Cancer Clinical Trials in the Tropical Area

Abstract

The global distribution of clinical trials is grossly imbalanced to support evaluation of new treatments for prevalent cancers in developed countries with relative lack of research to improve outcome of the most lethal cancers in tropical countries. There are potential benefits in tropical countries from participating in such trials, provided the infrastructure is in place, since patients may receive treatment on trial that is not otherwise available because of cost, pharmaceutical companies benefit from rapid recruitment, and oncologists and their centres may receive financial support. However, the results of such trials can rarely be applied subsequently because the cost of new drugs is high and set by profit-driven considerations in developed countries. There is a great need for trials focussed on types of cancer that are common in tropical countries: International organisations, and the small number of wealthy countries in tropical regions, should support and lobby for infrastructure and resources to allow them to take place. Lessons can be learned from the coordinated response to the HIV epidemic.