María Natalia Gandur Quiroga, Chief of the Division of Genitourinary Medical Oncology at the Angel H. Roffo Oncology Institute, shared Petros Grivas’s, Professor at University of Washington and Fred Hutch, post on X, adding:
“Does where you live determine your access to innovation in Bladder Cancer?
Title: Regional Variation in Bladder Cancer Clinical Trial Availability in the US
Authors: Koral U. Shah, Salvador Jaime-Casas, Ruchi Agarwal, George Zhang, Xiaochen Li, Vitor Abreu de Goes, Daniela V. Castro, Benjamin Mercier, Ruth Simon, Samuel Dickter, Lily M. Lau, Jaya Goud, Akasha Dukkipati, Jadon Fann, Lauren Lau, Joshua Lee, Kyra Shah, Ethan Swarat, Miguel Zugman, Nazli Dizman, Ali Moradi, Regina Barragan-Carrillo, Abhishek Tripathi, Charles B. Nguyen, Alex Chehrazi-Raffle, Sumanta K. Pal
436 trials / 3,145 US counties. 77.3% of counties had NO bladder cancer trial site.
And the geographic mismatch is striking:
- Higher BladderCancer incidence → more trials IRR 1.03 (95% CI 1.00–1.06)
- Higher bladder cancer mortality → fewer trials IRR 0.80 (95% CI 0.73–0.88)
Counties with the lowest social vulnerability had 2.53× the trial rate of the most socially vulnerable counties. Only 3.2% of 7,091 trial sites were located in counties within the highest bladder cancer mortality quintile.
Another striking finding: Industry-sponsored trials were substantially less likely than academic trials to be located in high-mortality counties:
OR 0.11 (95% CI 0.04–0.29; P<.001)
Clinical innovation matters only if patients can access it.
Clinical takeaway: Trial geography should better reflect disease burden and social vulnerability. Expanding research through community oncology networks may be a practical pathway toward more equitable access.
If this mismatch exists in one of the world’s most research-intensive health systems, where are our trials – and where are our patients – globally?”
Petros Grivas: New Research Highlights Gaps in Cancer Clinical Trial Availability
