The Importance of Inclusive Clinical Trials — in conversation with John Stewart

Today we are in conversation with Dr. John H. Stewart, IV, MD, MBA, an advanced researcher, strategist, and clinician. He is the founding director of the Louisiana State university — Louisiana Children’s Medical Cancer Center. He is a strong believer in equal access to value-based healthcare that prioritize the patient and his/her medical needs above all else. Under his leadership, Dr. Stewart sets the overall mission, vision and direction for multidisciplinary cancer care and cancer clinical research programs for LSU Health New Orleans and LCMC Health.

John, in your 2-decade long experience as a progressive leader in healthcare, you have attributed part of your inspiration to various forms of clinical investigations, especially advocating for equal access to them for people from all backgrounds. What are some of the reasons why you are passionate about inclusive clinical trials?

“Clinical trials are important because they allow us to improve care for patients with cancer. Unfortunately, not all patients have equal access to the clinical trials and they’re therefore potentially cut out of the opportunity to access this higher level of care. I think that having clinical trials that are inclusive of all populations that are affected by cancer are important so that we can understand how those treatments impact each segment of the population of study.”

“I think that there are two ways in which we should approach this. First, we need to design clinical trials that are more inclusive populations. When I say design clinical trials, we have to evaluate the points of delivery of care, and we have to evaluate potential exclusion criteria for those trials to see if those exclusion criteria are actually artifacts of previous thoughts around cancer in a patient’s suitability for trials.”

“Secondly, I think that we need to have a fair amount of education in the community around clinical trials. Our interaction with patients should not be around enrolling them in a clinical trial. I think our first interaction with patients should be around health issues that are pertinent to them. For instance, during my previous experience at the University of Illinois, Chicago, the cancer center was very keen on addressing issues such as maternal mortality trauma and food insecurity in the neighborhoods that surrounded the medical school or the medical center. After having genuine efforts to support care around those issues, we began to have discussions around clinical trial participation.”

“I think that towards the end of my tenure at the state university in Chicago, we were beginning to create a community to bench top model and we were actually able to get input from the community to design clinical trials and studies that affected the community. I think that is a much more significant approach to cancer because again it has an impact.”

Thank you for sharing, John.

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