SC CTSI mentee wins career development award to improve diversity participation in pediatric clinical trials
Mallory Chavannes, MD, MHSc, FRCPC, FAAP, a pediatric gastroenterologist at Children’s Hospital Los Angeles (CHLA), has received the Robert A. Winn Diversity in Clinical Trials: Career Development Award, which aims to increase the diversity of patients enrolled in clinical trials and enhance development of therapeutics for all populations. Chavannes specializes in the digestive system and diseases that affect the gastrointestinal tract, including inflammatory bowel disease (IBD), in patients between six and 17 years old.
“In the IBD literature, clinical trials tend to focus on children of European descent or other Caucasian populations,” said Chavannes, Assistant Professor of Clinical Pediatrics, Keck School of Medicine of USC. “Although about 60% of the children we see in our clinics are from Hispanic or other non-white backgrounds, those populations are not well represented.”
Because of a lack of racial and ethnic participation in trials, researchers may not learn whether treatments could be less effective for some groups.
“This grant will help us develop a framework on how to approach patients and propose the best projects that would ensure that a diverse population enrolls at the start so that we can see more representation within clinical trials and more generalizable results,” Chavannes added.
Serving as her mentor since she was recruited to CHLA, but now at a different institution, Brent Polk, MD, has seen Chavannes through her time as an SC CTSI-funded KL2 scholar to independent academic. Polk is the Martin Brotman Professor and Chief of Pediatric Gastroenterology, Hepatology & Nutrition, Executive Vice Chair of the Department of Pediatrics at Rady Children’s Hospital San Diego at the University of California San Diego. Polk further highlighted how important it is to recognize the challenges traditionally underserved patients face when trying to access specialized care.
“Not all patients have ready access to the pediatric gastroenterologists or systems of care necessary to provide these procedures,” he said. “Working to include patients traditionally underrepresented in biomedical research is an admirable mission of the Winn Clinical Investigator Pathway Program and should inform our understanding of how to best deliver equitable care for our patients.”
Chavannes’ research evaluates non-invasive methods of diagnosing and monitoring IBD activity in children. An important indicator of IBD is swelling of the bowel wall. Pediatric IBD patients are typically diagnosed with colonoscopies weeks after their first clinical appointment and periodically monitored with colonoscopies following treatment to track bowel swelling and other symptoms.
But a pilot study by Chavannes and her colleagues showed that ultrasound imaging in a clinical visit can identify pediatric bowel wall swelling and accurately predict IBD diagnoses by later colonoscopy, potentially quickening the route to early treatment and providing non-invasive monitoring after treatment. The study was published May 2023 in the journal Inflammatory Bowel Diseases.
“We found that the thicker appearance of the bowel wall, the more severe the disease is endoscopically,” she said. "Now we have evidence that we can diagnose IBD bedside at a first appointment and expedite the next steps in diagnosis, instead of having the patient wait perhaps multiple weeks to begin those investigations.”
Chavannes points out that her recent research advances have been made possible because of her participation in the three-year Mentored Career Development in Clinical and Translation Science (KL2) program of the Southern California Clinical and Translational Science Institute (SC CTSI). The KL2 program supports career development of health professionals or individuals with research doctoral degrees who wish to pursue formal training and a career in clinical and translational research.
“Winning this CDA will be instrumental in providing her protected time and tools to further develop her clinical trials expertise,” said Sonia Michail, MD, FAAP, AGAF, Director of Inflammatory Bowel Disease research, Director of the Donnell Society for Pediatric Scholars, Vice Chair of Faculty Development, and Professor of Clinical Pediatrics Keck School of Medicine and Children’s Hospital of Los Angeles. She serves as a faculty mentor to Chavannes. “Her research is cutting edge and will likely change how we care for children with inflammatory bowel disease. Her work will result in a paradigm shift in the care of these children.”
Chavannes views the support of SC CTSI as a gamechanger for her career.
“The SC CTSI staff and the KL2 program have been instrumental in helping me develop a framework for conducting reproducible research,” Chavannes said. “SC CTSI staff have been invaluable in helping me find solutions to every barrier that may come up and building a team. Now I have a team of two clinical research coordinators, one clinical research assistant, and two students working with me. SC CTSI staff especially helped me learn presentation skills that I didn’t have before. I learned how to accurately write and communicate research to other researchers so I could catch their attention rapidly and form new collaborators.”
That’s how Chavannes identified scientists who have joined her to help establish the Intestinal Ultrasound Group of the United States and Canada, which will follow up on her findings from her single-center pilot study.
“We are building a multicenter collaborative project, developing the database and the building blocks that are needed,” she said.