Asia Society’s Cure4Cancer Initiative Proposes Solutions for Unlocking $80bn Oncology R&D Investment and Reducing Global Cancer Disparities
New York, September 24, 2024 – Today, Cure4Cancer and the Bloomberg New Economy Cancer Coalition published its latest study in Cancer Discovery on the global access and participation in oncology clinical trials, a first of its kind analysis through a multi-stakeholder collaboration. Pulling from public data based on annual reports for publicly traded companies and cross referenced with industry association data, the study estimated that the biopharmaceutical industry investment for oncology R&D has exponentially grown to over $80 billion globally, which has far surpassed the annual spending of the National Cancer Institute. However, the study [link to final report] also revealed many barriers exist at patient, clinician and site, industry, regulatory, country and global ecosystem levels limiting patient enrollment in oncology clinical trials at fewer than 5% globally.
The Coalition and Cure4Cancer, proposed solutions such as leapfrog technologies (e.g. liquid biopsy and remote monitoring), implementing master protocols and promoting international data sharing to advance health equity in clinical trials access globally. The Coalition and Cure4Cancer envisions a sustainable global “hub and spoke model” to expand trial access through technology and collaboration, ultimately reducing costs, accelerating discoveries, and bringing life-saving treatment to patients more quickly.
Dr. Bob T. Li, Vice President Global Research Affairs at Memorial Sloan Kettering Cancer Center and Co-Founder of Cure4Cancer & the Coalition, and the study’s corresponding author said ”Advancing global health equity is not only the right thing to do, but a business strategy in an otherwise unsustainable global ecosystem for oncology R&D.”
The Coalition was formed in 2021 to explore ways to drive international collaboration and better access to clinical trials, while also encouraging regulatory harmonization that would accelerate the development of novel cancer treatments, screening, and prevention. The Coalition is comprised of leaders from academic medical centers, government regulatory agencies, the pharmaceutical and biotechnology industry, contract research organizations, patient advocacy groups and policy think tanks.
Cure4Cancer is a global movement launched in 2018 by the Asia Society, Memorial Sloan Kettering Cancer Center (MSK) and the Chinese Thoracic Oncology Group (CTONG), joined by Bloomberg New Economy Forum, Forbes China, Thoracic Oncology Group of Australasia (TOGA), Hospital Sirio-Libanes, and KRAS Kickers and others over the years, with a mission to accelerate the development of cancer cures and prevention through increased public awareness, international cooperation, and regulatory harmonization on patient-centric international clinical trials.
“Cure4Cancer has been steadfast in its efforts, through both public and private diplomacy over the past 6 years, to create more political space and foster policy innovations aimed at saving millions of lives through international collaboration on cancer research,” said Jing Qian, Co-Founder of Cure4Cancer and Managing Director of the Center for China Analysis at the Asia Society Policy Institute. “This mission transcends geographical, political, and ideological boundaries.”
Summary of Key Findings
Despite significant advancements in oncology research and treatment, cancer remains a leading cause of death worldwide, with an estimated over 19 million new diagnoses, and 10 million cancer-related deaths (ref Sung CA Cancer J Clin. 2021). The burden of cancer is highest in China (24% of global cancer cases, over 30% of global cancer deaths), followed by the U.S and India. However, the true number of cases in Low- and Middle-Income Countries (LMICs) may be higher than reported due to lack of cancer registries.
Figure 1: Number of cancer cases and deaths across indications in 2020, Millions
Figure 2: Number of cancer cases and deaths across geography in 2020, Millions
Figure references: Globocan 2020". World Health Organization, 15 June. 2023. Accessed 15. June. 2023, Cancer Survival Rates by Country 2023." World Population Review, 1 Jan. 2023,. Accessed 13 June. 2023.
The study estimates the global pharmaceutical industry investment for oncology R&D has grown exponentially to over $80 billion annually, far surpassing other therapeutic areas. The estimation was triangulated across three different top-down and bottom-up approaches, leveraging data sources such as publicly available annual R&D spending reports and clinical trials posting, and making assumptions around average clinical trial cost per patient per therapeutic area. However, despite the heavy investment in oncology R&D and the recognition of clinical trials as the best treatment to improve outcomes, patient participation in these trials remains at below 5% globally.
The study reveals there is a growing interest for patients to participate in clinical trials and more than 50% of patients indicated willingness to participate if given the opportunity. However, patient, clinician, regulatory, and other barriers exist to prevent eligible patients from participating in clinical trials. However, there are several barriers that currently exist for clinical trials, including:
- Patient-Level Barriers
- Physician/Site-Level Barriers
- Regulatory Barriers
While the study states there is no single definitive solution to the complex problems of oncology clinical trials, Coalition members put forward several strategies that can be employed to mitigate these challenges, enhance trial accessibility, and improve outcomes. These include:
Implementation of the Global ‘Hub and Spoke’ Network Model
Increasing access to clinical trial sites can dramatically improve participation. The ‘hub and spoke’ network model can operate by having the academic hospital centers (AMCs) act as the hubs of the trial, while community hospitals and clinics operate as the spokes. In this new model, AMCs can help community hospitals and clinics set up clinical trials by offering expertise and experiences, so rural patients can participate in clinical trials without traveling long distances. There are multiple advantages when transitioning to this model including increased awareness of clinical trials and increased access in diverse patient communities, and rural patients can reduce travel time and financial burden by visiting the spoke locations for trials closer to home.
Optimization of Clinical Trial Recruitment and Operations
Implementing a master protocol as the trial design, increasing the use of liquid biopsies for patient selection and trial monitoring, and leveraging advances in artificial intelligence such as trained natural language processing algorithms to digitally enhance electronic data capture (EDC) that may streamline clinical trial patient selection, operations, data sharing and reduce costs.
Improving Patient Access by Investing in Low- and Middle-Income Countries
LMICs face many similar barriers to high income countries HICs regarding clinical trials, but to a more significant degree across factors such as low clinical trial awareness and education, clinical trials only occurring in urban areas at AMCs, and health care professional staffing shortages. LMICs can also learn from their success in managing infectious diseases to enhance regulatory framework and processes for clinical trials. This includes streamlining ethic review processes, ensuring participant safety, and facilitating efficient approval mechanisms. These potential solutions highlight the need for a multi-pronged, collaborative, and concerted effort to overcome the barriers facing oncology clinical trials.
”The fight against cancer is a global movement that belongs to all of humanity, and international collaboration is key to ending cancer as a major cause of death in this lifetime”, said His Excellency the Honorable Dr. Kevin Rudd, Australian Ambassador to the United States, the 26th Prime Minister of Australia and Co-Chair of the Coalition.
To find out more, you can view the full study here.