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Open AccessArticle

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

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Division of Cancer Care and Epidemiology, Queen’s University Cancer Research Institute, Kingston, ON K7L 3N6, Canada
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Department of Oncology, Queen’s University, Kingston, ON K7L 5P9, Canada
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Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
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Department of Oncology, Northern Ontario School of Medicine, Thunder Bay, ON P3E 2C6, Canada
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Department of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada
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Canadian Cancer Trials Group, Queen’s University, Kingston, ON K7L 3N6, Canada
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Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(2), 1518-1527; https://doi.org/10.3390/curroncol28020143
Received: 3 March 2021 / Revised: 31 March 2021 / Accepted: 9 April 2021 / Published: 13 April 2021
Canada has a long tradition of leading practice-changing clinical trials in oncology. Here, we describe methodology, results, and interpretation of oncology RCTs with Canadian involvement compared to RCTs from other high-income countries (HICs). A literature search identified all RCTs evaluating anti-cancer therapies published 2014–2017. RCTs were classified based on the country affiliation of first authors. The study cohort included 636 HIC-led RCTs; 155 (24%) had Canadian authors. Three-quarters (112/155, 72%) of Canadian RCTs were conducted in the palliative setting, compared to two thirds (299/481, 62%) of RCTs from other HICs (p = 0.022). Canadian RCTs were more likely than those from other HICs to be supported by industry (85% vs. 69%, p < 0.001). The proportion of positive Canadian trials that met the ESMO-MCBS threshold for substantial clinical benefit was comparable to RCTs without Canadian authors (29% vs. 32%, p = 0.137). Thirteen percent (20/155) of all Canadian trials were affiliated with the Canadian Cancer Trials Group (CCTG). Canada plays a meaningful role in the global cancer research ecosystem but is overly reliant on industry support. The very low proportion of trials that identify a new treatment with substantial clinical benefit is worrisome. A renewed investment in cancer clinical trials is needed in Canada. View Full-Text
Keywords: cancer; clinical trials; research funding; Canada; high-income countries cancer; clinical trials; research funding; Canada; high-income countries
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MDPI and ACS Style

Sharma, S.; Wells, J.C.; Hopman, W.M.; Del Paggio, J.C.; Gyawali, B.; Hammad, N.; Hay, A.E.; Booth, C.M. Cancer, Clinical Trials, and Canada: Our Contribution to Worldwide Randomized Controlled Trials. Curr. Oncol. 2021, 28, 1518-1527. https://doi.org/10.3390/curroncol28020143

AMA Style

Sharma S, Wells JC, Hopman WM, Del Paggio JC, Gyawali B, Hammad N, Hay AE, Booth CM. Cancer, Clinical Trials, and Canada: Our Contribution to Worldwide Randomized Controlled Trials. Current Oncology. 2021; 28(2):1518-1527. https://doi.org/10.3390/curroncol28020143

Chicago/Turabian Style

Sharma, Shubham; Wells, J. C.; Hopman, Wilma M.; Del Paggio, Joseph C.; Gyawali, Bishal; Hammad, Nazik; Hay, Annette E.; Booth, Christopher M. 2021. "Cancer, Clinical Trials, and Canada: Our Contribution to Worldwide Randomized Controlled Trials" Curr. Oncol. 28, no. 2: 1518-1527. https://doi.org/10.3390/curroncol28020143

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