cancer clinical trials research funding Canada high-income countries

Cancer, Clinical Trials, and Canada: Our Contribution to Worldwide Randomized Controlled Trials

by Shubham Sharma, J Connor Wells, Wilma M Hopman, Joseph C Del Paggio, Bishal Gyawali, Nazik Hammad, Annette E Hay, Christopher M Booth

Apr 13^th 2021
10 mins
Current Oncol. 2021 Apr 13;28(2):1518–1527

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Summary

This document reviews Canadian involvement in oncology randomized controlled trials (RCTs) from 2014-2017, comparing them to those from other high-income countries (HICs).

Canada contributed to 155 (24%) of 636 HIC-led RCTs.
Canadian RCTs focused more on palliative care (72%) compared to 62% in other HICs (p = 0.022).
Canadian trials were more often industry-supported (85% vs. 69%, p < 0.001).
The clinical benefit achieved by Canadian trials was similar to those from other HICs.

Randomized controlled trials (RCTs) are the gold standard for evaluating the efficacy of new cancer therapies. Since widespread adoption of the RCT in the 1970s, cancer clinical trials have evolved considerably. Work by our group and others have shown that RCTs have evolved over time to become larger, more likely to be industry-funded, with more multi-center and international involvement. There has also been a marked shift to the use of surrogate primary endpoints.

While the majority of North American research output is driven by the United States (US), Canada’s cancer research spending is comparable to that of other high-income countries across Europe and Asia. Like other parts of the world, most clinical research funding in Canada now comes from industry sources as it has become increasingly difficult for independent Canadian investigators to support the increasing costs of clinical trial infrastructure. Several groups have demonstrated that the volume of research output is associated with allocation of research funds rather than burden of disease.

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cancer, clinical trials, research funding, Canada, high-income countries