pediatric oncology
clinical trials
research
Africa
collaborative research
Pediatric Oncology Clinical Trials and Collaborative Research in Africa: Current Landscape and Future Perspectives
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by Jaques van Heerden, MD, Mohamed Zaghloul, MD, Anouk Neven, MSc, Teresa de Rojas, MD, PhD, Jennifer Geel, MD, Catherine Patte, MD, Joyce Balagadde-Kambugu, MD, Peter Hesseling, MD, Francine Tchintseme, MD, Eric Bouffet, MD, and Laila Hessissen, MD
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Aug 7th 2020
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10 mins
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JCO Global Oncology: Volume 6, 2020, 1264-1275
- Current childhood cancer survival rates in African countries range from 8.1% to 30.3%.
- The review focuses on pediatric oncology trials in Africa, highlighting challenges and suggesting research collaboration opportunities.
- Data were collected from the SIOP global mapping survey, ClinicalTrials.gov, and relevant literature, supported by expert opinions.
- Out of 47 African countries surveyed, 23 have active clinical research programs. Only 12.1% of African oncology studies involve children and adolescents, with 50.5% being interventional trials.
- African contributions to pediatric oncology publications are less than 1% in both regional and international journals.
- International collaborations are crucial for strengthening services and research.
- Despite challenges, high-quality clinical research is ongoing, and initiatives are enhancing research capacity in Africa.
By mid-2019, the population of African children age < 15 years was > 535.1 million, 41% of the total population. Although infectious diseases, malnutrition, and neonatal deaths are the main causes of childhood mortality on the continent, noncommunicable diseases such as childhood cancer are becoming increasingly important, with 100,000 new diagnoses per year. These figures originate in a context were only 57% of childhood cancer cases are diagnosed. The overall survival for childhood malignancies is poor: North Africa reports survival rates of 30.3% for all malignancies, and Southern Africa, West Africa, and East Africa report 21.7%, 8.5%, and 8.1%, respectively.
The main barriers to adequate childhood cancer care in Africa include low socioeconomic status, underdiagnosis, under-reporting, understaffing, inadequate clinical care, and a paucity of high-quality research. Clinical trials facilitate the creation of evidence to guide clinical interventions and improve overall care on many levels: They represent a critical link between scientific innovation and improvements in health care delivery. Prospective clinical trials may improve diagnostic accuracy, decrease treatment failure, and improve efficacy of specific interventions. Furthermore, they may assist in building capacity and consistency of clinical care in a multidisciplinary setting, improve facilities, and fund treatment and support costs for patients.
The ability to participate in clinical trials is intertwined with the capacity of local pediatric oncology units (POUs) to deliver clinical services in a severely resource-constrained environment. Historically, many services and research projects were established in collaboration with North American and European groups. In addition, regional African collaborations and training programs have led to studies that were influenced by regional priorities, socioeconomic factors, and availability of resources.
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pediatric oncology, clinical trials, research, Africa, collaborative research
