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Hotchkiss J, Bula AK, Zimba C, Bingo S, Chinkhata M, Song L, Bryant AL. Evaluating the Knowledge Change Before and After Continuing Cancer Education in Malawian Nurses. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1624-1628. [PMID: 37208558 PMCID: PMC10198782 DOI: 10.1007/s13187-023-02310-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 05/21/2023]
Abstract
Malawi has a high cancer incidence and mortality. Efforts to train and educate oncology nurses have been identified as an area of need. This study evaluates the educational needs of oncology nurses in Malawi and the effects of a virtual cancer education program on improving the knowledge of cancer epidemiology, treatment, and nursing care of common cancers among oncology nurses in Malawi. The educational programs consisted of four sessions at one-month intervals focused on Cancer Screening, Survivorship, Radiation Therapy, and Complementary and Alternative Therapies. A pretest-posttest design was used. Overall, there was an increase in knowledge at each session: cancer screening (47% vs 95%), survivorship (22% vs 100%), radiation therapy (66% vs 100%), and complementary and alternative therapies (63% vs 88%). Using virtual continuing education sessions is an effective tool to enhance the knowledge of oncology nurses in Malawi. These education sessions can serve as an example of how other Schools of Nursing and cancer centers in high-resource countries can collaborate with hospitals and Schools of Nursing in low- and middle-resource countries to support the advancement of oncology nursing knowledge, and ultimately, oncologic care.
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Affiliation(s)
- Jennifer Hotchkiss
- UNC School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Agatha Kapatuka Bula
- UNC School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, USA
- UNC Project Malawi, Lilongwe, Malawi
| | - Chifundo Zimba
- UNC School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Samuel Bingo
- National Cancer Centre, Kamuzu Central Hospital, PO Box 149, Lilongwe, Malawi
| | | | - Lixin Song
- School of Nursing UT Health San Antonio, 7703 Floyd Curl Drive, Mail Code 7947, San Antonio, TX 78229 USA
| | - Ashley Leak Bryant
- UNC School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, USA
- UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA
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2
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Kizub D, Manner CK, Graef K, Abubakar B, Orem J, Odedina F, Adeyeye MC, Nakigudde G, Ayalew K, Kalidas C, Lyerly HK, Norman T, Fashoyin-Aje L, Freedman J, Dent J, Cance B, Gralow J. Action for Increasing Diversity, Market Access, and Capacity in Oncology Registration Trials—Is Africa the Answer? Report From a Satellite Session of the Accelerating Anti-Cancer Agent Development and Validation Workshop. JCO Glob Oncol 2022; 8:e2200117. [PMID: 35714309 PMCID: PMC9232363 DOI: 10.1200/go.22.00117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Patients of African ancestry are not well-represented in cancer clinical trials despite bearing a disproportionate share of mortality both in United States and Africa. We describe key stakeholder perspectives and priorities related to bringing early-stage cancer clinical trials to Africa and outline essential action steps. Increasing Diversity, Market Access, and Capacity in Oncology Registration Trials—Is Africa the Answer? satellite session was organized at 2021 Accelerating Anti-Cancer Agent Development and Validation Workshop. Panelists included representatives of African Organization for Research and Training in Cancer, Uganda Cancer Institute, Uganda Women's Cancer Support Organization, BIO Ventures for Global Health, Bill & Melinda Gates Foundation, the US Food and Drug Administration, Nigeria's National Agency for Food and Drug Administration and Control, Bayer, and Genentech, with moderators from ASCO and American Cancer Society. Key discussion themes and resulting action steps were agreed upon by all participants. Panelists agreed that increasing diversity in cancer clinical trials by including African patients is key to ensuring novel drugs are safe and effective across populations. They underscored the importance of equity in clinical trial access for patients in Africa. Panelists discussed their values related to access and barriers to opening clinical trials in Africa and described innovative solutions from their work aimed at overcoming these obstacles. Multisectoral collaboration efforts that allow leveraging of limited resources and result in sustainable capacity building and mutually beneficial long-term partnerships were discussed as key to outlined action steps. The panel discussion resulted in valuable insights about key stakeholder values and priorities related to bringing early-stage clinical trials to Africa, as well as specific actions for each stakeholder group.
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Affiliation(s)
- Darya Kizub
- University of Texas MD Anderson Research Center, Houston, TX
| | | | - Katy Graef
- BIO Ventures for Global Health, Seattle, WA
| | - Bello Abubakar
- National Hospital, Abuja, Nigeria
- African Organization for Research and Training in Cancer (AORTIC), Rondebosch, South Africa
| | | | - Folakemi Odedina
- African Organization for Research and Training in Cancer (AORTIC), Rondebosch, South Africa
- Mayo Clinic, Rochester, MN
| | | | | | - Kassa Ayalew
- United States Food and Drug Administration, Silver Spring, MD
| | | | | | - Thea Norman
- Bill & Melinda Gates Foundation, Seattle, WA
| | | | | | | | | | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, VA
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3
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Ntekim A, Olopade OI. Innovative Strategies for Developing Biomarker-Informed Cancer Clinical Trials to Accelerate Progress in Precision Oncology in Sub-Saharan Africa. Am Soc Clin Oncol Educ Book 2022; 42:1-9. [PMID: 35687824 DOI: 10.1200/edbk_349955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Well-designed, pragmatic, patient-centered clinical trials in low- and middle-income countries are essential to drive approval of more effective and less toxic cancer medicines to address the rising burden of cancer among populations in low- and middle-income countries. Moreover, through reverse innovation, clinical trials informed by genomic research enable development of precision medicine strategies for underserved populations within all populations. The African continent is home to many low- and middle-income countries; yet, it has seen very few cancer clinical trials. Considering that Africa is the cradle of humanity, with its diverse populations and geography, this represents a missed opportunity to understand the heterogeneity of cancer genomes and their implications for developmental therapeutics. Since 1998, the Nigerian Breast Cancer Study Group has striven to gain a better understanding of the root causes of breast cancer and accelerate progress in clinical research that will benefit the African ancestry diaspora globally through deployment of innovative "leapfrog" technologies. The University of Chicago supports interdisciplinary and interprofessional teams of researchers through the African Cancer Leaders Institute and in partnership with the African Organization for Research and Training in Cancer. By fostering public-private partnerships, the African Organization for Research and Training in Cancer can identify and integrate significant resources needed to build regional networks and establish clinical trial coordinating centers across African countries, enabling resources to be developed and shared equitably. Such resources include a standardized curriculum for specialist training in oncology, including medical oncology and oncology nursing, to increase the numbers of qualified team leaders and principal investigators. Adequate support for study participants-financial and psychosocial-and patient navigation services will be important in growing a clinical trials network. Finally, full participation of African clinical researchers in global oncology trials will ensure workforce retention in Africa and improve financial security and job satisfaction of health professionals on the African continent.
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Affiliation(s)
- Atara Ntekim
- Department of Radiation Oncology, Faculty of Clinical Sciences, College of Medicine/University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, Section of Hematology/Oncology, Department of Medicine The University of Chicago, Chicago, IL
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4
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Buckle GC, Mrema A, Mwachiro M, Ringo Y, Selekwa M, Mulima G, Some FF, Mmbaga BT, Mody GN, Zhang L, Paciorek A, Akoko L, Ayuo P, Burgert S, Bukusi E, Charles A, Chepkemoi W, Chesumbai G, Kaimila B, Kenseko A, Kibwana KS, Koech D, Macharia C, Moirana EN, Mushi BP, Mremi A, Mwaiselage J, Mwanga A, Ndumbalo J, Nvakunga G, Ngoma M, Oduor M, Oloo M, Opakas J, Parker R, Seno S, Salima A, Servent F, Wandera A, Westmoreland KD, White RE, Williams B, Mmbaga EJ, Van Loon K. Treatment outcomes of esophageal cancer in Eastern Africa: protocol of a multi-center, prospective, observational, open cohort study. BMC Cancer 2022; 22:82. [PMID: 35045815 PMCID: PMC8772224 DOI: 10.1186/s12885-021-09124-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background Esophageal squamous cell carcinoma (ESCC) is a major cause of cancer morbidity and mortality in Eastern Africa. The majority of patients with ESCC in Eastern Africa present with advanced disease at the time of diagnosis. Several palliative interventions for ESCC are currently in use within the region, including chemotherapy, radiation therapy with and without chemotherapy, and esophageal stenting with self-expandable metallic stents; however, the comparative effectiveness of these interventions in a low resource setting has yet to be examined. Methods This prospective, observational, multi-center, open cohort study aims to describe the therapeutic landscape of ESCC in Eastern Africa and investigate the outcomes of different treatment strategies within the region. The 4.5-year study will recruit at a total of six sites in Kenya, Malawi and Tanzania (Ocean Road Cancer Institute and Muhimbili National Hospital in Dar es Salaam, Tanzania; Kilimanjaro Christian Medical Center in Moshi, Tanzania; Tenwek Hospital in Bomet, Kenya; Moi Teaching and Referral Hospital in Eldoret, Kenya; and Kamuzu Central Hospital in Lilongwe, Malawi). Treatment outcomes that will be evaluated include overall survival, quality of life (QOL) and safety. All patients (≥18 years old) who present to participating sites with a histopathologically-confirmed or presumptive clinical diagnosis of ESCC based on endoscopy or barium swallow will be recruited to participate. Key clinical and treatment-related data including standardized QOL metrics will be collected at study enrollment, 1 month following treatment, 3 months following treatment, and thereafter at 3-month intervals until death. Vital status and QOL data will be collected through mobile phone outreach. Discussion This study will be the first study to prospectively compare ESCC treatment strategies in Eastern Africa, and the first to investigate QOL benefits associated with different treatments in sub-Saharan Africa. Findings from this study will help define optimal management strategies for ESCC in Eastern Africa and other resource-limited settings and will serve as a benchmark for future research. Trial registration This study was retrospectively registered with the ClinicalTrials.gov database on December 15, 2021, NCT05177393. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09124-5.
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Affiliation(s)
- Geoffrey C Buckle
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 505 Parnassus Ave, M1296, San Francsico, CA, 94143, USA.
| | - Alita Mrema
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | | | - Yona Ringo
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Msiba Selekwa
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Fatma F Some
- Moi University School of Medicine, Eldoret, Kenya
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Gita N Mody
- University of North Carolina, Chapel Hill, USA
| | - Li Zhang
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 505 Parnassus Ave, M1296, San Francsico, CA, 94143, USA
| | - Alan Paciorek
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 505 Parnassus Ave, M1296, San Francsico, CA, 94143, USA
| | - Larry Akoko
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paul Ayuo
- Moi University School of Medicine, Eldoret, Kenya
| | | | | | | | | | | | | | - Aida Kenseko
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - David Koech
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | | | | | - Alex Mremi
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | | | - Ally Mwanga
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Gissela Nvakunga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | | | - Mark Oloo
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Jesse Opakas
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Robert Parker
- Tenwek Hospital, Bomet, Kenya.,Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Saruni Seno
- Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Furaha Servent
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | | | - Kate D Westmoreland
- University of North Carolina, Chapel Hill, USA.,UNC-Project Malawi, Lilongwe, Malawi
| | - Russell E White
- Tenwek Hospital, Bomet, Kenya.,Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | | | - Elia J Mmbaga
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Katherine Van Loon
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, 505 Parnassus Ave, M1296, San Francsico, CA, 94143, USA
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Shamley D, Ezeani A, Okoye I. Oncology Clinical Trials in Africa: Partnering for Quality. JCO Glob Oncol 2021; 7:572-576. [PMID: 33886365 PMCID: PMC8651154 DOI: 10.1200/jgo.19.00315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Oncology clinical trials are requisite for testing the safety and effectiveness of promising treatments and deciphering new knowledge into concrete benefits for patients. They present opportunities to innovate promising, novel cancer remedies. A dearth of local evidence to guide cancer treatment in Africans is creating an increased interest in oncology clinical trials to improve patient care. This is primarily because of limitations in pathology, surgery, medical oncology, radiation, and palliation that are leading to worse cancer outcomes on the continent. Investment in oversight of Human Research Ethics committees and Medicines Regulatory Authorities in Africa has improved the potential for many countries to host clinical trials. However, the distribution of cancer trials remains poor across the continent, resulting in inadequate treatment options for patients with cancer. There are some initiatives aimed at developing research capacity to host trials in Africa. However, there is now a need to establish strategic partnerships whose aim should be to achieve harmonized, accredited Clinical Trials Units capable of running trials to meet Good Clinical Practice standards. This article discusses what has been achieved and proposes a model for quality oversight of Clinical Trials Units in Africa.
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Affiliation(s)
- Delva Shamley
- Clinical Research Centre, University of Cape Town, Cape Town, South Africa
| | - Adaora Ezeani
- University of Florida, College of Pharmacy, Gainesville, FL
| | - Ifeoma Okoye
- College of Medicine, University of Nigeria, Nsukka, Enugu, Nigeria
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6
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Menon MP, Niyonzima N, Gralow J, Orem J. Breast Cancer Clinical Trials: The Landscape at the Uganda Cancer Institute and Lessons Learned. JCO Glob Oncol 2021; 7:127-132. [PMID: 33449804 PMCID: PMC8081514 DOI: 10.1200/go.20.00185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The Uganda Cancer Institute, the sole national comprehensive cancer center in Uganda, has a long and rich history of clinical investigation and locally relevant cancer research. Given the increasing burden of breast cancer in Uganda and elsewhere in sub-Saharan Africa (SSA) and driven by the limited availability of immunohistochemistry (IHC), we launched a clinical trial aimed at evaluating locally available diagnostics to detect the presence of hormone receptors (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2. Preliminary data from 32 women in the diagnostic component of the study reveal high sensitivity and specificity for estrogen receptor and progesterone receptor and high specificity for human epidermal growth factor receptor 2 when comparing reverse transcriptase polymerase chain reaction with the gold standard (IHC). Innovative diagnostic and treatment strategies are required to address the burden of breast cancer that is increasing throughout SSA. Given the costs, infrastructure, and trained personnel associated with IHC, alternative testing options (including reverse transcriptase polymerase chain reaction as tested in our study) may provide an expedited and cost-effective method to determine receptor testing in breast cancer. Clinical trials conducted in the local setting are critical to determining optimal strategies for effective breast cancer management in SSA.
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Affiliation(s)
- Manoj P Menon
- Fred Hutchinson Cancer Research Center, Seattle, WA.,University of Washington, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA
| | - Nixon Niyonzima
- Fred Hutchinson Cancer Research Center, Seattle, WA.,Uganda Cancer Institute, Kampala, Uganda
| | - Julie Gralow
- Fred Hutchinson Cancer Research Center, Seattle, WA.,University of Washington, Seattle, WA.,Seattle Cancer Care Alliance, Seattle, WA
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7
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Odedina FT, Shamley D, Okoye I, Ezeani A, Ndlovu N, Dei-Adomakoh Y, Meza K, Agaba R, Fathi P, Askins N. Landscape of Oncology Clinical Trials in Africa. JCO Glob Oncol 2021; 6:932-941. [PMID: 32614728 PMCID: PMC7392757 DOI: 10.1200/jgo.19.00189] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The burden of cancer in Africa is of significant concern for several reasons, including that incidence of cancer in Africa continues to rise while Africa is also dealing with communicable diseases. To combat cancer in Africa, oncology clinical trials are needed to develop innovative interventions for cancer prevention, screening, diagnosis, treatment, and survivorship. Unfortunately, there is a paucity of clinical trials in Africa and it is difficult for African clinicians to get information on open oncology clinical trials and impossible for African patients with cancer to access this information. The primary objective of this study was to identify open oncology clinical trials in Africa. METHODS This project was part of a large-scale study to develop an African Virtual Platform for Oncology Clinical Trials Registry. The study was a quantitative, web-based, retrospective review of clinical trials registries. RESULTS A total of 109 open oncology clinical trials were identified. Most of the trials were in Egypt, South Africa, Algeria, and Kenya. The top cancer types for oncology clinical trials in Africa were breast, cervical, and lung cancers. The top sponsor of oncology clinical trials in Africa was academic institutions, especially institutions in the United States. CONCLUSION The paucity of clinical trials in Africa will continue to magnify the global disparities of cancer in the African population. Clinical trials are needed to ensure therapeutic interventions are safe and effective in the African population. In the era of personalized and precision health, it no longer suffices to assume that drugs developed in North America, Europe, or Asia will be effective in the African population.
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Affiliation(s)
- Folakemi T Odedina
- University of Florida, Orlando, FL.,Prostate Cancer Transatlantic Consortium, Orlando, FL
| | | | - Ifeoma Okoye
- Prostate Cancer Transatlantic Consortium, Orlando, FL.,University of Nigeria, Nsukka, Nigeria
| | - Adaora Ezeani
- University of Florida, Orlando, FL.,Prostate Cancer Transatlantic Consortium, Orlando, FL
| | - Ntokozo Ndlovu
- University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | | | - Kimberly Meza
- Prostate Cancer Transatlantic Consortium, Orlando, FL
| | - Ruth Agaba
- Prostate Cancer Transatlantic Consortium, Orlando, FL
| | - Parisa Fathi
- University of Florida, Orlando, FL.,Prostate Cancer Transatlantic Consortium, Orlando, FL
| | - Nissa Askins
- University of Florida, Orlando, FL.,Prostate Cancer Transatlantic Consortium, Orlando, FL
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8
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Ntekim A, Ibraheem A, Adeniyi-Sofoluwe A, Adepoju T, Oluwasanu M, Aniagwu T, Awolude O, Balogun W, Kotila O, Adejumo P, Babalola CP, Arinola G, Ojengbede O, Olopade CO, Olopade OI. Implementing oncology clinical trials in Nigeria: a model for capacity building. BMC Health Serv Res 2020; 20:713. [PMID: 32746811 PMCID: PMC7397583 DOI: 10.1186/s12913-020-05561-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background There is both higher mortality and morbidity from cancer in low and medium income countries (LMICs) compared with high income countries (HICs). Clinical trial activities and development of more effective and less toxic therapies have led to significant improvements in morbidity and mortality from cancer in HICs. Unfortunately, clinical trials remain low in LMICs due to poor infrastructure and paucity of experienced personnel to execute clinical trials. There is an urgent need to build local capacity for evidence-based treatment for cancer patients in LMICs. Methods We conducted a survey at facilities in four Teaching Hospitals in South West Nigeria using a checklist of information on various aspects of clinical trial activities. The gaps identified were addressed using resources sourced in partnership with investigators at HIC institutions. Results Deficits in infrastructure were in areas of patient care such as availability of oncology pharmacists, standard laboratories and diagnostic facilities, clinical equipment maintenance and regular calibrations, trained personnel for clinical trial activities, investigational products handling and disposals and lack of standard operating procedures for clinical activities. There were two GCP trained personnel, two study coordinators and one research pharmacist across the four sites. Interventions were instituted to address the observed deficits in all four sites which are now well positioned to undertake clinical trials in oncology. Training on all aspects of clinical trial was also provided. Conclusions Partnerships with institutions in HICs can successfully identify, address, and improve deficits in infrastructure for clinical trial in LMICs. The HICs should lead in providing funds, mentorship, and training for LMIC institutions to improve and expand clinical trials in LMIC countries.
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Affiliation(s)
- Atara Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Abiola Ibraheem
- Section of Hematology Oncology, University of Chicago, Chicago, USA
| | | | - Toyosi Adepoju
- Department of Pharmacy, University College Hospital, Ibadan, Nigeria
| | - Mojisola Oluwasanu
- Department of Health Promotion and Education, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Toyin Aniagwu
- School of Occupational Health Nursing, University College Hospital, Ibadan, Nigeria
| | - Olutosin Awolude
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan /University College Hospital, Ibadan, Nigeria
| | - Williams Balogun
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Olayinka Kotila
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Prisca Adejumo
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Chinedum Peace Babalola
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Ganiyu Arinola
- Department of Chemical Pathology, Faculty of Basic Medical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladosu Ojengbede
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan /University College Hospital, Ibadan, Nigeria.,Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Ntekim AI, Ibraheem A, Sofoluwe AA, Kotila O, Babalola C, Karrison T, Olopade CO. ARETTA: Assessing Response to Neoadjuvant Taxotere and Subcutaneous Trastuzumab in Nigerian Women With HER2-Positive Breast Cancer: A Study Protocol. JCO Glob Oncol 2020; 6:983-990. [PMID: 32628583 PMCID: PMC7392776 DOI: 10.1200/go.20.00043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Human epidermal growth factor receptor 2 (HER2) subtype of breast cancer is aggressive, leading to a poor outcome. Targeted therapy with trastuzumab has been shown to be effective in the treatment of HER2-positive breast cancer. Cardiotoxicity is a specific adverse effect associated with trastuzumab. The initial formulation of trastuzumab was intravenous, but presently, a subcutaneous formulation (Herceptin SC) is available. Insufficient data on the response rate and cardiotoxic effects of trastuzumab among indigenous Black populations exist. In all studies evaluating the efficacy and toxicity of trastuzumab alone or in combination with chemotherapy, indigenous Black populations in Africa were not included, yet they are the ones most likely to benefit from highly effective cancer medicines. This is partly due to poor oncology clinical trial infrastructure in sub-Saharan Africa. The ARETTA study protocol (ClinicalTrials.gov identifier: NCT03879577) is a phase II multicenter feasibility study to evaluate the efficacy and toxicity of docetaxel given every 3 weeks for 4 cycles plus trastuzumab in 60 previously untreated women with nonmetastatic breast cancer. The primary endpoint is to assess the proportion of patients with complete pathologic response. Secondary endpoints include the number of patients who require dose delays in docetaxel and trastuzumab attributed to hematologic, GI, and cardiac toxicity. Pharmacokinetic profiles of subcutaneous trastuzumab will also be determined. The ARETTA study will provide important information on the clinical response and cardiac safety of subcutaneous trastuzumab in combination with docetaxel among indigenous African women with nonmetastatic breast cancer. It can also be used as a blueprint for conducting biomarker-driven oncology clinical trials in low-resource settings such as sub-Saharan Africa.
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Affiliation(s)
- Atara I Ntekim
- Department of Radiation Oncology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Abiola Ibraheem
- Section of Hematology Oncology, University of Chicago, Chicago, IL
| | - Adenike A Sofoluwe
- Department of Radiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayinka Kotila
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Chinedum Babalola
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Theodore Karrison
- Department of Public Health Sciences, University of Chicago, Chicago, IL
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10
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Razis E, Balogun J, Lushi M, Abdel Karim K, Kalapanida D, Kadzatsa W. Report from the Front: a Glimpse at Breast Cancer Research in Low- and Middle-Income Countries. CURRENT BREAST CANCER REPORTS 2019. [DOI: 10.1007/s12609-019-00329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Saleh M, Naik G, Mwirigi A, Shaikh AJ, Sayani S, Ghesani M, Asaria S, Sohani AR, Sayed S, Moloo Z, Budhwani KI, Talib Z. Bridging the Gap in Training and Clinical Practice in Sub-Saharan Africa. CURRENT BREAST CANCER REPORTS 2019. [DOI: 10.1007/s12609-019-00322-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Vogel AL, Freeman JA, Duncan K, Alaro J, Welch JJ, Rodrigues B, Vanderpuye V, Harford JB, Williams M. Advancing Cancer Research in Africa Through Early-Career Awards: The BIG Cat Initiative. J Glob Oncol 2019; 5:1-8. [PMID: 31009270 PMCID: PMC6528731 DOI: 10.1200/jgo.18.00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The burden of cancer in Africa is growing rapidly, and increased cancer research on the continent is a critical component of an effective response. In 2010, the US National Cancer Institute, in partnership with the African Organization for Research and Training in Cancer, launched the Beginning Investigator Grant for Catalytic Research (BIG Cat) initiative to support cancer research projects conducted by early-career African investigators. METHODS To date, BIG Cat has provided 18 awards of up to $50,000 to support 2-year cancer research projects. In 2017, the National Cancer Institute evaluated BIG Cat's early outcomes for cancer research and impacts on career development and local cancer research capacity. Data collection consisted of a review of project documentation and a survey fielded to the 12 investigators who had completed their BIG Cat awards. RESULTS BIG Cat-supported research projects have generated locally relevant findings that address a range of cancer sites and multiple areas of scientific interest. The 11 survey respondents produced 43 scholarly products (e.g., publications, presentations) about findings from their BIG Cat research. They reported increases in cancer research funding applications and awards after receipt of the BIG Cat award compared with before the award. They also reported increased resources for cancer research, participation in teaching and mentoring on cancer research, and supervision of cancer research staff. Investigators identified scientific mentoring as a key facilitator of the success of their BIG Cat projects and limited time and funding as key challenges. CONCLUSION Findings provide early evidence that BIG Cat advanced locally relevant cancer research and facilitated career advancement and development of local cancer research capacity. Findings have implications for the design of future related efforts.
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Affiliation(s)
- Amanda L. Vogel
- Frederick National Laboratory for Cancer Research, Frederick, MD
| | | | | | | | | | - Belmira Rodrigues
- African Organization for Research and Training in Cancer, New York, NY
| | - Verna Vanderpuye
- African Organization for Research and Training in Cancer, New York, NY
| | - Joe B. Harford
- Capacity Building for Innovation and Transformation, Potomac, MD
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