{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:20:07Z","timestamp":1784679607664,"version":"3.55.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Racial differences in epithelial ovarian cancer (EOC) might result in survival inequities.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate enrollment and outcomes by race in Gynecologic Oncology Group (GOG) randomized clinical trials (RCTs) among patients with EOC.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used ancillary data from completed RCTs using protocols GOG-111, GOG-114, GOG-158, and GOG-172 under a data sharing agreement with National Research Group Oncology. Patients with stage III or IV EOC in first-line RCT protocol GOG-111 had suboptimally resected disease, whereas those in GOG-114, GOG-158, or GOG-172 had optimally resected disease. RCTs were conducted and published between 1996 and 2006, and data for this study were analyzed in August 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Race was categorized as Asian, Black or African American (Black), or White or Caucasian (White). Patients of other races were excluded. Spanish ethnicity and additional details regarding residual disease status were not available for analysis.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Overall survival (OS) was the primary end point and progression-free survival (PFS) was the secondary end point, evaluated using multivariable Cox proportional-hazards modeling and log-rank testing. Statistical significance was set at\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This study included 1903 evaluable participants, of whom 35 (1.84%) self-identified as Asian, 121 (6.36%) as Black, and 1747 (91.80%) as White. Black patients had lower OS (median [IQR], 36.8 [19.2-73.4] months) than Asian (50.9 [23.9-109.2] months) or White (48.4 [24.5-93.4] months) patients (\n P<\/jats:italic>\n \u2009=\u2009.03), with a higher risk of death than White patients (adjusted hazard ratio, 1.30; 95% CI, 1.06-1.59;\n P<\/jats:italic>\n \u2009=\u2009.01). PFS and adjusted risk of disease progression were statistically similar across racial groups. Median (IQR) PFS was 18.9 (9.7-84.6), 18.0 (9.1-34.0), and 19.7 (11.5-43.3) months among Asian, Black, and White patients, respectively (\n P<\/jats:italic>\n \u2009=\u2009.08). Adjusted risk of disease progression was similar for Black patients compared with White patients (adjusted hazard ratio, 1.21; 95% CI, 1.00-1.47;\n P<\/jats:italic>\n \u2009=\u2009.06).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, Black and Asian patients were underrepresented in RCT trial populations. Black patients had lower OS than White and Asian patients but similar PFS. Equitable enrollment in clinical trials ensures access to cutting-edge treatments and can lead to outcomes comparable to those of White counterparts. Sustained efforts to improve RCT diversity remain essential to long-term equity in cancer care and survival.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.38648","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T15:31:22Z","timestamp":1761147082000},"page":"e2538648","source":"Crossref","is-referenced-by-count":1,"title":["Trial Enrollment and Survival Disparities Among Patients With Advanced Epithelial Ovarian Carcinoma"],"prefix":"10.1001","volume":"8","author":[{"given":"Caitlin Ruth","family":"Johnson","sequence":"first","affiliation":[{"name":"Sutter Health, Walnut Creek, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex A.","family":"Francoeur","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandeep","family":"Grewal","sequence":"additional","affiliation":[{"name":"Sutter Health, Walnut Creek, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie L.","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Irvine, Orange"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Kapp","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Darcy","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, Maryland"},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunqiao","family":"Tian","sequence":"additional","affiliation":[{"name":"Gynecologic Cancer Center of Excellence, Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, Maryland"},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Sutter Health, Walnut Creek, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"issue":"2","key":"zoi251070r1","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1513\/pats.200701-009GC","article-title":"Population issues in clinical trials.","volume":"4","author":"Mosenifar","year":"2007","journal-title":"Proc Am Thorac Soc"},{"issue":"7","key":"zoi251070r2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.22515","article-title":"Racial and ethnic inequities in US oncology clinical trial participation from 2017 to 2022.","volume":"6","author":"Pittell","year":"2023","journal-title":"JAMA Netw 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