Incentivizing RCC Research Investment Across Lower-Income Countries

CancerNetwork® spoke with Regina Barragan-Carrillo, MD, postdoctoral fellow of medical oncology and medical therapeutics at City of Hope Comprehensive Cancer Center in Duarte, CA, about what can be done to incentivize investment in renal cell carcinoma (RCC) research across lower-income countries and similar areas with limited resources following a real-world analysis study she presented at the 2025 ASCO Genitourinary Cancers Symposium.

Barragan-Carrillo began by describing a phenomenon in the oncology space called “reverse engineering,” wherein ideas developed in lower-income countries lead to alternative, and often economic, interventions. Therefore, she explained, these strategies can be brought back to a high-income country (HIC) and integrated into practice as a cost-effective strategy.

Regarding incentivization for investment in RCC research, Barragan-Carrillo suggested that addressing the availability of clinical trials in this indication was a good starting point given the available expertise and apparent need of clinical trials in non-HICs. Additionally, Barragan-Carrillo expressed that there is a need for aid from private, government, and non-governmental organization (NGO) stakeholders.

Data from the real-world analysis show that RCC trials that were available in upper-middle, lower-middle, and lower-income countries did not receive any NIH, NCI, or Department of Justice (government) sponsorship (P < .001). By contrast, 6.6% of RCC trials solely available in HICs received government sponsorship.

Additionally, pharmaceutical companies sponsored 64.3% of RCC trials available in upper-middle, lower-middle, and lower-income countries, and academia sponsored 33.3% of these trials. By contrast, trials available in HICs had 50.5% of sponsorship from academia, and 37.0% of sponsorship came from pharmaceutical companies. Furthermore, a greater percentage of RCC trials were later stage in countries available to lower-income countries than HICs; 25.0% vs 8.1% (P < .001).

Transcript:

There is this term we use in global oncology that is called reverse engineering, which means we [often] develop an idea, a project, or a specific intervention in lower-income countries or countries with [fewer] resources, and this leads to, for example, more economic interventions. Once we have developed that in a more resource-constrained setting, we are able to bring it back, for example, to more high-income countries, and make it more cost-effective. [It is about] understanding the many strategies we can use whenever highly developed technologies or specific types of machines are not available; how can we start solving this problem?

There are many things we can learn from applying the knowledge from a resource-constrained setting into a resource-rich setting because at the end of the day, resources are not unlimited. We need to start being thoughtful and critical on how we end up applying them. The availability of critical trials is going to be a good ground to stand on because it's definitely a need, and there's a lot of worthwhile [expertise]. We need the extra push from pharmaceutical companies, as well as government stakeholders, NGOs, and international agencies.

Reference

Barragan-Carrillo R, Zugman M, Castro D, et al. Assessing global disparities in clinical trial availability for renal cell carcinoma (RCC). J Clin Oncol. 2025;43(suppl 5):449. doi:10.1200/JCO.2025.43.5_suppl.449