Vulnerability index impacts distribution of prostate cancer clinical trials in the United States.
- 1Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
- 2MD Anderson Cancer Center, Houston, TX, United States.
Abstract
Background
Availability of clinical trials for prostate cancer in the US varies greatly by region. County-level analyses are vital to characterize healthcare access, disease burden, and population-level disparities.Methods
Utilizing the ClinicalTrials.gov trial database, we collated all interventional prostate cancer trials between June 1, 2019, and June 1, 2025. We compiled data on county characteristics along with Social Vulnerability Index (SVI) designations derived from the CDC, NCI, and the Agency for Toxic Substances and Disease Registry data. A zero-inflated negative binomial regression model was used to evaluate trial availability. Trial characteristics were summarized using descriptive analysis.Results
We found 884 eligible trials. Among 3,145 counties, only 631 had at least one clinical trial over the study period. Most trials (51%) included patients with metastatic disease. Sixteen percent of trials investigated curative treatments, while 65% examined palliative interventions. The majority of studies (52.5%) had funding from pharmaceutical companies. There was no significant relationship between trial availability and incidence or mortality rates. Among counties with at least one trial, those with a low SVI had twice as many trials per household when compared to those with high SVI (IRR 2.05, 95% CI 1.54 - 2.74, p<0.001). Counties with no trials were more rural (72.3% vs 22.0%) and had fewer specialist physicians (17.1% vs 69.1%).Conclusion
Prostate cancer trials are disproportionately concentrated in the US, with lower representation in vulnerable areas. Expanding trial access to underserved areas is a crucial step in promoting equitable access to care.
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BibTeX
@article{goes2026vulnerability,
title = {{Vulnerability index impacts distribution of prostate cancer clinical trials in the United States.}},
author = {Vitor Abreu de Goes and Benjamin Mercier and Yu Jun Li and Koral Shah and Xiaochen Li and George Zhang and Daniela V Castro and Jadon Fann and Salvador Jaime-Casas and Lauren M Lau and Lily M Lau and Joshua Lee and Kyra Shah and Ethan Swarat and Akasha Dukkipati and Ruchi Agarwal and Ruth Simon and Jaya Goud and Rahul Winayak and Miguel Zugman and Regina Barragan-Carrillo and Nazli Dizman and Charles Nguyen and Sumanta K Pal and Alexander Chehrazi-Raffle},
journal = {Frontiers in oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1874405},
url = {https://europepmc.org/article/MED/42899081},
note = {CC BY},
}
RIS
TY - JOUR
TI - Vulnerability index impacts distribution of prostate cancer clinical trials in the United States.
AU - Vitor Abreu de Goes
AU - Benjamin Mercier
AU - Yu Jun Li
AU - Koral Shah
AU - Xiaochen Li
AU - George Zhang
AU - Daniela V Castro
AU - Jadon Fann
AU - Salvador Jaime-Casas
AU - Lauren M Lau
AU - Lily M Lau
AU - Joshua Lee
AU - Kyra Shah
AU - Ethan Swarat
AU - Akasha Dukkipati
AU - Ruchi Agarwal
AU - Ruth Simon
AU - Jaya Goud
AU - Rahul Winayak
AU - Miguel Zugman
AU - Regina Barragan-Carrillo
AU - Nazli Dizman
AU - Charles Nguyen
AU - Sumanta K Pal
AU - Alexander Chehrazi-Raffle
PY - 2026
DA - 2026/10/05
JO - Frontiers in oncology
DO - 10.3389/fonc.2026.1874405
UR - https://europepmc.org/article/MED/42899081
AB - Background Availability of clinical trials for prostate cancer in the US varies greatly by region. County-level analyses are vital to characterize healthcare access, disease burden, and population-level disparities.Methods Utilizing the ClinicalTrials.gov trial database, we collated all interventional prostate cancer trials between June 1, 2019, and June 1, 2025. We compiled data on county characteristics along with Social Vulnerability Index (SVI) designations derived from the CDC, NCI, and the Agency for Toxic Substances and Disease Registry data. A zero-inflated negative binomial regression model was used to evaluate trial availability. Trial characteristics were summarized using descriptive analysis.Results We found 884 eligible trials. Among 3,145 counties, only 631 had at least one clinical trial over the study period. Most trials (51%) included patients with metastatic disease. Sixteen percent of trials investigated curative treatments, while 65% examined palliative interventions. The majority of studies (52.5%) had funding from pharmaceutical companies. There was no significant relationship between trial availability and incidence or mortality rates. Among counties with at least one trial, those with a low SVI had twice as many trials per household when compared to those with high SVI (IRR 2.05, 95% CI 1.54 - 2.74, p<0.001). Counties with no trials were more rural (72.3% vs 22.0%) and had fewer specialist physicians (17.1% vs 69.1%).Conclusion Prostate cancer trials are disproportionately concentrated in the US, with lower representation in vulnerable areas. Expanding trial access to underserved areas is a crucial step in promoting equitable access to care.
SN - 2234-943X
ER -