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Gössling G, Rebelatto TF, Villarreal-Garza C, Ferrigno AS, Bretel D, Sala R, Giacomazzi J, William WN, Werutsky G. Current Scenario of Clinical Cancer Research in Latin America and the Caribbean. Curr Oncol 2023; 30:653-662. [PMID: 36661699 PMCID: PMC9858272 DOI: 10.3390/curroncol30010050] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/22/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
In Latin America and the Caribbean (LAC), progress has been made in some national and regional cancer control initiatives, which have proved useful in reducing diagnostic and treatment initiation delays. However, there are still significant gaps, including a lack of oncology clinical trials. In this article, we will introduce the current status of the region's clinical research in cancer, with a special focus on academic cancer research groups and investigator-initiated research (IIR) initiatives. Investigators in LAC have strived to improve cancer research despite drawbacks and difficulties in funding, regulatory timelines, and a skilled workforce. Progress has been observed in the representation of this region in clinical trial development and conduct, as well as in scientific productivity. However, most oncology trials in the region have been sponsored by pharmaceutical companies, highlighting the need for increased funding from governments and private foundations. Improvements in obtaining and/or strengthening the LAC cancer research group's financing will provide opportunities to address cancer therapies and management shortcomings specific to the region. Furthermore, by including this large, ethnic, and genetically diverse population in the world's research agenda, one may bridge the gap in knowledge regarding the applicability of results of clinical trials now mainly conducted in populations from the Northern Hemisphere.
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Affiliation(s)
- Gustavo Gössling
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre 90619-900, RS, Brazil
| | - Taiane F. Rebelatto
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre 90619-900, RS, Brazil
| | - Cynthia Villarreal-Garza
- Breast Cancer Center Hospital Zambrano Hellion TecSalud—Tecnologico de Monterrey, Monterrey 66278, NL, Mexico
| | - Ana S. Ferrigno
- Breast Cancer Center Hospital Zambrano Hellion TecSalud—Tecnologico de Monterrey, Monterrey 66278, NL, Mexico
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos del Perú (GECO PERU), Lima 15038, Peru
| | - Raul Sala
- Grupo Argentino de Investigación Clínica en Oncología (GAICO), Rosario S2124KBO, Argentina
| | - Juliana Giacomazzi
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre 90619-900, RS, Brazil
| | - William N. William
- Hospital BP—Beneficência Portuguesa de São Paulo, São Paulo 01323-001, SP, Brazil
| | - Gustavo Werutsky
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre 90619-900, RS, Brazil
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Werutsky G, Barrios CH, Cardona AF, Albergaria A, Valencia A, Ferreira CG, Rolfo C, de Azambuja E, Rabinovich GA, Sposetti G, Arrieta O, Dienstmann R, Rebelatto TF, Denninghoff V, Aran V, Cazap E. Perspectives on emerging technologies, personalised medicine, and clinical research for cancer control in Latin America and the Caribbean. Lancet Oncol 2021; 22:e488-e500. [PMID: 34735818 DOI: 10.1016/s1470-2045(21)00523-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 12/23/2022]
Abstract
Challenges of health systems in Latin America and the Caribbean include accessibility, inequity, segmentation, and poverty. These challenges are similar in different countries of the region and transcend national borders. The increasing digital transformation of health care holds promise of more precise interventions, improved health outcomes, increased efficiency, and ultimately reduced health-care costs. In Latin America and the Caribbean, the adoption of digital health tools is in early stages and the quality of cancer registries, electronic health records, and structured databases are problematic. Cancer research and innovation in the region are limited due to inadequate academic resources and translational research is almost fully dependent on public funding. Regulatory complexity and extended timelines jeopardise the potential improvement in participation in international studies. Emerging technologies, artificial intelligence, big data, and cancer research represent an opportunity to address the health-care challenges in Latin America and the Caribbean collectively, by optimising national capacities, sharing and comparing best practices, and transferring scientific and technical capabilities.
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Affiliation(s)
- Gustavo Werutsky
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil.
| | - Carlos H Barrios
- Latin American Cooperative Oncology Group, Porto Alegre, Brazil; Oncology Department, Rio de Janeiro, Brazil
| | - Andres F Cardona
- Thoracic and Brain Tumor Unit, Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia; Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad el Bosque, Bogotá, Colombia
| | - André Albergaria
- Translational Research & Industry Partnerships Unit, Instituto de Inovação em Saúde (i3S), Porto, Portugal
| | - Alfonso Valencia
- Institución Catalana de Investigación y Estudios Avanzados (ICREA) and Barcelona Supercomputing Center, Barcelona, Spain
| | | | - Christian Rolfo
- Center for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Evandro de Azambuja
- Medical Oncology Department, Institut Jules Bordet and l'Université Libre de Bruxelles, Brussels, Belgium
| | - Gabriel A Rabinovich
- Laboratory of Immunopathology, Institute of Biology and Experimental Medicine, and School of Exact and Natural Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - Georgina Sposetti
- Instituto de Investigaciones Clinicas Mar del Plata, Buenos Aires, Argentina; Un Ensayo para Mi, Buenos Aires, Argentina
| | - Oscar Arrieta
- Department of Thoracic Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Rodrigo Dienstmann
- Oncoclínicas Precision Medicine and Big Data Initiative, Rio de Janeiro, Brazil
| | | | - Valeria Denninghoff
- University of Buenos Aires - National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina
| | - Veronica Aran
- Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Eduardo Cazap
- Latin American and Caribbean Society of Medical Oncology (SLACOM), Buenos Aires, Argentina
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Cucunubá ZM. Latin American scientific research prorities for COVID-19 prevention and control. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2020; 40:9-13. [PMID: 33152182 PMCID: PMC7676846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Zulma M. Cucunubá
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, United Kingdom Departamento de Epidemiología Clínica, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia Pontificia Universidad JaverianaPontificia Universidad JaverianaBogotáD.C.Colombia
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Ndwandwe D, Dube K, Mathebula L, Wiysonge CS. Description of vaccine clinical trials in Africa: a narrative review. Hum Vaccin Immunother 2020; 16:972-980. [PMID: 31730397 PMCID: PMC7227700 DOI: 10.1080/21645515.2019.1693720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/26/2019] [Accepted: 10/12/2019] [Indexed: 01/10/2023] Open
Abstract
Clinical research is important in establishing the effects of health-care interventions. Vaccine clinical trials are to examine the effectiveness and safety of vaccines for the prevention of diseases. Africa has a high burden of infectious diseases such as malaria, tuberculosis, HIV/AIDS, and Ebola virus disease. Here we report a database surveillance study of vaccine-related clinical trials conducted in Africa. An objective is to address and profile vaccine clinical trials conducted in Africa. Data were extracted from the WHO International Clinical Trials Registry Platform on 22 July 2018 and updated on 05 September 2019. We found that 61% of the 377 clinical trials were registered prospectively and 35% registered retrospectively. About 72% of the trials were single-country studies and within the country, most trials (86%) were single-center studies. The proportion of trials involving multiple African countries was 11% and that of trials involving countries outside of Africa was 16%. The biggest funder of the vaccine trials (34%) was industry, followed by governments (25%) and universities (21%). The most studied diseases were malaria (20%), HIV/AIDS (15%), tuberculosis (7%), and Ebola virus disease (6%). Most of the vaccine trials were conducted in adults (42%). The trials ranged from phase I to phase IV, with most of the trials being in phase I (18%) and phase III (18%). The conduct of vaccine clinical trials in Africa seeks to address the disease epidemics faced by the continent. There is a need for more investments from governmental bodies toward vaccine research in Africa. Further, African country collaborations are needed in efforts to find African solutions to the current infectious disease threats faced by the continent.
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Affiliation(s)
- Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Kopano Dube
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Lindi Mathebula
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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