Developing neuro-oncology clinical trials in low- and middle-income countries: a scoping review of the current literature

Abstract

Low- and middle-income countries (LMICs) have
historically been under-represented in clinical trials,
leading to a disparity in evidence-based
recommendations for the management of neurooncological
conditions. To address this knowledge gap,
we conducted a scoping review to assess the current
literature on clinical trials in neuro-oncology from LMICs.
The eligibility criteria for inclusion in this review included
clinical trials registered and conducted with human
subjects, with available English language text or
translation, and focussed on neuro-oncological cases. The
literature search strategy captured 408 articles, of which
61 met these criteria, with a significant number of
randomised controlled trials from specific LMICs. The
review found that LMIC clinical trials have contributed
significantly to understanding surgical,
chemotherapeutic, and radiation therapy interventions
for brain tumours, paediatric cancers, and the
repurposing of drugs as new targets in neuro-oncology.
These findings highlight the potential for expanding
clinical trials research in neuro-oncology in LMICs, which
may significantly impact global understanding and
management of these conditions, particularly from
diverse populations from the global south.
Keywords: neuro-oncology, brain tumour, drug
Repositioning