Miami Cancer Institute Leads Initiatives to Reduce Health Disparities in Cancer Care

Black men have a 70 percent higher incidence of prostate cancer than white men and are twice as likely to die from the disease. Global disparities exist in cancer and there is a lack of minority enrollment in clinical trials. In spite of making up one-third of the U.S. population, just 6 percent to 7 percent of participants in oncology clinical drug trials are Hispanic or Black.

The worrisome statistics on health inequities continue to roll in. It’s a problem so troubling that the White House has made it a focus in President Biden’s moon-shot program. Manmeet Ahluwalia, M.D., MBA, FASCO and researchers at Miami Cancer Institute, a part of Baptist Health, are taking action by leading international, national and local efforts to solve the dilemma.

While the COVID-19 pandemic exacerbated racial and ethnic health disparities, for Manmeet Ahluwalia awareness began years ago. “I was a 12-year-old boy in India when I lost my grandmother, who was my caregiver, to cervical cancer,” he said. “Her journey exemplifies the journey of minority women everywhere.”

Manmeet Ahluwalia, M.D., deputy director, chief scientific officer and chief of solid tumor medical oncology at Baptist Health Miami Cancer Institute.

 

Today, Dr. Ahluwalia is a world authority on brain cancer and is spearheading research initiatives in South Florida that broaden access to clinical trials and reduce disparities in cancer care. He is also the Fernandez Family Foundation Endowed Chair in Cancer Research, chief of medical oncology, chief scientific officer and deputy director of Miami Cancer Institute and Baptist Health Cancer Care. Recently, he shared his story with other healthcare professionals at the Inaugural Baptist Health Academic Conference: Forging Paths to Achieve Health Equity.

“Studies looking at thousands of clinical trials have shown that fewer than half even reported ethnicity,” Dr. Ahluwalia said. “We talk about precision medicine and designer drugs, but if we don’t even know who is in these trials, we aren’t getting representative data.”

The study by Brigham and Women’s Hospital researchers also showed that when data was reported, minorities were vastly underrepresented. Having inclusive studies is important, because people with the same disease respond differently to treatment and can have far different outcomes based on ethnicity and race, age, gender and other factors.

The problem is a global one, Dr. Ahluwalia adds, and spans everything from screening and diagnosis to treatment and clinical trials. Even when cancer is diagnosed at the same stage, minorities have worse outcomes. “We must do better,” he said. “How can we work together to bridge this gap and promote better cancer care for the global community?”

It is a question that has driven Miami Cancer Institute to establish the Center for Equity in Cancer Care & Research, founded by executive sponsor Leonard Kalman, M.D., Executive Deputy Director and Chief Medical Officer at Miami Cancer Institute, and led by Dr. Ahluwalia. To identify and decrease disparities in cancer care and to improve minority participation in clinical trials, the Institute is involved in a number of initiatives with groups such as the American Society of Clinical Oncology, American Cancer Society and the SWOG Cancer Research Network.

Miami Cancer Institute is also the coordinating site for 35 top cancer programs in the world that are part of the International Radiosurgery Research Foundation. The organization works collaboratively on clinical trials and outcomes research in the area of stereotactic brain surgery, where radiation therapy is given when traditional surgery isn’t possible.

Funding from the National Institutes of Health and other federal agencies has also been awarded to the Institute for a variety of studies. Dr. Ahluwalia and a colleague from a renowned university, for example, received a $3.9 million award to continue their study developing sex-specific image-based recurrence classifiers (differentiating between radiation related change versus tumor recurrence that they have developed for use in glioblastoma patients).

Baptist Health recognizes that in order to reduce health disparities, the problem must be addressed from a multitude of angles, Dr. Ahluwalia said. There must be help with transportation for patients who have difficulty getting to facilities, more educational materials in multiple languages and additional multilingual staff, alternative payment systems and improved outreach into communities using existing faith-based organizations to gain the trust and understanding of area residents. Cultural awareness is also important.

He is confident that progress will be made, particularly because of gains recorded in recent years by a Baptist Health campaign to promote lung cancer screenings. In a partnership with the American Lung Association, Baptist Health began its “Saved by the Scan” campaign in 2021. A low-dose CT scan can detect lung cancer in its earliest stages, before symptoms arise. The campaign resulted in a 62% increase in screenings.

“I am very proud of all of my colleagues who are committed to inclusivity to drive better care,” Dr. Ahluwalia said. In addition to other Baptist Health experts, the educational program included Garth Graham, M.D., MPH, the director and global head of Healthcare and Public Health for Google/YouTube, and Margarita Alegria, Ph.D., a Harvard professor and chief of the Disparities Research Unit at Massachusetts General Hospital.