trial sponsors to incorporate those patient-centered technologies and solutions to help reduce the burden on the patient, make it all easier, and reduce the redundancy of transferring paper logs to electronic charts.

Hopefully, this all leads to an enrollment boost in clinical trials because we are trying to make it easier and more attainable for a larger number of people.

References

1. “Bringing Cancer Research to the Community: Strategic Approaches to Representative Oncology Clinical Trial Design,” by Dr. Nicole A Colwell, et al. ACCC Community Oncology Research Institute.
2. Expanding Clinical Trial Access for Patients With Cancer, by Ryan Scott. CURE, Aug. 11, 2025. https://www.curetoday.com/view/expanding-clinical-trial-access-for-patients-with-cancer

Transcript has been edited for clarity and conciseness

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