Advancing equitable access to innovation in breast cancer

This manuscript critically examines the challenges associated with the design and conduct of academic global breast cancer trials outside the influence of pharmaceutical companies, leveraging insights from the Breast International Group (BIG). In the past 4 decades significant declines in breast can...

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Main Authors: Seamus O’Reilly, Ines Vaz Luis, Virginie Adam, Evangelia D. Razis, Ander Urruticoechea, Amal Arahmani, Eva Carrasco, Boon H. Chua, Judith Bliss, Carolyn Straehle, Theodora Goulioti, Barbro Lindholm, Gustavo Werustsky, Etienne Brain, Philippe L. Bedard, Giuseppe Curigliano, Sherene Loi, Shigehira Saji, David Cameron
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Breast Cancer
Online Access:https://doi.org/10.1038/s41523-025-00768-1
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author Seamus O’Reilly
Ines Vaz Luis
Virginie Adam
Evangelia D. Razis
Ander Urruticoechea
Amal Arahmani
Eva Carrasco
Boon H. Chua
Judith Bliss
Carolyn Straehle
Theodora Goulioti
Barbro Lindholm
Gustavo Werustsky
Etienne Brain
Philippe L. Bedard
Giuseppe Curigliano
Sherene Loi
Shigehira Saji
David Cameron
author_facet Seamus O’Reilly
Ines Vaz Luis
Virginie Adam
Evangelia D. Razis
Ander Urruticoechea
Amal Arahmani
Eva Carrasco
Boon H. Chua
Judith Bliss
Carolyn Straehle
Theodora Goulioti
Barbro Lindholm
Gustavo Werustsky
Etienne Brain
Philippe L. Bedard
Giuseppe Curigliano
Sherene Loi
Shigehira Saji
David Cameron
author_sort Seamus O’Reilly
collection DOAJ
description This manuscript critically examines the challenges associated with the design and conduct of academic global breast cancer trials outside the influence of pharmaceutical companies, leveraging insights from the Breast International Group (BIG). In the past 4 decades significant declines in breast cancer mortality have occurred, partly related to industry-academic clinical and translational partnerships with long term study follow up. However, in the past decade these partnerships have largely uncoupled. The increasing complexity and non-alignment of trials, funding constraints, regulatory complexity, declining academic freedom, lack of transparency, and lack of affordability of new agents have become key barriers to equitably improving cancer outcomes. Industry research expenditure in the United States is now 5 fold greater than publically funded academic research. To address these challenges, we advocate for patient centred systemic reforms, with trials balancing commercial interests with public health imperatives. These reforms should include equitable research funding models, streamlined international clinical trial regulatory processes, and increased collaboration across diverse stakeholders. Practical solutions to enhance global trial accessibility and efficacy include leveraging digital technologies, artificial intelligence, real world data, decentralizing clinical trial infrastructure, and embedding translational research frameworks across countries.
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spelling doaj-art-5133b99f80e7495b9ea244615d96a2d42025-08-20T03:05:07ZengNature Portfolionpj Breast Cancer2374-46772025-07-0111111010.1038/s41523-025-00768-1Advancing equitable access to innovation in breast cancerSeamus O’Reilly0Ines Vaz Luis1Virginie Adam2Evangelia D. Razis3Ander Urruticoechea4Amal Arahmani5Eva Carrasco6Boon H. Chua7Judith Bliss8Carolyn Straehle9Theodora Goulioti10Barbro Lindholm11Gustavo Werustsky12Etienne Brain13Philippe L. Bedard14Giuseppe Curigliano15Sherene Loi16Shigehira Saji17David Cameron18Cancer Trials Ireland, Royal College of SurgeonsInstitute Gustave RoussyBreast International Group3rd Oncology Department, Hygeia HospitalR&D department, Fundación OnkologikoaBreast International GroupGEICAM Spanish Breast Cancer Group, Av de Los Pinneos. 28703 San Sebastian de los ReyesFaculty of Medicine and Health, University of New South WalesThe Institute of Cancer Research, ICR_CTSUBreast International GroupBreast International GroupInstitution of Clinical Sciences, Dept of Oncology, Sahlgrenska Academy at Gothenburg UniversityLatin American Cooperative Oncology GroupInstitut Curie-Hôpital Rene HugueninDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of TorontoEarly Drug Development for Innovative Therapies Division, Istituto Europeo di Oncologia, IRCCSSir Peter MacCallum Department of Oncology, University of MelbourneDepartment of Medical Oncology, Fukushima Medical UniversityUniversity of Edinburgh Cancer Center, Western General Hospital, EDINBURGH United KingdomThis manuscript critically examines the challenges associated with the design and conduct of academic global breast cancer trials outside the influence of pharmaceutical companies, leveraging insights from the Breast International Group (BIG). In the past 4 decades significant declines in breast cancer mortality have occurred, partly related to industry-academic clinical and translational partnerships with long term study follow up. However, in the past decade these partnerships have largely uncoupled. The increasing complexity and non-alignment of trials, funding constraints, regulatory complexity, declining academic freedom, lack of transparency, and lack of affordability of new agents have become key barriers to equitably improving cancer outcomes. Industry research expenditure in the United States is now 5 fold greater than publically funded academic research. To address these challenges, we advocate for patient centred systemic reforms, with trials balancing commercial interests with public health imperatives. These reforms should include equitable research funding models, streamlined international clinical trial regulatory processes, and increased collaboration across diverse stakeholders. Practical solutions to enhance global trial accessibility and efficacy include leveraging digital technologies, artificial intelligence, real world data, decentralizing clinical trial infrastructure, and embedding translational research frameworks across countries.https://doi.org/10.1038/s41523-025-00768-1
spellingShingle Seamus O’Reilly
Ines Vaz Luis
Virginie Adam
Evangelia D. Razis
Ander Urruticoechea
Amal Arahmani
Eva Carrasco
Boon H. Chua
Judith Bliss
Carolyn Straehle
Theodora Goulioti
Barbro Lindholm
Gustavo Werustsky
Etienne Brain
Philippe L. Bedard
Giuseppe Curigliano
Sherene Loi
Shigehira Saji
David Cameron
Advancing equitable access to innovation in breast cancer
npj Breast Cancer
title Advancing equitable access to innovation in breast cancer
title_full Advancing equitable access to innovation in breast cancer
title_fullStr Advancing equitable access to innovation in breast cancer
title_full_unstemmed Advancing equitable access to innovation in breast cancer
title_short Advancing equitable access to innovation in breast cancer
title_sort advancing equitable access to innovation in breast cancer
url https://doi.org/10.1038/s41523-025-00768-1
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