Inequities in cancer drug development in terms of unmet medical need

This study measures inequality and inequity in the distribution of clinical trials on cancer drug development between 1996 and 2016, comparing the number of clinical trials with cancer need, proxied by prevalence, incidence, or survival rates for both rare and non-rare cancers. We leverage a unique global database of clinical trials activity and costs between 1996 and 2016, constructed for 227 different cancer types to measure for rare and non-rare cancers: i) inequalities and inequity of clinical trial activity, considering all trials as well as split by R&D stage; ii) inequalities and inequity in R&D investment proxied by trial enrollment and duration; iii) evolution of inequity over time. Inequalities are measured with concentration curves and indices and inequities measured with the health inequity index. We find four important results. First, we show pro-low need inequity across cancer types for both rare and non-rare cancers, for all need proxies. Second, we show inequity differs across R&D stages and between rare and non-rare cancers. The distribution of clinical trials for non-rare cancers disproportionately favors low-need non-rare cancers from earlier to later stages of R&D, whilst for rare cancers this only occurs in Phase 2 trials. Third, inequity analyses in R&D investment show that only trial enrollment for rare cancers and trial duration for non-rare cancers are disproportionately concentrated among low-need cancers. Finally, while pro-low need inequity has persisted between 1996 and 2016 for non-rare cancers, it has faded for rare cancers post-EU orphan drugs’ legislation

Prokaryotic Hydrocarbon Degraders

Hydrocarbons have been part of the biosphere for millions of years, and a diverse group of prokaryotes has evolved to use them as a source of carbon and energy. To date, the vast majority of formally defined genera are eubacterial, in 7 of the 24 major phyla currently formally recognized by taxonomists (Tree of Life, http://tolweb.org/Eubacteria. Accessed 1 Sept 2017, 2017); principally in the Actinobacteria, the Bacteroidetes, the Firmicutes, and the Proteobacteria. Some Cyanobacteria have been shown to degrade hydrocarbons on a limited scale, but whether this is of any ecological significance remains to be seen – it is likely that all aerobic organisms show some basal metabolism of hydrocarbons by nonspecific oxygenases, and similar “universal” metabolism may occur in anaerobes. This chapter focuses on the now quite large number of named microbial genera where there is reasonably convincing evidence for hydrocarbon metabolism. We have found more than 320 genera of Eubacteria, and 12 genera of Archaea. Molecular methods are revealing a vastly greater diversity of currently uncultured organisms – Hug et al. (Nat Microbiol 1:16048, 2016) claim 92 named bacterial phyla, many with almost totally unknown physiology – and it seems reasonable to believe that the catalog of genera reported here will be substantially expanded in the future