The cervix cancer research network: increasing access to cancer clinical trials in low- and middle-income countries.
BACKGROUND
The burden of cervical cancer is large and growing in developing countries, due in large part to limited access to screening services and lack of human papillomavirus (HPV) vaccination. In spite of modern advances in diagnostic and therapeutic modalities, outcomes from cervical cancer have not markedly improved in recent years. Novel clinical trials are urgently needed to improve outcomes from cervical cancer worldwide.


METHODS
The Cervix Cancer Research Network (CCRN), a subsidiary of the Gynecologic Cancer InterGroup, is a multi-national, multi-institutional consortium of physicians and scientists focused on improving cervical cancer outcomes worldwide by making cancer clinical trials available in low-, middle-, and high-income countries. Standard operating procedures for participation in CCRN include a pre-qualifying questionnaire to evaluate clinical activities and research infrastructure, followed by a site visit. Once a site is approved, they may choose to participate in one of four currently accruing clinical trials.


RESULTS
To date, 13 different CCRN site visits have been performed. Of these 13 sites visited, 10 have been approved as CCRN sites including Tata Memorial Hospital, India; Bangalore, India; Trivandrum, India; Ramathibodi, Thailand; Siriaj, Thailand; Pramongkutklao, Thailand; Ho Chi Minh, Vietnam; Blokhin Russian Cancer Research Center; the Hertzen Moscow Cancer Research Institute; and the Russian Scientific Center of Roentgenoradiology. The four currently accruing clinical trials are TACO, OUTBACK, INTERLACE, and SHAPE.


CONCLUSIONS
The CCRN has successfully enrolled eight sites in developing countries to participate in four randomized clinical trials. The primary objectives are to provide novel therapeutics to regions with the greatest need and to improve the validity and generalizability of clinical trial results by enrolling a diverse sample of patients.
Department of Radiation Oncology, University of Utah School of Medicine , Salt Lake City, UT , USA.
Gita
G
Suneja
GCIG: Gynecologic Cancer Intergroup , Kingston, ON , Canada.
Monica
M
Bacon
Department of Radiation Oncology, Stritch School of Medicine Loyola University , Chicago, IL , USA.
William
W
Small
Department of Surgery, Division of Gastroenterologic Surgery, Chonnam National University Medical School , Gwangju , South Korea.
Sang Y
SY
Ryu
Institute of Cancer Sciences, St Mary's Hospital, University of Manchester , Manchester , UK.
Henry C
HC
Kitchener
Department of Radiation Oncology, University of Utah School of Medicine , Salt Lake City, UT , USA.
David K
DK
Gaffney
HIV cancer; cervix cancer; clinical trials as topic; global health; radiation oncology