Global drug development in cancer: a cross-sectional study of clinical trial registries.
BACKGROUND
Drug development in cancer is costly and may be directed toward 'profitable' cancers of the more developed regions (MDR) as compared with those of the less developed regions (LDR) of the world. Here, we describe drug development in relation to cancer type and geographic location.


METHODS
We reviewed phase II and III clinical trials evaluating new cancer drugs, which were registered from January to June 2008. Correlations were sought between the number of clinical trials and incidence, mortality and prevalence of the cancers studied (obtained from GLOBOCAN 2002) and stratified by region of the world.


RESULTS
We identified 399 newly registered trials. Most trials (N = 229, 57%) were sponsored by industry. The most common types of cancer studied were breast 73 (18%), lung 57 (14%), prostate 44 (11%) and colorectal 28 (7%). In MDR, incidence, mortality and prevalence correlated significantly (Pearson r = 0.80, 0.73 and 0.63; P < or = 0.01) with the number of all registered clinical trials, whereas in LDR, only prevalence showed significant association (Pearson r = 0.55; P = 0.03) with the number of trials for a given type of cancer.


CONCLUSIONS
Lethal cancers that are common in the LDR (e.g. stomach, liver and esophageal cancers) deserve greater emphasis for drug development.
Seruga
B
B
Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
Hertz
P C
PC
Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
Le
L W
LW
Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada.
Tannock
I F
IF
Division of Medical Oncology and Hematology, Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada. Electronic address: ian.tannock@uhn.on.ca.
D000970:Antineoplastic Agents / Q000138:chemical synthesis / Q000302:isolation & purification / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D055808:Drug Discovery / Q000379:methods*; D005260:Female; D005843:Geography; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D015995:Prevalence; D012042:Registries; D016019:Survival Analysis
D000970:Antineoplastic Agents