Could African and Low- and Middle-Income Countries Contribute Scientifically to Global Cancer Care? The Answer Is Yes!
نویسنده
چکیده
In my humble opinion, there is a need to develop more clinical trials tailored to the socioeconomic conditions of LMICs. For example, herceptin’s efficacyandsurvivaladvantage in treatingbreastcancer has been proven in well-developed prospective clinical trials. However, only a meager percentage of thepopulationof LMICscanaffordherceptin,which, according to world standards, must be taken for 1 year in an adjuvant setting. However, another study, from a Finnish group, suggests that only 9 weeks of herceptin use shows a disease-free and overall survival advantage (hazard ratios, 0.42 and0.41). Although the studywas not powered to illustrate the difference between the herceptin arms, it presents the possibility for a shorter duration of this costly treatment regimen,whichalmost85%to90% ofpatientswithbreastcancer inLMICscannotafford. Obviously, the cost of 9 weeks of herceptin will be more affordable. Hopefully, the answer will come from the results of the ongoing Synergism or Long Duration(SOLD)study(NCT00593697).Conducting such trials in LMICswill helppoor andneedypatients and will reduce the cost of cancer care in already fragile health care systems.
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