Abstract 438P
Background
Thoracic oncology has considerably evolved these last two decades thanks to technical and biological innovations, implemented in clinical practice after clinical trials. Nevertheless, worldwide access to these trials remains highly inequal. This study aimed to evaluate the evolution of purpose and international repartition of thoracic oncology trials between 2005 (date of trial registration requirement by ICMJE) and 2024.
Methods
The ClinicalTrials database was searched for cancer trials on December 5th, 2024. We identified and included records related to thoracic oncology, based on regular expression pattern recognition on study titles, interventions and conditions. International repartition was analyzed considering both the countries and their income groups according to the World Bank’s classification. To better consider multicenter design, the number of trial sites was calculated by multiplying the number of trials by the number of sites, and trial-sites density per million of inhabitants were calculated to consider the inequal population sizes of the countries.
Results
Clinicaltrials.gov database listed 110,432 oncology trials, of which 9350 (8.5%) started since 2005 and were related to thoracic oncology. Among them, 8722 (93.3%) involved trial sites located only in high income countries. Mesothelioma and thymic tumors were (at least part of) the investigated neoplasms in 4.3% (n=427) and 1.6% (n=158), respectively. While 176 thoracic oncology trials started in 2005, this number drastically rose to 688 in 2024 (+290%). Most registered trial focused on treatment (93.7% in 2005 vs 84.3% in 2024), while other purpose such as supportive care and health services research are emerging (0% and 0.1% in 2005, vs 2.2% and 1.1% in 2024). Only 30 countries had >20 ongoing trial-sites per million of inhabitants. Among them, 28 (93.3%) were high-income countries, led by the USA and Spain with 134,1 and 73,7 trial-sites per million of inhabitants.
Conclusions
The number of thoracic oncology trials drastically grew these last two decades, and molecular biology is now commonplace of trials. Nevertheless, we still face great disparities in access to thoracic oncology trials. The challenge to ensure equitable, accessible, and sustainable research thus remains.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.