Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada.
Department of Oncology, Queen's University, Kingston, Canada.
JCO Glob Oncol. 2023 Sep;9:e2300294. doi: 10.1200/GO.23.00294.
Rapidly expanding systemic treatment options, combined with improved screening, diagnostic, surgical, and radiotherapy techniques, have led to improved survival outcomes for many cancers over time. However, these overall survival gains have disproportionately benefited patients in high-income countries, whereas patients in low- and middle-income countries (LMICs) continue to experience challenges in accessing timely and guideline concordant care. In September 2022, the Accelerating Anticancer Agent Development and Validation workshop was held, focusing on global cancer drug development. Panelists discussed key barriers such as the lack of diagnostic services and human resources, drug accessibility and affordability, lack of research infrastructure, and regulatory and authorization challenges, with a particular focus on Africa and Latin America. Potential opportunities to improve access and affordability were reviewed, such as the importance of prioritizing investments in diagnostics, investing health infrastructure and work force planning, coordinated drug procurement efforts and streamlined regulatory processing, incentivized pricing through regulatory change, and the importance of developing and promoting clinical trials that can answer relevant clinical questions for patients in LMICs. As a cancer community, we must continue to advocate for and work toward equitable access to high-quality interventions for patients, regardless of their geographical location.
随着快速发展的全身性治疗选择的出现,以及改进的筛查、诊断、手术和放疗技术,许多癌症的总体生存结果在一段时间内得到了改善。然而,这些总体生存获益主要使高收入国家的患者受益,而中低收入国家(LMICs)的患者在获得及时和符合指南的治疗方面仍然面临挑战。2022 年 9 月,举办了“加速抗癌药物开发和验证”研讨会,重点关注全球癌症药物开发。小组成员讨论了关键障碍,例如缺乏诊断服务和人力资源、药物的可及性和可负担性、缺乏研究基础设施以及监管和授权方面的挑战,特别关注非洲和拉丁美洲。还讨论了改善可及性和可负担性的潜在机会,例如优先投资诊断、投资卫生基础设施和劳动力规划、协调药物采购工作和简化监管程序、通过监管变革激励定价,以及开发和推广能够为 LMIC 患者回答相关临床问题的临床试验的重要性。作为癌症界,我们必须继续倡导并努力为患者提供公平获得高质量干预措施的机会,无论他们的地理位置如何。