What is the extent of disparities in cancer clinical trials among low- and middle-income countries?

Study uncovers unequal development over 20 years, with economic growth playing a role

Wiley

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New research reveals that the number and complexity of cancer clinical trials since 2001 have varied across low- and middle-income countries (LMICs), with economic growth contributing to disparities, but only to a certain extent. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

Although LMICs are expected to experience the greatest global burden of cancer in the coming years, cancer clinical trials are disproportionally concentrated in high-income countries. Because evidence suggests that LMICs have increased the number of cancer clinical trials over the last few decades, researchers investigated disparities in the number and complexity of such trials among LMICs over time and according to economic changes.

Between 2001 and 2020, a total of 16,977 cancer clinical trials in LMICs were registered. The Asian countries of China and South Korea experienced strong economic growth and increases in clinical trials. Similar trends, though less impressive, were observed in East European countries and the West Asian/Southern European country of Turkey. Conversely, South and Southeast Asian countries like India, Thailand, and Vietnam—which also experienced strong economic growth—had mainly inconsistent growth in clinical trials. The North and South American countries of Argentina, Brazil, and Mexico were able to increase their number of clinical trials despite relative economic stagnation. Among African countries, Egypt showed strong economic growth with a corresponding increase in clinical trials, but no such correlation was seen in South Africa.

Taken together, the findings suggest that economic growth is a contributor but not the single determinant of cancer clinical trial growth among LMICs.

“We believe these data offer valuable insights for LMICs aiming to enhance clinical research,” said senior author Max S. Mano, MD, PhD, of the Latin American Cooperative Oncology Group and Einstein Hospital Israelita, in Brazil.

 

Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com

Full Citation:
“Disparities in Cancer Clinical Trials Among Low- and Middle-income Countries: a 20-year Analysis.” Fanny G.A. Cascelli, Milene C. Mitsuyuki, Gustavo Werutsky, Carlos H.E. Barrios, Malu V.R. Barbosa, Michelle S. Almeida, and Max S. Mano. CANCER; Published Online: October 20, 2025 (DOI: 10.1002/cncr.70067).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.70067

Author Contact: Cauana Tavares, of the Latin American Cooperative Oncology Group, at cauana.tavares@lacog.group.

About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer and Instagram @ACSJournalCancer, and stay up to date with the American Cancer Society Journals on LinkedIn.

About Wiley      
Wiley is a global leader in authoritative content and research intelligence for the advancement of scientific discovery, innovation, and learning. With more than 200 years at the center of the scholarly ecosystem, Wiley combines trusted publishing heritage with AI-powered platforms to transform how knowledge is discovered, accessed, and applied. From individual researchers and students to Fortune 500 R&D teams, Wiley enables the transformation of scientific breakthroughs into real-world impact. From knowledge to impact—Wiley is redefining what's possible in science and learning. Visit us at Wiley.com and Investors.Wiley.com. Follow us on Facebook, X, LinkedIn and Instagram.

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Journal

Cancer

DOI

10.1002/cncr.70067 

Article Title

Disparities in Cancer Clinical Trials Among Low- and Middle-income Countries: a 20-year Analysis

Article Publication Date

20-Oct-2025

 

Sodium-ion battery breakthrough could power greener energy – and even make seawater drinkable

University of Surrey

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video: 

Salt water with universal indicator turns red at the counter electrode, showing that the new electrode isn't evolving gas.

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Credit: University of Surrey

Sodium-ion batteries may be the answer to the future of sustainable energy storage and could be used to make drinking water out of seawater. Scientists at the University of Surrey have discovered a simple way to boost their performance - by leaving the water inside a key component rather than removing it. 

Unlike lithium-ion technology, which currently dominates the energy storage market and relies on expensive, environmentally damaging materials, sodium is far more abundant and widely available. However, developing sodium-ion batteries that can compete on performance has remained a challenge. 

In a study published in the Journal of Materials Chemistry A, researchers detail how an existing sodium-based material, sodium vanadium oxide, can perform significantly better when the water it naturally contains is not removed.  

The material – known as a nanostructured sodium vanadate hydrate (NVOH) – showed a major boost in performance, storing far more charge, charging much faster and remaining stable for more than 400 charge cycles.  

In tests, the ‘wet’ version of the material could hold almost twice as much charge as typical sodium-ion materials, placing it among the best-performing cathodes reported to date. 

Dr Daniel Commandeur, Research Fellow at the University of Surrey School of Chemistry and Chemical Engineering, and lead author of the paper, said: 

“Our results were completely unexpected. Sodium vanadium oxide has been around for years, and people usually heat-treat it to remove the water because it’s thought to cause problems. We decided to challenge that assumption, and the outcome was far better than we anticipated. The material showed much stronger performance and stability than expected and could even create exciting new possibilities for how these batteries are used in the future.” 

The research team also tested how the material behaved in salt water – one of the most challenging environments possible. Results showed it not only continued to function effectively but also removed sodium from the solution while a graphite electrode extracted chloride – a process known as electrochemical desalination. 

Dr Commandeur added: 

“Being able to use sodium vanadate hydrate in salt water is a really exciting discovery, as it shows sodium-ion batteries could do more than just store energy – they could also help remove salt from water. In the long term, that means we might be able to design systems that use seawater as a completely safe, free and abundant electrolyte, while also producing fresh water as part of the process.” 

The breakthrough could accelerate the development of sodium-ion batteries as a viable alternative to current lithium-based technology. Using abundant, low-cost materials makes these batteries safer and more sustainable, with potential applications ranging from storing renewable energy on the grid to powering electric vehicles. The Surrey team’s approach also simplifies how high-performance sodium batteries are made, helping to bring large-scale, commercially viable energy storage a step closer. 

[ENDS] 

Notes to editors 

• Dr Daniel Commandeur is available for interview; please contact mediarelations@surrey.ac.uk to arrange. 

• The full paper can be found here: https://pubs.rsc.org/en/Content/ArticleLanding/2025/TA/D5TA05128B  

• A video can be found here. (Credit) University of Surrey (Caption) Salt water with universal indicator turns red at the counter electrode, showing that the new electrode isn't evolving gas. 

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Journal

Journal of Materials Chemistry A

DOI

10.1039/d5ta05128b 

Article Title

Nanostructured sodium vanadate hydrate as a versatile sodium ion cathode material for use in organic media and for aqueous desalination

Article Publication Date

15-Oct-2025

 

Krill in the Antarctic: Scientific data directly from krill fishing vessels

AWI study presents new concept for sustainable management of krill stocks in the Southern Ocean, in close cooperation with fisheries

Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research

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Antarctic Krill

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Credit: Alfred Wegener Institute / Carsten Pape

Swarms of krill in the Southern Ocean form the second tier of the Antarctic food pyramid, following plant plankton. If stocks were to shrink due to over-intensive fishing, this would incur direct consequences for many animal species that feed almost exclusively on krill. From 20 to 31 October, the annual meeting of the International Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR) will take place in Hobart, Australia, where the future regulation of krill fishery will represent a central topic. Prior to this, an international research team headed by Bettina Meyer from the Alfred Wegener Institute presented the sustainable management concept in the scientific journal PNAS, which involves the krill industry in the research and could thereby secure the stocks for the future.

Weighing in at an estimated 300 to 500 million tonnes of biomass in the Southern Ocean, Antarctic krill ranks as one of the most abundant multicellular wild animal species in the world. In the Antarctic food web, it forms the central link between primary marine production and many higher animals, such as seals, fish, penguins and baleen whales, whose populations are directly reliant on krill stocks. And humans have also joined the ranks of consumers in recent years. Large quantities of Antarctic krill are fished by humans and processed into feed pellets for aquaculture (salmon farms, shrimp farming) and food supplements (omega-3 fatty acid oil) and also find use in cosmetic products, toothpaste and animal feed.

The CCAMLR regulates and controls the krill fishery in the Southern Ocean (also known as the Antarctic Ocean). The annual general meeting of this international commission will commence on 20 October in Hobart, Australia. "We published a sustainable management concept in advance, which links fishing activities with closely-meshed scientific monitoring," says Prof Dr Bettina Meyer, head of the Ecophysiology of Pelagic Key Species working group at the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI). "Current management is based on historical fisheries data and only one large-scale survey of krill biomass from the year 2000. In order to utilise krill stocks in a sustainable manner whilst also ensuring the survival of penguins, seals and whales, it is imperative that we adapt our approach to the challenges of the 21st century and strengthen the scientific basis of our decisions."

In line with their new concept, Bettina Meyer and her team of authors are therefore focussing on closely integrating and involving the fishing industry – regarding the latter less as an opponent and more as a partner. "Since 2020, every fishing vessel must have a scientific observer on board who collects biological data on the krill that have been caught - such as length, sex and degree of maturity," says the AWI expert. "This data, however, is not included in current krill monitoring." In view of this situation, the researchers propose that fishing vessels should be used more as research platforms to collect essential data for the development of sustainable krill fishery management. Acoustic data from echo sounders that detect swarms of krill, recorded sightings of krill predators such as seals and whales, in addition to data collection on the composition of krill catches in terms of length, sex and maturity of the shrimp iwould provide a comprehensive picture of krill populations that individual research vessels would not be able to generate. This study presents data collection methods that could be implemented on krill fishing vessels in order to develop sustainable fishery management for the species. This approach ensures that commercial interests are aligned with the long-term protection of the Southern Ocean ecosystem, which is also in the interests of fisheries.

The integration of this concept into a new management strategy is to be discussed and implemented at CCAMLR this year - if all members can agree, as proposals are only implemented by consensus. Current catch quotas document just how important this is: Although Antarctic krill are distributed throughout the Southern Ocean, krill fishing is concentrated almost exclusively in the Atlantic sector of the Southern Ocean (CCAMLR Area 48), which is home to around 63 million tonnes of krill biomass. Fishing activities are focused on three main fishing areas close to the coast: the Antarctic Peninsula, the South Orkney Islands and South Georgia. Since 1991, a maximum catch quota of 0.62 million tonnes has applied to the entire area. As from 2009, the quota has been divided into four smaller sub-areas (48.1 to 48.4) to prevent fishing from becoming too concentrated in one area. For instance, the total allowable catch of krill in sub-area 48.1, which encompasses the Antarctic Peninsula, was limited to 0.155 million tonnes.

" Despite extensive consultations, CCAMLR members were unable to reach a consensus on the continuation of this regulation last year," as Bettina Meyer explains. "Due to the absence of regional restrictions, the amount of krill fished in sub-area 48.1 more than doubled to almost 0.4 million tonnes by July of this year and the maximum permitted catch in the entire fishing area 48 was reached for the first time."  It is unclear what impact this will have on the stocks and krill-dependent predators in this ecologically sensitive marine region in the vicinity of the Antarctic Peninsula.

"Our monitoring concept provides a pragmatic approach to the actual realities. It is evident that eliminating fishing in the Antarctic would be a highly preferable scenario," Bettina Meyer states. "However, given the economic interests of individual CCAMLR states, this is not a viable option." Close cooperation with the fishing industry can multiply the available scientific data and yield a much better picture of the population dynamics of Antarctic krill. On this foundation, sensitive regions such as spawning grounds and hotspots for krill-eating animals can be specifically identified and effectively protected. By carefully planning catch quotas, fishing areas and fishing seasons, the permitted amount can be utilised efficiently, while minimising the impact on the krill population and the entire ecosystem.

The involvement of the industry in this area can deliver significant benefits: On the one hand, regular, seasonal data collection on krill biomass and population composition – as is already being conducted in some cases – can provide valuable information for fishery management. Conversely, the provision of direct financial support for research projects with the objective of enhancing the management of fisheries can assist in the long-term security and expansion of international research programmes.

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2412624122 

Method of Research

Survey

Subject of Research

Animals

Article Title

Adjusting the management of the Antarctic krill fishery to meet the challenges of the 21st century

 

New white paper urges policymakers to modernize practice laws to unlock AI’s full potential in healthcare

HealthFORCE, AAPA, and West Health release second report in groundbreaking series on AI and the healthcare workforce

West Health Institute

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Alexandria, Va. – October 20, 2025 — As the U.S. confronts a historic healthcare workforce crisis, a new white paper released today calls on federal and state policymakers to modernize outdated laws, regulations, and payment systems in order to harness the full potential of artificial intelligence (AI) in care delivery.

Titled “Aging Well with AI: Transforming Care Delivery,” the report was commissioned by HealthFORCE, in collaboration with the American Academy of Physician Associates (AAPA) and West Health, and developed by The LINUS Group. It is the second in a two-part series examining how AI can support care teams, expand access, and ease the growing strain on America’s healthcare system.

“America’s healthcare system is not built for the future. We can’t just innovate around broken infrastructure—we need to modernize it,” said Lisa M. Gables, CEO of AAPA and founder of HealthFORCE. “This paper makes clear that AI alone won’t fix workforce shortages, but with policy reform, it can dramatically ease the burden and bring care to more people.”

With a projected shortfall of 3.2 million healthcare workers by 2026 and an aging population whose care needs are becoming more complex, the U.S. is facing a compounding access and workforce crisis.

The paper highlights the promise offered by AI tools to address these challenges. Some of the promising tools on the horizon include ambient documentation that reduces time spent on charts, virtual care coordination systems that streamline referrals and follow-ups, and personalized clinical education that helps providers stay current in a fast-evolving field. Such innovations are already proving their impact in pilot programs across the country.

The paper proposes a Risk/Impact Matrix to guide adoption and policy prioritization. Use cases that rank low risk, and high impact should be accelerated first, including:

• Ambient AI Scribes: Freeing clinicians from redundant charting to focus more on patients.
• AI-Supported Care Coordination: Reducing duplicative tests and missed referrals through smart triage and automated workflows.
• On-Demand Clinical Training: Empowering providers to stay current with AI-enhanced continuing education tailored to evolving roles.

High-impact but more complex use cases, like AI-assisted diagnostics and at-home monitoring for vulnerable patients, are also discussed as future-critical innovations.|

Critically, the paper acknowledges that even the most promising tools will stall if providers are still bound by outdated supervision requirements, restricted from using digital platforms independently, or reimbursed based on outdated models that reward documentation over outcomes. The report outlines specific policy developments needed to enable scalable integration of AI in care delivery:

• Modernize Practice Laws: Update state and federal laws to allow providers—especially PAs and NPs—to practice to the full extent of their training, enabling broader use of AI in clinical care, care coordination, and home-based models.
• Shift Payment Models: Move away from volume-based reimbursement and instead incentivize continuity, outcomes, and technology-enabled care.
• Streamline Documentation Requirements: Align federal billing rules with the capabilities of AI-powered systems to reduce unnecessary administrative burden.
• Establish National AI Standards: Develop cross-cutting safety, equity, and interoperability frameworks to guide the responsible deployment of AI tools across all care settings.

“Breakthroughs in discovery won’t transform care if we don’t invest in the infrastructure to deliver them, “AI is a powerful tool driving operational innovation – helping us streamline workflows, coordinate care, and extend capacity – but without modern systems and policies, its potential will remain untapped.”

Together, the two reports in the Aging Well with AI series make a compelling case: AI can help solve the workforce crisis, but only if we solve the policy crisis first.

Find the latest report here.

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Media Contact: Jenni Roberson, 703.380.2764

 About the American Academy of Physician Associates (AAPA)
AAPA is the national membership organization for all physician associates/physician assistants (PAs). PAs are licensed clinicians who practice medicine in every specialty and setting. Trusted, rigorously educated and trained healthcare professionals, PAs are dedicated to expanding access to care and transforming health and wellness through patient-centered, team-based medical practice. Learn more about the profession at aapa.org and engage through Facebook, LinkedIn, Instagram, and X.

About HealthFORCE
HealthFORCE is a national alliance of leaders dedicated to addressing the root causes of our nation’s healthcare workforce crisis. Our founding members include healthcare providers, administrators, and technicians; industry leaders; advocates; educators and community-based leaders united in our mission of rebuilding, expanding, and diversifying the U.S. healthcare workforce. Learn more at healthforce.org

About West Health
Solely funded by philanthropists Gary and Mary West, West Health is a family of nonprofit and nonpartisan organizations that include the Gary and Mary West Foundation and Gary and Mary West Health Institute in San Diego and the Gary and Mary West Health Policy Center in Washington, D.C. West Health is dedicated to lowering healthcare costs to enable seniors to successfully age in place with access to high-quality and affordable health and support services that preserve and protect their dignity, quality of life and independence. Learn more at westhealth.org.