Hematologist Arushi Khurana, M.B.B.S., is a clinical investigator in the field of lymphoma and cellular therapy. Her main research interests include designing interventions to increase clinical trial enrollment, especially for groups historically underrepresented in trials. These underrepresented participants often include members of ethnic minority groups, people who have multiple conditions, called comorbidities, older adults and people who have had solid organ transplants. Dr. Khurana has identified how eligibility criteria disproportionately exclude members of minority groups. She has also found ways to modify these criteria related to laboratory tests to increase trial accrual.
Dr. Khurana also has a keen interest in the development of lymphoma related to immunosuppression from post-transplant medicines and autoimmune diseases. Dr. Khurana received a grant to fund research to identify how lymphoma develops in these settings and create new and safer medicines to treat this condition.
- Diffuse large B-cell lymphoma (DLBCL). Dr. Khurana is evaluating the impact of lab-based eligibility criteria by race and ethnicity in frontline clinical trials for diffuse large B-cell lymphoma, a common type of non-Hodgkin's lymphoma. This research focuses on identifying specific criteria and how they impact trial exclusion in underrepresented groups.
- Rituximab and steroid optimization in DLBCL. This intervention is designed specifically for patients who have been excluded from frontline clinical trials because of organ function problems related to high-risk lymphoma. This is a phase 2 trial under development.
- Lymphoma treatment targets. In this work, Dr. Khurana is identifying diffuse large B-cell lymphoma associated with pathogenic mechanisms of immune suppression and differentiating it from immunocompetent de novo DLBCL. This research focuses on identifying new targets to treat lymphoma in people with immune suppression.
Significance to patient care
Eligibility criteria in frontline clinical trials exclude up to 53% of people newly diagnosed with diffuse large B-cell lymphoma. The number of eligibility criteria in large phase 3 trials for DLBCL also has increased over time. The impact of this exclusion is disproportionately felt in underrepresented minority groups and people with comorbidities.
Patients with DLBCL who are treated outside of a clinical trial are generally older and frailer and have more comorbidities, resulting in increased chemotherapy toxicity, dose reductions or treatment delays. This makes it difficult to generalize the results of clinical trials to real-world populations. It also makes it harder to assess how well patients tolerate newer and more effective treatments. Dr. Khurana hopes her research helps modernize eligibility criteria to allow more participation in clinical trials by people in underrepresented groups, allowing them to benefit from scientific advances.
- Robert A. Winn Diversity in Clinical Trials Career Development Award (Winn CDA), Bristol Myers Squibb Foundation, 2022-2024.
- Career Enhancement Program award, University of Iowa/Mayo Clinic Lymphoma SPORE, 2021-2023.
- Clinical Research LRF Scholar, Lymphoma Scientific Research Mentoring Program, Lymphoma Research Foundation, 2021-2023.