Accelerating oncology research through strategic site selection and modular construction

As a medical oncologist and Executive Director of the Uganda Cancer Institute, Dr Jackson Orem has decades of experience in oncology research. In an article in Nature’s Communications Medicine, he shed light on the complexity and dynamism of cancer care, a practice based deeply on evolving research and advancing technologies.

Drawing from his extensive experience in East Africa, Dr Orem points out that most low- and middle-income countries (LMICs) are keen on establishing holistic cancer care programmes for their populations. However, a lack of robust systems, best practices, and supportive public healthcare systems act as hurdles in their paths towards better oncology care.

More importantly, Dr Orem highlights the importance of localised cancer research to develop medical interventions well suited to every country and region’s unique epidemiological landscape. Many stakeholders in the health sector assume that research findings generated in affluent countries, where clinical trial ecosystems are more developed, can be copy-pasted in other locations. However, this isn’t the case – not only because of distinct cancer epidemiologies but also because of differences in culture, attitudes towards healthcare, climatic conditions, and infrastructural support.

There isn’t enough appreciation for the need for contextual, targeted cancer research in LMICs. Consequently, not enough resources are invested in investigating cancers that disproportionately affect the populations of developing countries. For instance, despite HIV being a major driver of malignancies in sub-Saharan Africa, research into HIV-related cancers in the region is lacking. This must change.

However, oncology research in sub-Saharan Africa isn’t unprecedented. Quite the opposite. As far back as 1958, Dr Denis Burkitt’s work, in collaboration with researchers at Makerere University in Kampala, Uganda, on Burkitt’s lymphoma was informed by observations of Ugandan patients. Over the years, African scientists have added to the body of work on the disease and its relationship with malaria and Epstein-Barr virus. African researchers have also been integral to the development of Burkitt’s lymphoma treatments like chemotherapy.

The work on cancer coming out of Africa isn’t insignificant, but it isn’t enough and it’s been slow to reach healthcare delivery and ultimately, cancer patients in Africa. We can blame global socioeconomic disparities between affluent countries and less-developed countries in sub-Saharan Africa for this.

Nonetheless, research is and must be prioritised as an essential part of any health system. This holds even for cancer in Africa.

Strategic site selection to accelerate oncology research in LMICs

Clinical trials are a crucial element of health and biopharmaceutical research. As researchers in LMICs try to bridge the research gap by conducting more clinical trials in their home countries, strategic site selection is one of the critical factors which will determine their success.

The site selected to conduct a clinical trial will affect the researchers’ access to the right patient population, lab and medical expertise, infrastructure, and regulatory environment. As such, the site of a clinical trial can significantly impact the cost-effectiveness, efficiency, and ability of the trial to generate clinical data that is robust and reliable. Naturally, then, the decision of where a clinical trial will be conducted is not one to take lightly.

When selecting a clinical trial site, you – as a researcher, funder and other stakeholder – should carefully consider all the variables that could affect the success of the endeavour.

Access to the right patient population. If you want to conduct a trial for say, a potential new cervical cancer treatment, you should identify locations which have access to enough cervical cancer patients so that you have an adequate sample size. This involves a fair bit of research. You could refer to disease-specific databases and national or local cancer registries. You should also acquire a good grasp of demographic factors, cervical cancer prevalence, and genetic characteristics common in a region before you finalise a site.

Access to the right infrastructure. When it comes to clinical trials, infrastructure may include cleanrooms, imaging tools, laboratory facilities, diagnostic tools, manufacturing setups to produce the drug candidate, and more. These are critical requirements which are directly linked to your ability to conduct a clinical trial. Sufficient and appropriate infrastructural support is key to hitch-free progress in a trial. Additionally, a research site with already established connections with hospitals, academic institutions, and/or development sector organisations can leverage these connections to accelerate and enhance patient recruitment.

Access to the right expertise. When you choose a clinical trial site, you want to make sure that local research teams whose support you will need have the experience and expertise necessary to effectively implement the trial. You could assess this by looking into their history of conducting cancer-related trials and any research they may have published in the field.

Regulations governing clinical research. In addition to international standards, every country has its own regulatory and ethical frameworks within which clinical research must be conducted. It is important to understand these requirements well in advance to ensure compliance. This ranges from getting approvals from institutional review boards (IRB), ethically recruiting patients, and adopting appropriate processes to procure informed consent. Having a local partner who has a strong understanding of such guidelines can make the entire process smoother than if you had to go it alone.

Geographic and cultural considerations. Every region has its unique local features, in terms of terrain, climate and culture, which could impact your clinical trial. For instance, inadequate transportation infrastructure, lack of cold storage facilities, or extremely harsh climate could affect your ability to effectively transport and store the drug candidate or patients’ ability to access the trial site. Language barriers, local customs, and attitudes towards modern medicine could also affect patient enrolment, comfort, and engagement rates. Having insight into the on-ground situation before you select a site is crucial.

Portable, modular systems to the rescue

Prefabricated pharma and clinical facilities can’t address all the issues you might encounter when working towards or on a clinical trial. But they sure can make things easier, faster, and more cost-effective.

Clinical trials are notoriously expensive and time-consuming. By relying on prefabricated modular systems for cleanrooms, laboratories, diagnosis, patient recovery, and drug production, you can significantly cut down your costs and timelines.

PodTech™’s podules are prefabricated and pre-engineered, meaning that their modular components are manufactured off-site. On-site, at your clinical trial location, they simply need to be assembled, connected to electricity and basic utilities, and voila! They’re ready to house your clinical trial. No lengthy wait times for deployment. No hassles to integrate HVAC, plumbing, lighting, or fire protection. Only a small team for installation. The podules™ are plug-and-play in the truest sense of the phrase.

Site selection is an important decision – one that can make or break your chances for success in a clinical trial. Don’t let conventional construction further add to your burden. Let PodTech™ take care of things for you, so that you can focus on getting novel medications into the hands of patients that need them the most.