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

• Published in: Cancer Vol. 129; no. 9; pp. 1313 - 1315
• Main Authors: Patel, Tej A., Ting, Frederic Ivan L., Jain, Bhav, Eala, Michelle Ann B., Jacomina, Luisa E., Mejia, Michael Benedict A., Dee, Edward Christopher
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2023
• Subjects: Cancer; Chemotherapy; Clinical trials; Clinical Trials as Topic; Delivery of Health Care; epistemic injustice; global health; Humans; Immunotherapy; low‐ and middle‐income countries; Oncology; Patient-Centered Care; randomized clinical trials; global health; epistemic injustice; randomized clinical trials; low- and middle-income countries; chemotherapy; immunotherapy
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.34674

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.