The Bona Lab at Dana-Farber Cancer Institute studies outcome disparities in childhood cancer with a focus on improving childhood cancer outcomes by systematically considering social determinants of health as risk factors in the clinical trial setting and potential targets for intervention.
One in five children diagnosed with cancer in the United States lives in poverty, and we have demonstrated that poverty is associated with higher rates of relapse, decreased overall survival, and higher symptom burden even when children are treated on clinical trials at large academic medical centers. Poverty-associated outcome disparities in this context highlight the stubborn reality that increased understanding of tumor and host biology and the development of rational therapeutics may be necessary, but not sufficient, to achieve the cures we desire. Our research is based on the premise that transformative improvements in outcome are most likely to be achieved if we expand our conceptual model of discovery and intervention beyond biology to include social determinants of health outcomes at every stage in pediatric cancer research.