Minority patients continue to be underrepresented in multiple myeloma (MM) trials, in terms of both inclusion and reporting of results, according to a comment written by Ghulam Rehman Mohyuddin, MD, from the University of Kansas Cancer Center in Kansas City, and colleagues in The Lancet Haematology.

“Our results show poor reporting and enrolment of minorities in multiple myeloma trials over a time period where significant advances have been made in the care of these patients,” Dr Mohyuddin and colleagues wrote in their report.

Dr Mohyuddin and colleagues reviewed 1171 studies involving patients with MM and randomized controlled trials (RCTs) with publication dates from the years 2005 through 2019 and found 100 trials (including 45,524 patients) that met various criteria for analysis. From these 100 trials they identified 26 that noted the racial composition of included patients.

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From the 26 studies that identified race among enrolled patients, non-White status was found in 16% of patients. Of the set of 100 trials, 19 trials noted the number of patients who were Black, and in these studies 6% of included patients were Black.

Over the study period, reporting on race of included patients did not appear to improve. In the earliest period, from 2005 through 2009, 29% of trials reported on race, and in the latest period, from 2015 through 2019, 26% of trials reported on race.

Single-country and multinational studies did not significantly differ in race reporting (32% and 23%, respectively; P =.32). However, multinational studies did appear to recruit minority patients more often, at a rate of 18% of patients overall, compared with 13% for single-country studies (P <.0001). There was no statistically significant difference in reporting of minority patients between studies led by academic groups or sponsored by pharmaceutical companies (18% and 33%, respectively; P =.09).

The authors noted that for Black patients, the incidence of MM is twice that of patients who are White, and they indicated that enrollment trends in MM trials may affect their applicability to racial minorities.

“We advocate for increased minority representation on trials, and transparent reporting of proportions of such patients on RCTs to provide meaningful counselling and equitable care for all,” Dr Mohyuddin and colleagues concluded in their report.

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.


Mohyuddin GR, Koehn K, Costa L, Kumar SK, McClune B. Enrolment of racial minorities across 15 years of multiple myeloma randomised trials; calling on researchers to become agents of change. Lancet Haematol. Published online September 1, 2020. doi:10.1016/S2352-3026(20)30281-7