Epistemic equity in oncology: Opportunities to leverage patient‐centric implementation in clinical trial design

Author:

Patel Tej A.1ORCID,Ting Frederic Ivan L.234ORCID,Jain Bhav5ORCID,Eala Michelle Ann B.67ORCID,Jacomina Luisa E.8ORCID,Mejia Michael Benedict A.8ORCID,Dee Edward Christopher9ORCID

Affiliation:

1. University of Pennsylvania Philadelphia Pennsylvania USA

2. Department of Clinical Sciences College of Medicine University of St. La Salle Bacolod Philippines

3. Division of Oncology Department of Medicine Corazon Locsin Montelibano Memorial Regional Hospital Bacolod Philippines

4. Division of Oncology Department of Internal Medicine Dr. Pablo O. Torre Memorial Hospital Bacolod Philippines

5. Harvard‐MIT Division of Health Sciences and Technology Massachusetts Institute of Technology Cambridge Massachusetts USA

6. College of Medicine University of the Philippines Manila Philippines

7. Department of Radiation Oncology University of California Los Angeles Los Angeles California USA

8. Department of Radiation Oncology Benavides Cancer Institute University of Santo Tomas Hospital Manila Philippines

9. Department of Radiation Oncology Memorial Sloan Kettering Cancer Center New York New York USA

Abstract

In addition to the ethical imperative to combat epistemic injustice in cancer research, work from differently resourced settings may shed light on questions of implementation and access. This piece discusses several recent randomized controlled trials whose findings advance not only clinical science but also the implementation of care. One trial demonstrates the efficacy of dose‐reduced immunotherapy and another demonstrates the utility of oral chemotherapy, respectively tackling issues of cost and ease of access. This commentary explores the implications of these and similar studies in light of financial, geographic, and social barriers to access experienced by many people with cancer in low‐ and middle‐income countries, proposes actionable next steps to improve epistemic equity in cancer research, and calls for patient‐centric implementation in clinical trial design.

Publisher

Wiley

Subject

Cancer Research,Oncology

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