Browsing by Author "Muller, B"

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    Choosing Wisely in oncology in Latin America: what SLACOM does not recommend in the care of cancer patients in Latin America
    (ecancer Global Foundation, 2024) Ismael, J; Esandi, E; Arroyo, G; Becerra, S; Bejarano, S; Castro, C; Enrique, C; Gauna, C; Gutiérrez-Delgado, F; Deza, EG; Kopitowsky, K; Lewi, D; Muller, B; Murillo, R; Pomata, A; Puyol, J; Quintanilla, G; Rompato, S; Santini, L; Vidaurre, T; Solano, A; Cazap, E
    Choosing Wisely is an initiative by the American Board of Internal Medicine (ABIM) and ABIM Foundation to deter unnecessary medical treatments and procedures. Faced with the burden of modern technologies and treatments, it is crucial to identify practices lacking value in daily care. The Latin American and Caribbean Society (SLACOM), comprising cancer control experts, deems it vital to tailor this initiative for enhancing cancer care in the region. Through a modified DELPHI methodology involving two rounds of electronic questionnaires and a hybrid meeting to discuss key points of contention, ten essential recommendations were identified and prioritised to avoid harmful oncology procedures in our region. These consensus-based recommendations, contextualised for Latin America, have been compiled and shared to benefit patients. The Scientific Committee, consisting of prominent oncologists and health experts, collaborates remotely to drive this project forward.
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    Personalizing Precision Oncology Clinical Trials in Latin America: An Expert Panel on Challenges and Opportunities
    (AlphaMed Press, 2019) Arai, RJ; Guindalini, RSC; Llera, AS; O'Connor, JM; Muller, B; Lema, M; Freitas, HC; Soria, T; Delgado, L; Landaverde, D; Montenegro, P; Riechelmann, RP
    The participation of patients in precision oncology trials needs to fulfill molecular-based selection criteria. This strongly limits accrual, and as a consequence, screening successes have decreased, costs have increased, and fewer subjects are enrolled. To achieve narrowed targets, studies have been forced to be multicenter and multinational to reach a larger pool of candidates. However, this globalization faces many challenges, as, for example, in the case of precision oncology trials. These trials have a complex structure that is dependent upon a high-tech infrastructure and knowledge in a dynamic environment. Given the movement of precision clinical cancer research to regions other than Europe and the U.S., it is important to evaluate the feasibility of performing such trials in lower-middle- and low-income countries. Here we critically discuss the advantages of conducting precision oncology clinical trials in Latin America and make suggestions on how to overcome the main challenges involved. IMPLICATIONS FOR PRACTICE: Precision clinical trials in oncology are studies that require candidates to have tumors with specific molecular alterations, which are considered the target for the trial experimental therapy. Because many molecular alterations are rare, fewer patients are enrolled. This has led to trials being forced to be multicenter and multinational, including trials in Latin America. This article discusses the challenges and opportunities to conduct precision oncology trials in Latin America, aiming to help sponsors and investigators to solve complex issues that ultimately lead to more of such trials being run in the region, potentially benefiting more Latin American patients with cancer.