The Consortium on Disparities of Urologic Conditions (ConDUC): Addressing Disparities in Urologic Conditions and Clinical Trials for African Americans - Curtis A. Pettaway & Walter Rayford
May 28, 2023
In this conversation, Samuel Washington speaks with Walter Rayford and Curtis Pettaway about the Consortium on Disparities of Urologic Conditions (ConDUC). ConDUC was established in 2017 to address the need for increased African American participation in clinical trials and prostate cancer registries. The structure of ConDUC involves an executive team, a scientific review committee, and an external advisory board. Their focus is on developing a prospective registry called the SCOPE registry, which aims to enroll a large number of African American patients and collect data on social determinants of health, clinical information, pathology, and molecular profiling. The ultimate goal is to reduce disparities in urologic conditions and serve as a resource for pharmaceutical companies and sponsored organizations seeking to increase African American participation in clinical trials. ConDUC also aims to expand its efforts to other urologic conditions and serve as a model for addressing disparities in other chronic diseases. The conversation emphasizes the importance of partnerships and community engagement in achieving these goals and creating opportunities for young scientists to study and contribute to this important work.
Biographies:
Walter Rayford, PhD, MD, MBA, Urologic Oncologist, The Urology Group, Memphis, TN
Curtis A. Pettaway, MD, Urologist, MD Anderson Cancer Center, Houston, TX
Samuel L Washington III, MD, MAS, Assistant Professor of Urology, Goldberg-Benioff Endowed Professorship in Cancer Biology, University of California San Francisco, San Francisco, Ca
Biographies:
Walter Rayford, PhD, MD, MBA, Urologic Oncologist, The Urology Group, Memphis, TN
Curtis A. Pettaway, MD, Urologist, MD Anderson Cancer Center, Houston, TX
Samuel L Washington III, MD, MAS, Assistant Professor of Urology, Goldberg-Benioff Endowed Professorship in Cancer Biology, University of California San Francisco, San Francisco, Ca
Related Content:
The Role of Community Partnerships in Advancing Our Understanding of Prostate Cancer Disparities and Improving Patient Outcomes - Samuel Washington & Yaw Nyame
AUA 2023: Racial Disparities in Future Development of Lethal Prostate Cancer Based on PSA Levels in Midlife
Disparities in Genitourinary Cancers Incidence and Mortality in the United States - Expert Commentary
The Role of Community Partnerships in Advancing Our Understanding of Prostate Cancer Disparities and Improving Patient Outcomes - Samuel Washington & Yaw Nyame
AUA 2023: Racial Disparities in Future Development of Lethal Prostate Cancer Based on PSA Levels in Midlife
Disparities in Genitourinary Cancers Incidence and Mortality in the United States - Expert Commentary
Read the Full Video Transcript
Samuel Washington: Hi, everyone, Dr. Samuel Washington with UroToday. Today I'm glad to have two leaders within ConDUC, which we'll discuss today. Dr. Walter Rayford, CEO and Dr. Curtis Pettaway, chief scientific officer. Thank you for taking the time to discuss what ConDUC is, how it came to be, and where it's headed. To start, could we just describe or just tell our audience what ConDUC is?
Walter Rayford: ConDUC is an acronym for Consortium on Disparities of Urologic Conditions. We started somewhere around 2017 with a recognition of the need to increase African American participation in clinical trials as well as in prostate cancer registries. So a group of us who had been friends for a number of years got together and started the organization.
Curtis Pettaway: One of the things, just to embellish that a little bit, is that we would come to meetings like the AUA or the Society of Urologic Oncology, and we would notice that many presentations about large populations, what have you, had very few African American men and women. So over time, we got tired of having, seeing that same observation. So the thoughts were, "Okay, how could we spur the development of a prospective registry that would accrue large numbers of African American patients who have disparities in many different types of chronic diseases, specifically cancer, of course, and develop the kind of high level evidence that would lead to potentially reductions in mortality or desperate outcomes?" So that's what our charge is really.
Samuel Washington: It's exciting. There's been a lot of discussion recently around clinical trial participation and a lot of energy and interest in increasing participation clinical trials for African American men, but structured approaches to that have been less common, I would say. Can you describe a little bit about the structure in the format of ConDUC?
Walter Rayford: Right now we have an executive team, and there are seven of us on executive team. The executive team consists of urologists who are in private practice, who are in academia as well as in healthcare executives. We think that brings a nice diverse approach to the effort in which we are trying to accomplish. In addition to the executive team, we have a scientific review committee, and Curtis, as you mentioned, is the chief scientific officer, and he heads that division. We have an external advisory board that is designed to help provide insight into the direction which we're going.
Curtis Pettaway: When I look at it, when we got together, this is obviously a very huge question. We have a passion about many different things amongst our groups, but what we decided to do was to look at where that low lying fruit was first. So we decided to target prostate cancer first. So with that, we have developed a prospective registry. We're using a very well known company that has a track record in developing this kind of resource before, and we've worked with them to develop this registry, which we've called the SCOPE registry. So our initial challenge was to develop the registry to develop the instrument to test it. We've done all that now and we've actually launched our first two pilot sites. So we're really happy about that, and Walter actually has one of the first pilot sites, so.
Walter Rayford: Right, the SCOPE registry, Scientific Consortium on Prostate Cancer Education. As Curtis say, we launched a couple of months ago with our site here in Memphis, and our goal is to be the largest registry of African American patients in existence. To be able to do that, we are interested in identifying clinical practices regardless of private academia or government-related, that have access to a large number of African American patients. We've identified right now about at least 20 sites that have such patient populations, and we have two sites that are actively enrolling patients onto the registry.
We are working with three additional sites in getting them onboarded to be able to enroll patients. Then once we have those onboarded, then we'll reach out to the larger audience to enroll patients. We feel confident that within a few years we'll have a very large number of African American patients, primarily it's not exclusive, but primarily African American patients, into the registry. This registry will be a little different than most other registries because most other registries have a very small African American participation. One of the things that these registries have tried to do is try to generalize their findings across the entire population, and you just can't do that. So hopefully our registry will fill that gap.
Curtis Pettaway: Yeah. One of the things that we realize that is a key factor that will differentiate this cohort will be that we're collecting data on social determinants of health as well, and we know how that impacts so many things. It's huge. So to be able to have that kind of data along with clinical data, pathologic data, to be able to have data on molecular profiling, to be able to marry that to tissue will be such a powerful thing going forward. So we want to be really the catalyst for a team science approach. Because the question is who's going to lead it, and that's the thing. So we want to step in and fill that void, but we're inviting everyone to the effort because it's a huge question. There are many questions.
Walter Rayford: In addition to that, this network of healthcare providers, this will serve as a nice consortium such that when pharmaceutical companies or other sponsored agents for clinical trials, they will see us as a resource for African American patients so that we can increase the percentage of African American patients onto these clinical trials.
Curtis Pettaway: Absolutely.
Walter Rayford: We will already have a collective body, which they can do that.
Curtis Pettaway: Yeah.
Samuel Washington: That's so exciting in this context. There are many groups trying to increase participation on clinical trials from an academic center where we know the populations in which they reach different than the communities around them, different than where we see a lot of African American men being seen. So structuring ConDUC in a way that you have, the different levels on the provider healthcare system side, but also integrated with the community side, biology side, all the stakeholders if you will, in the different domains in a multi-level fashion is exciting.
Curtis Pettaway: Yeah, yeah, absolutely. I think that you hit on a really important point, and that's why we've increased the participation of our community members, even on our external advisory board as well. So I think that's so important.
Walter Rayford: That's where many of the patients are. The patients are in the community. One of the challenges of many pharmaceutical companies, is if they targeted the academic centers, it's not that there's a problem with that, but oftentimes the patients are in the community. If you can increase the infrastructure of those community physicians, I think you certainly can increase the number of African American patients onto these clinical trials, which I would suggest that may be cheaper to do so.
Curtis Pettaway: Yeah. Yeah, and from a standpoint of view of the way we've approached this, we've approached this as a very kind of an inductive kind of thing. We have certainly invited the participation of so many different organizations to get so many thoughts about how we might move forward. In 2021, we had our first scientific retreat and it was really amazing. We've got a formal partnership now with Clark Atlanta University, historically Black college. That's where our offices are actually located. Last year, in our second annual symposium, we had representation from the National Cancer Institute and the American Cancer Society. So we're really... How should we say it, using large brush strokes to bring in partners to partner with us in this effort.
Walter Rayford: And that's key. If we are going to be successful, we have to have partners in this effort because unlike other registries in the past where they've had a single partner, it's a little bit more challenging in today's time.
Samuel Washington: Leveraging the breadth of partnerships that you have now, big picture, where would you see ConDUC ideally positioned in the next five years?
Walter Rayford: I'd like to say we at that point would be one of the premier resources of prostate cancer information specifically for African American patients. Secondly, a large consortium in which pharmaceutical companies, government, and other sponsored organizations will look to us to increase African American participation for prostate cancer. But hopefully by that time we will extend our tentacles to other urologic conditions, and then we'll also use that hopefully as a model for other chronic conditions in which African Americans are disproportionately impacted.
Curtis Pettaway: Speaking of one who's in academics, I recognize the challenges that young Black professionals, underserved minorities in academics, may face in this situation. That's why when we looked at structuring our external advisory board and our scientific committee, we really want this to be a very win-win situation because there are a lot of young scientists out there who want to study these issues, and this will be a perfect opportunity for them to do these kinds of studies once we've built this repository, once we have this kind of data. We invite them to be involved in this as well, because again, the more minds we have targeted to this important issue, these important issues, the better off we'll all be. It'll be a win-win situation.
Walter Rayford: Absolutely. And I say win-win. I'd just like to add one more win to win-win-win for the patients as well.
Curtis Pettaway: There you go.
Samuel Washington: Yeah.
Walter Rayford: Absolutely.
Samuel Washington: Yeah.
Curtis Pettaway: Mm-hmm.
Samuel Washington: It's exciting.
Walter Rayford: Yeah, we're excited about it.
Curtis Pettaway: Yeah, we're excited.
Samuel Washington: Yeah. Thank you so much for taking the time. I know you guys are incredibly busy. Again, thank you again.
Walter Rayford: Thank you for the invitation. Allowing us to talk with y'all about ConDUC.
Samuel Washington: Hi, everyone, Dr. Samuel Washington with UroToday. Today I'm glad to have two leaders within ConDUC, which we'll discuss today. Dr. Walter Rayford, CEO and Dr. Curtis Pettaway, chief scientific officer. Thank you for taking the time to discuss what ConDUC is, how it came to be, and where it's headed. To start, could we just describe or just tell our audience what ConDUC is?
Walter Rayford: ConDUC is an acronym for Consortium on Disparities of Urologic Conditions. We started somewhere around 2017 with a recognition of the need to increase African American participation in clinical trials as well as in prostate cancer registries. So a group of us who had been friends for a number of years got together and started the organization.
Curtis Pettaway: One of the things, just to embellish that a little bit, is that we would come to meetings like the AUA or the Society of Urologic Oncology, and we would notice that many presentations about large populations, what have you, had very few African American men and women. So over time, we got tired of having, seeing that same observation. So the thoughts were, "Okay, how could we spur the development of a prospective registry that would accrue large numbers of African American patients who have disparities in many different types of chronic diseases, specifically cancer, of course, and develop the kind of high level evidence that would lead to potentially reductions in mortality or desperate outcomes?" So that's what our charge is really.
Samuel Washington: It's exciting. There's been a lot of discussion recently around clinical trial participation and a lot of energy and interest in increasing participation clinical trials for African American men, but structured approaches to that have been less common, I would say. Can you describe a little bit about the structure in the format of ConDUC?
Walter Rayford: Right now we have an executive team, and there are seven of us on executive team. The executive team consists of urologists who are in private practice, who are in academia as well as in healthcare executives. We think that brings a nice diverse approach to the effort in which we are trying to accomplish. In addition to the executive team, we have a scientific review committee, and Curtis, as you mentioned, is the chief scientific officer, and he heads that division. We have an external advisory board that is designed to help provide insight into the direction which we're going.
Curtis Pettaway: When I look at it, when we got together, this is obviously a very huge question. We have a passion about many different things amongst our groups, but what we decided to do was to look at where that low lying fruit was first. So we decided to target prostate cancer first. So with that, we have developed a prospective registry. We're using a very well known company that has a track record in developing this kind of resource before, and we've worked with them to develop this registry, which we've called the SCOPE registry. So our initial challenge was to develop the registry to develop the instrument to test it. We've done all that now and we've actually launched our first two pilot sites. So we're really happy about that, and Walter actually has one of the first pilot sites, so.
Walter Rayford: Right, the SCOPE registry, Scientific Consortium on Prostate Cancer Education. As Curtis say, we launched a couple of months ago with our site here in Memphis, and our goal is to be the largest registry of African American patients in existence. To be able to do that, we are interested in identifying clinical practices regardless of private academia or government-related, that have access to a large number of African American patients. We've identified right now about at least 20 sites that have such patient populations, and we have two sites that are actively enrolling patients onto the registry.
We are working with three additional sites in getting them onboarded to be able to enroll patients. Then once we have those onboarded, then we'll reach out to the larger audience to enroll patients. We feel confident that within a few years we'll have a very large number of African American patients, primarily it's not exclusive, but primarily African American patients, into the registry. This registry will be a little different than most other registries because most other registries have a very small African American participation. One of the things that these registries have tried to do is try to generalize their findings across the entire population, and you just can't do that. So hopefully our registry will fill that gap.
Curtis Pettaway: Yeah. One of the things that we realize that is a key factor that will differentiate this cohort will be that we're collecting data on social determinants of health as well, and we know how that impacts so many things. It's huge. So to be able to have that kind of data along with clinical data, pathologic data, to be able to have data on molecular profiling, to be able to marry that to tissue will be such a powerful thing going forward. So we want to be really the catalyst for a team science approach. Because the question is who's going to lead it, and that's the thing. So we want to step in and fill that void, but we're inviting everyone to the effort because it's a huge question. There are many questions.
Walter Rayford: In addition to that, this network of healthcare providers, this will serve as a nice consortium such that when pharmaceutical companies or other sponsored agents for clinical trials, they will see us as a resource for African American patients so that we can increase the percentage of African American patients onto these clinical trials.
Curtis Pettaway: Absolutely.
Walter Rayford: We will already have a collective body, which they can do that.
Curtis Pettaway: Yeah.
Samuel Washington: That's so exciting in this context. There are many groups trying to increase participation on clinical trials from an academic center where we know the populations in which they reach different than the communities around them, different than where we see a lot of African American men being seen. So structuring ConDUC in a way that you have, the different levels on the provider healthcare system side, but also integrated with the community side, biology side, all the stakeholders if you will, in the different domains in a multi-level fashion is exciting.
Curtis Pettaway: Yeah, yeah, absolutely. I think that you hit on a really important point, and that's why we've increased the participation of our community members, even on our external advisory board as well. So I think that's so important.
Walter Rayford: That's where many of the patients are. The patients are in the community. One of the challenges of many pharmaceutical companies, is if they targeted the academic centers, it's not that there's a problem with that, but oftentimes the patients are in the community. If you can increase the infrastructure of those community physicians, I think you certainly can increase the number of African American patients onto these clinical trials, which I would suggest that may be cheaper to do so.
Curtis Pettaway: Yeah. Yeah, and from a standpoint of view of the way we've approached this, we've approached this as a very kind of an inductive kind of thing. We have certainly invited the participation of so many different organizations to get so many thoughts about how we might move forward. In 2021, we had our first scientific retreat and it was really amazing. We've got a formal partnership now with Clark Atlanta University, historically Black college. That's where our offices are actually located. Last year, in our second annual symposium, we had representation from the National Cancer Institute and the American Cancer Society. So we're really... How should we say it, using large brush strokes to bring in partners to partner with us in this effort.
Walter Rayford: And that's key. If we are going to be successful, we have to have partners in this effort because unlike other registries in the past where they've had a single partner, it's a little bit more challenging in today's time.
Samuel Washington: Leveraging the breadth of partnerships that you have now, big picture, where would you see ConDUC ideally positioned in the next five years?
Walter Rayford: I'd like to say we at that point would be one of the premier resources of prostate cancer information specifically for African American patients. Secondly, a large consortium in which pharmaceutical companies, government, and other sponsored organizations will look to us to increase African American participation for prostate cancer. But hopefully by that time we will extend our tentacles to other urologic conditions, and then we'll also use that hopefully as a model for other chronic conditions in which African Americans are disproportionately impacted.
Curtis Pettaway: Speaking of one who's in academics, I recognize the challenges that young Black professionals, underserved minorities in academics, may face in this situation. That's why when we looked at structuring our external advisory board and our scientific committee, we really want this to be a very win-win situation because there are a lot of young scientists out there who want to study these issues, and this will be a perfect opportunity for them to do these kinds of studies once we've built this repository, once we have this kind of data. We invite them to be involved in this as well, because again, the more minds we have targeted to this important issue, these important issues, the better off we'll all be. It'll be a win-win situation.
Walter Rayford: Absolutely. And I say win-win. I'd just like to add one more win to win-win-win for the patients as well.
Curtis Pettaway: There you go.
Samuel Washington: Yeah.
Walter Rayford: Absolutely.
Samuel Washington: Yeah.
Curtis Pettaway: Mm-hmm.
Samuel Washington: It's exciting.
Walter Rayford: Yeah, we're excited about it.
Curtis Pettaway: Yeah, we're excited.
Samuel Washington: Yeah. Thank you so much for taking the time. I know you guys are incredibly busy. Again, thank you again.
Walter Rayford: Thank you for the invitation. Allowing us to talk with y'all about ConDUC.