title: Clinical trials in low and middle-income countries - Successes and challenges.
abstract: Gynecologic malignancies affect women in low and middle-income countries (LMICs) at equal or higher rates compared to high income countries (HICs), yet practice guidelines based on clinical trials performed in HICs do not routinely account for resource disparities between these regions. There is a need and growing interest for executing clinical trials in LMICs. This has led to the creation of multinational cooperative groups and the initiation of several ongoing clinical trials in Mexico, China, and Korea. In this article we describe the challenges involved in initiating clinical trials in LMICs, review current efforts within surgical, medical, and radiation oncology, and introduce high priority topics for future research.
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Grover
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, United States.
authors.forename: Melody
authors.initials: M
authors.lastname: Xu
authors.affiliation: Division of Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, United States.
authors.forename: Anuja
authors.initials: A
authors.lastname: Jhingran
authors.affiliation: Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors.forename: Umesh
authors.initials: U
authors.lastname: Mahantshetty
authors.affiliation: Department of Gynecological Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
authors.forename: Linus
authors.initials: L
authors.lastname: Chuang
authors.affiliation: Department of Radiation Oncology, Loyola University, Chicago, IL, United States.
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.affiliation: Department of Radiation Oncology, University of Utah, Salt Lake City, UT, United States.
authors.forename: David
authors.initials: D
authors.lastname: Gaffney
keywords: Clinical trials; Gynecological cancers; Low and middle-income countries