Improving Clinical Trial Diversity by Building Trust: Melanie Sheen, MD

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Clinical trial enrollment has nearly doubled in the past 2 decades, yet nearly half of the US population doesn’t know anything about clinical trials. But at Ochsner MD Anderson Cancer Centers, community partnerships and awareness have diversified the clinical trial patient population and increased enrollment.1,2

At an Institute for Value-Based Medicine® event in New Orleans, Louisiana, on November 4, hematology and oncology specialists from Ochsner MD Anderson described their institution's success in recruitment and addressed pivotal issues in equity and access. Ochsner has multiple locations throughout the state of Louisiana, which contribute heavily to their patient population and clinical trial enrollment. African Americans make up almost 30% of the patients enrolled in their clinical trials, said Melanie Sheen, MD, panelist and hematology and oncology specialist who caters to patients with breast cancer at MD Anderson.

“We are one of the leaders in enrolling diverse patient populations in the region,” she said.

However, barriers to access are still persistent among the community, she explained. Common barriers to enrollment are often based on fear related to potential adverse effects, costs, logistical barriers, or lack of transportation. Furthermore, many of these barriers disproportionately impact patients with a low socioeconomic status, who are older, and of a minority racial or ethnic group.2

Aside from barriers like transportation, finding childcare, or other social determinants of health, Sheen says the biggest barrier is not having a solid patient-physician relationship. More than 50% of people surveyed by the National Cancer Institute said that the first source they would reach out to for information on clinical trials is their health care provider.2

“We have been very successful in treating our patients with autonomy, with respect, and really gaining that trust across the board in our entire department,” Sheen said. “Over time, the more trust we build with our patients, the more enrollment in clinical trials and diverse enrollment in clinical trials will improve.”

Additionally, partnering with organizations and rural centers within the community has also been advantageous to Ochsner’s goal to provide access to advanced cancer treatments to Louisiana. Through technological advancements and consistent partnership with community centers, awareness of cancer treatments for patients improves, Sheen said.

“Partnership and community among physicians allow for partnership and community for the patients so that patients have access to that knowledge,” Sheen said.

She also emphasized the burden this alleviates from community physicians, specifically those practicing in rural areas, who may be overwhelmed catering to patients with a vast variation of cancers. Community engagement and partnerships have also allowed providers to share preventive health care information with patients. Sheen said these partnerships have allowed them to discuss common health risks, family medical history, and when they should get screenings, all of which improve early detection.

Technology has also helped bridge the gap between academic and community centers to improve access to newer, reputable treatments. The emphasis on community engagement, combined with a diverse demographic, has helped Ochsner center its care around the patients who need it the most, yet there is still work to be done nationally.

References

1. Unger JM, Xiao H, Vaidya R, LeBlanc M. Patient enrollment to industry-sponsored versus federally sponsored cancer clinical trials. J Clin Oncol. 2024;(42):3917-3925. doi:10.1200/JCO.24.00843

2. Clinical trial participation among US adults. National Cancer Institute HINTS brief 48. June 2022. Accessed November 13, 2025. https://hints.cancer.gov/docs/Briefs/HINTS_Brief_48.pdf