Clinical Cancer Research in Vulnerable Populations

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About this Research Topic

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Background

The underrepresentation of the majority of cancer patients in clinical trials represents a major drawback. Patients included in clinical trials are not always representative of the target population. Indeed, the generalizability of translation of trial results is usually hampered by the strict inclusion criteria of the clinical trials. There are many populations that are underrepresented in a cancer patient population. These populations are listed under below;

-Older patients / geriatrics / Children / minors / Adolescents and young adults / Pregnant patients
-Migrant populations / Ethnic minorities / Geographic (rural) isolation / Indigenous people
- LGBTQ+ patients
- Detainees / Prisoners
- Veterans
- Dementia sufferers / Cognitively impaired / Psychiatric comorbidities / Psychosocial vulnerabilities / Psychiatric patients
- Organ dysfunction sufferers (chronic renal impairment, hepatic impairment, kidney failure, hemodialysis, liver failure) / Solid organ transplant recipients
- Patients with auto-immune disease
- Patients with chronic viral infections (HIV, HBV, viral hepatitis, etc.)
- Socioeconomically deprived / Patients with poor performance status / Socially disadvantaged populations / Social isolation / Remote isolation
- Physically handicapped patients / Obesity patients / Cachexia sufferers
- People with limited health literacy
- Addictions / Drug/substance abusers

Those considered as vulnerable subjects require adequate and often more specialized care. The challenges that vulnerable patient populations bring along contribute to transformation in cancer care. Holistic care implies striving towards physical, psychological, social, and spiritual wellbeing for all cancer patients.

The extrapolation of clinical trial results to a real life population involves the risk of exposing many patients to strategies that have never proven to be effective in the respective subpopulations. In addition, the toxicity may be substantially higher in these vulnerable populations. Cost utility analysis results and health technology assessments (HTH) may in fact be not applicable to the vulnerable populations which constitute the majority of cancer patients. Moreover, inadequate treatments may pose a logistic and financial risk to the health systems.

This themed issue welcomes quantitative and qualitative research, both original, and systematic/pragmatic reviews. We're interested in all aspects of cancer research: prevention, therapeutics (phase I - IV), supportive and palliative care. We're also interested in subgroup analyses in vulnerable populations. Furthermore, we also welcome papers that study new methodologies to identify vulnerable patients or dedicated to cancer research in vulnerable populations or to health disparities. Papers dealing with cost-utility analyses or health economic assessments with focus on one or more subpopulations included in the keywords are also welcomed.

Important Note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.

Keywords: trial inclusion, vulnerable patients, health disparities, geriatric, migrant, minorities, LGBTQ+, children, minors, Organ dysfunctions, organ transplant recipients, auto-immune disease, chronic viral infections, Socioeconomic deprivation

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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