Can We Treat Cancer for a Dollar a Day? Guidelines for Low-Income Countries

Kerr, David J.; Midgley, Rachel

doi:10.1056/nejmp1002812

Cited by 64 publications

(44 citation statements)

References 4 publications

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“…Systematic treatment with tamoxifen is therefore inappropriate for most patients and, in patients with estrogen-independent cancer, could be responsible for harmful side effects such as deep vein thrombosis or osteoporosis with no significant effect on the tumor [36,37]. Treatment options for triple-negative breast cancer are currently limited to cytotoxic chemotherapy, but effective low-cost chemotherapy needs to be developed for low-income countries [38]. Novel targeted therapies for this subset of tumors are also under development [39].…”

Section: Discussionmentioning

confidence: 99%

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

Antoine

Dembélé

et al. 2012

Oncology

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Objective: Few studies have been conducted on breast cancer in Sub-Saharan Africa and their results have been suspected to be impaired by artefacts. This prospective study was designed to determine tumor and patient characteristics in Mali with control of each methodological step. These data are necessary to define breast cancer treatment guidelines in this country. Methods: Clinical and tumor characteristics and known risk factors were obtained in a consecutive series of 114 patients. Each technical step for the determination of tumor characteristics [histology, TNM, grade, estrogen (ER) and progesterone receptors (PR), HER2, and Ki67] was controlled. Results: Patients had a mean age of 46 years. Most tumors were invasive ductal carcinomas (94%), T3-T4 (90%) with positive nodes (91%), grade III (78%), and ER (61%) and PR (72%) negative. HER2 was overexpressed in 18% of cases. The triple-negative subgroup represented 46%, displaying a particularly aggressive pattern (90% grade III; 88% Ki67 >20%). Conclusion: This study demonstrates the high incidence of aggressive triple-negative tumors in Mali. Apart from a higher prevalence of premenopausal women, no significant difference in risk factors was observed between triple-negative tumors and other tumors. The hormonal therapy systematically prescribed therefore needs to be revised in light of this study.

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Section: Discussionmentioning

confidence: 99%

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

Antoine

Dembélé

et al. 2012

Oncology

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“…Cancer can affect anyone; young and old, rich and poor, men, women and children. Globally in 2015, cancer was found to be the cause of 8.8 million deaths, making it the second leading cause of death [3]. In addition to this in 2015, common cancers such as lung cancer, liver and colorectal cancer made up 3.22 million of the total cancer deaths toll [4].…”

Section: Introductionmentioning

confidence: 99%

Inequalities and Barriers to the Use of Health Care among Cancer Patients in the Pacific: A Systematic Review

Mohammadnezhad¹,

Mangum²,

Konrote³

2017

J Community Med Health Educ

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Introduction and aim: According to the WHO, the cancer threat is expected to rise by over 70% within the next two decades. To prevent cancer and reduce the consequences of cancer among patients it is essential to understand the barriers. Due to the close relation between the barriers, and also inequality on one side and lack of previous study among Pacific countries on the other side, this systematic review was conducted to understand inequalities and barriers to the use of health care among cancer patients in the Pacific.

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“…mentandintroductionofahostofnewandhighlyexpensive agentswhichmanydevelopingcountriesareunabletoafford [7]. When the treatment of MBC is considered, the agents introduced in recent years include the cytotoxic agents gemcitabine, ixabelipone and nab-paclitaxel, the targeted agents lapatinib and bevacizumab, and the hormonal drugs exemestaneandletrozole.Thelatterarelessexpensivethan the other drugs on this list where average sale prices are between$3,000and$8,000permonth [8].…”

Section: Disclosure Statementmentioning

confidence: 99%

Efficacy of the CMFVP Regimen in Patients with Metastatic Breast Cancer Previously Treated with Anthracycline and Taxane

Grenader¹

2012

Onkologie

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Background: The aim of this retrospective study was to assess the efficacy and safety of the relatively old lowcost CMFVP regimen (cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, prednisolone) as compared to newer and more costly chemotherapeutic agents. Patients and Methods: An analysis of the medical records of female patients with metastatic breast cancers treated with a CMFVP combination at the Shaare Zedek Medical Center (SZMC) was performed. 32 patients with measurable metastatic disease were included in the analysis. The median age was 59.9 years (range 36–102 years). 20 of the patients had previously been treated with both anthracyclines and taxanes. Results: Therapy was generally well tolerated and toxicity manageable. Median time to disease progression was 20.97 weeks (range 2–103 weeks). 6 patients (19%) demonstrated a partial response, and 7 patients (22%) had stable disease lasting 3 or more months for an overall clinical benefit of 41%. 4 of the 20 patients previously treated with both anthracyclines and taxanes had a partial response, and 4 patients had stable disease lasting 3 or more months for a clinical benefit of 40%. Conclusion: On the basis of this small retrospective survey, we conclude that CMFVP combination chemotherapy is both effective and safe in patients with metastatic breast cancer previously treated with both taxanes and anthracyclines.

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Can We Treat Cancer for a Dollar a Day? Guidelines for Low-Income Countries

Cited by 64 publications

References 4 publications

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

High Incidence of Triple-Negative Tumors in Sub-Saharan Africa: A Prospective Study of Breast Cancer Characteristics and Risk Factors in Malian Women Seen in a Bamako University Hospital

Inequalities and Barriers to the Use of Health Care among Cancer Patients in the Pacific: A Systematic Review

Efficacy of the CMFVP Regimen in Patients with Metastatic Breast Cancer Previously Treated with Anthracycline and Taxane

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