Decline in Clinical Trials for Cancer

The fall in the number of clinical trials in India together with blockbuster pipeline drying up from the global pharma majors are seen to seriously impact the access to newer drugs to treat tobacco related cancers. The fewer number of novel drugs is posing to be a huge challenge for oncologists to treat the growing number of cases.

With the stringent norms coming in from global regulatory majors where trial designs mandate use of electronic records, maintenance of total transparency from ethics committee registration, patient recruitment, monitoring of adverse drug reactions and reporting deaths have all resulted in a grinding  halt to novel medicines. There is a serious lack of the newer cancer drugs to treat oral cancer affecting the larynx, pharynx, food pipe, largely attributed to tobacco chewing and smoking, stated the cancer specialist hospitals.

Many patients in the early and late stages of lung, head and neck cancers were agreeable to be part of clinical trials because they did not have to pay for drugs which are expensive. 

Dr. S Krishnamurthy, Professor, Surigcal Oncology at Kidwai Memorial Institute of Oncology (KMIO) expressed that Kidwai was the centre for many of the cancer trials until recently. Also due to government restrictions, there are hardly any human studies being carried out.
As a result we are now forced to prescribe the patients with the existing drugs to treat cancer. Particularly for lung cancer Gemcitabine/cisplatin is among the most widely used regimens. There is also a class of platinum-containing anti-cancer drugs like carboplatin and oxaliplatin which are also popular along with Doxorubicin that is part of a group of chemotherapy drugs.

For the affordable patients, targeted therapies are seen to be the answer to treat cancers affecting the lung, head and neck areas. Currently the most opted commonly used drug is the epidermal growth factor receptor (EGFR) which is known to provide a big relief in terms of symptoms control and also enable patients to lead a somewhat normal life. 

While lung cancer which affects 90 per cent of the smokers is the most difficult to treat and a paucity of clinical trials is affecting patient care. For oral cavity and other tobacco induced cancers, oncologists would prefer to first consider surgery and remove the diseased cells. The second and third options put before the specialists are to go in for radiation and then chemotherapy. But these are known for side-effects. Now with a fall in the number of trails, oncologists are looking at targeted therapies where monoclonal bodies (MAbs) are seen to be an answer.