Is Clinical Research Serving the Needs of the Global Cancer Burden? An Analysis of Contemporary Global Radiation Therapy Randomized Controlled Trials

Dodkins, Joanna; Hopman, Wilma M.; Wells, J.C.; Lievens, Yolande; Malik, Rozita Abdul; Pramesh, C S; Gyawali, Bishal; Hammad, Nazik; Mukherji, Deborah; Sullivan, Richard; Parkes, Jeannette; Booth, Christopher M.; Aggarwal, Ajay

doi:10.1016/j.ijrobp.2022.01.053

Cited by 18 publications

(7 citation statements)

References 21 publications

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“…Ten percent (23/225) of published trials compared to 25.4% (17/67) of registered ongoing trials were funded by industry in our analysis. These observed rates of industry funding are comparable to a recent analysis of randomized trials of radiotherapy at 17% and to palliative care trials in general at 21% [30,32]. Cancer trials investigating systemic therapy, however, have shown higher rates of industry funding in recent years at up to 89% [25].…”

Section: Tablesupporting

confidence: 72%

Clinical endpoints in trials of palliative radiotherapy: A systematic meta-research analysis

Fabian

Domschikowski

Letsch

et al. 2022

Radiotherapy and Oncology

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Section: Tablesupporting

confidence: 72%

Clinical endpoints in trials of palliative radiotherapy: A systematic meta-research analysis

Fabian

Domschikowski

Letsch

et al. 2022

Radiotherapy and Oncology

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“…As such, more research is needed to determine if the findings of this study are applicable to a broader global oncology clinical research landscape 21 ,. 48–50 …”

Section: Discussionmentioning

confidence: 99%

“…gov, including perhaps those performed in low-middle income countries or Europe, were also not included in the analysis. As such, more research is needed to determine if the findings of this study are applicable to a broader global clinical research landscape 21,[48][49][50].…”

mentioning

confidence: 99%

Prevalence, trends, and characteristics of trials investigating local therapy in contemporary phase 3 clinical cancer research

Sherry

Corrigan

Kouzy

et al. 2023

Cancer

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BackgroundAlthough most patients with cancer are treated with local therapy (LT), the proportion of late‐phase clinical trials investigating local therapeutic interventions is unknown. The purpose of this study was to determine the proportion, characteristics, and trends of phase 3 cancer clinical trials assessing the therapeutic value of LT over time.MethodsThis was a cross‐sectional analysis of interventional randomized controlled trials in oncology published from 2002 through 2020 and registered on ClinicalTrials.gov. Trends and characteristics of LT trials were compared to all other trials.ResultsOf 1877 trials screened, 794 trials enrolling 584,347 patients met inclusion criteria. A total of 27 trials (3%) included a primary randomization assessing LT compared with 767 trials (97%) investigating systemic therapy or supportive care. Annual increase in the number of LT trials (slope [m] = 0.28; 95% confidence interval [CI], 0.15–0.39; p < .001) was outpaced by the increase of trials testing systemic therapy or supportive care (m = 7.57; 95% CI, 6.03–9.11; p < .001). LT trials were more often sponsored by cooperative groups (22 of 27 [81%] vs. 211 of 767 [28%]; p < .001) and less often sponsored by industry (5 of 27 [19%] vs. 609 of 767 [79%]; p < .001). LT trials were more likely to use overall survival as primary end point compared to other trials (13 of 27 [48%] vs. 199 of 767 [26%]; p = .01).ConclusionsIn contemporary late‐phase oncology research, LT trials are increasingly under‐represented, under‐funded, and evaluate more challenging end points compared to other modalities. These findings strongly argue for greater resource allocation and funding mechanisms for LT clinical trials.Plain language summary Most people who have cancer receive treatments directed at the site of their cancer, such as surgery or radiation. We do not know, however, how many trials test surgery or radiation compared to drug treatments (that go all over the body). We reviewed trials testing the most researched strategies (phase 3) completed between 2002 and 2020. Only 27 trials tested local treatments like surgery or radiation compared to 767 trials testing other treatments. Our study has important implications for funding research and understanding cancer research priorities.

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“…Moreover, the great clinical burden borne by a low number of oncologists serving a large population leaves little time for research, contributing to global disparities in epistemic power. [35][36][37] A greater number of cancer care providers, alongside their equitable distribution, is urgently needed to not only deliver clinical services but also to bolster research endeavors that are responsive to the needs of local communities. The implementation of cancer clinical trials, 38 community-based participatory research, and integrated knowledge translation 39 can only be made possible through cancer care providers who practice in the community.…”

Section: Oncology Training Opportunities In the Philippinesmentioning

confidence: 99%

Geographic Distribution of Cancer Care Providers in the Philippines

Eala

Maslog

Dee

et al. 2022

JCO Global Oncology

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PURPOSE In the Philippines, a lower middle-income country in Southeast Asia, 6 of 10 Filipinos die without seeing a doctor. To ensure universal access to cancer care, providers must be equitably distributed. Therefore, we evaluated the distribution of oncologists across all 17 regions in the Philippines. METHODS We gathered data from the official websites of national medical societies on their members' regional area of practice: Philippine Society of Medical Oncology, Philippine Radiation Oncology Society, Surgical Oncology Society of the Philippines, Society of Gynecologic Oncologists of the Philippines, and Philippine Society of Hospice and Palliative Medicine. We compared this with the regional census to determine the number of board-certified oncologists per 100,000 Filipinos. RESULTS For a population of almost 110 million, the Philippines has a total of 348 medical oncologists, 164 surgical oncologists, 99 radiation oncologists, 142 gynecologic oncologists, and 35 hospice and palliative medicine (HPM) specialists. This translates to 0.32 medical oncologists, 0.15 surgical oncologists, 0.09 radiation oncologists, 0.13 gynecologic oncologists, and 0.03 HPM specialists for every 100,000 Filipinos. The number of oncologists is highest in the National Capital Region in Luzon and lowest in the Bangsamoro Autonomous Region in Muslim Mindanao. All regions have at least one medical and gynecologic oncologist. Two regions (12%) have no surgical oncologists, five regions (29%) have no radiation oncologists, and eight regions (47%) have no HPM specialists. CONCLUSION Efforts are needed to increase the number of oncologists and improve equity in their distribution to ensure universal access to cancer care in the Philippines.

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Is Clinical Research Serving the Needs of the Global Cancer Burden? An Analysis of Contemporary Global Radiation Therapy Randomized Controlled Trials

Cited by 18 publications

References 21 publications

Clinical endpoints in trials of palliative radiotherapy: A systematic meta-research analysis

Clinical endpoints in trials of palliative radiotherapy: A systematic meta-research analysis

Prevalence, trends, and characteristics of trials investigating local therapy in contemporary phase 3 clinical cancer research

Geographic Distribution of Cancer Care Providers in the Philippines

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