Global Disparities in Current Clinical Trials in Nasopharyngeal Carcinoma Journal Article
| Authors: | Jainar, C. J. E.; Jacomina, L. E.; Dee, E. C.; Lee, A.; Lee, N. Y.; Chua, M. L. K.; Mejia, M. B. A. |
| Article Title: | Global Disparities in Current Clinical Trials in Nasopharyngeal Carcinoma |
| Abstract: | Purpose: Nasopharyngeal carcinoma (NPC) is characterized by a distinct geographic distribution, with more than 90% of worldwide incidence and mortality occurring in East/Southeast Asia and Northern Africa. Clinical trials that inform evidence-based care must represent the target population of NPC; however, little is known about their geographic distribution and the extent to which they investigate radiation therapy (RT), which plays a central role in NPC management. Methods and Materials: Using ClinicalTrials.gov, we characterized phase 2 and 3 clinical trials on adult patients with NPC from 2013 to 2023. Endemic countries were defined as having an age-standardized incidence rate higher than the world age-standardized incidence rate of 1.3 per 100,000 person-years using the Global Cancer Observatory (GLOBOCAN) 2022 database. Results: There were 266 clinical trials eligible for analysis. Trial interventions were immunotherapy/targeted therapy in 133 (50%), chemotherapy in 79 (30%), and RT in 25 (9%). Trials most commonly originated from China (80%), followed by the United States (4.5%) and Singapore (1.5%). Of the 29 NPC-endemic countries, only 5 (17%) are represented in the 11 international trials—China (including Taiwan, Hong Kong, and Macau), Malaysia, Singapore, Thailand, and Tunisia—4 (80%) of which are high- and upper-middle-income countries. In contrast, 18 (75%) out of the 24 underrepresented endemic countries are lower-income. Trials per absolute NPC incidence were significantly fewer in endemic versus nonendemic countries (P < .001) and in lower- versus higher-income countries (P < .001). Similar disparities were observed in the subset of trials that primarily tested RT. Conclusions: The current NPC clinical trial landscape demonstrates significant disparities that do not reflect the global distribution of disease burden and the central role of RT. Lower-income endemic countries are severely underrepresented. Enhanced regional and global collaboration is critical in fostering the inclusion of both patients and researchers from lower-resourced settings in clinical trials and in the global NPC dialogue. © 2025 Elsevier Inc. |
| Keywords: | clinical trial; radiotherapy; nasopharyngeal carcinoma; diseases; international cooperation; evidence-based; medical applications; southeast asia; singapore; geographical distribution; global disparities; 'current; low incomes; geographics; age-standardized incidence rates |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Publication status: | Online ahead of print |
| Date Published: | 2025-01-01 |
| Online Publication Date: | 2025-01-01 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2025.06.3870 |
| PUBMED: | 40614784 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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