Inherent Safety Assessment of Industrial-Scale Production of Chitosan Microbeads Modified with TiO2 Nanoparticles.

In this study, the inherent safety analysis of large-scale production of chitosan microbeads modified with TiO2 nanoparticles was developed using the Inherent Safety Index (ISI) methodology. This topology was structured based on two main stages: (i) Green-based synthesis of TiO2 nanoparticles based on lemongrass oil extraction and titanium isopropoxide (TTIP) hydrolysis, and (ii) Chitosan gelation and modification with nanoparticles. Stage (i) is divided into two subprocesses for accomplishing TiO2 synthesis, lemongrass oil extraction and TiO2 production. The plant was designed to produce 2033 t/year of chitosan microbeads, taking crude chitosan, lemongrass, and TTIP as the primary raw materials. The process was evaluated through the ISI methodology to identify improvement opportunity areas based on a diagnosis of process risks. This work used industrial-scale process inventory data of the analyzed production process from mass and energy balances and the process operating conditions. The ISI method comprises the Chemical Inherent Safety Index (CSI) and Process Inherent Safety Index (PSI) to assess a whole chemical process from a holistic perspective, and for this process, it reflected a global score of 28. Specifically, CSI and PSI delivered scores of 16 and 12, respectively. The analysis showed that the most significant risks are related to TTIP handling and its physical-chemical properties due to its toxicity and flammability. Insights about this process's safety performance were obtained, indicating higher risks than those from recommended standards.

The impact of chemoinformatics on drug discovery in the pharmaceutical industry.

Introduction: Even though there have been substantial advances in our understanding of biological systems, research in drug discovery is only just now beginning to utilize this type of information. The single-target paradigm, which exemplifies the reductionist approach, remains a mainstay of drug research today. A deeper view of the complexity involved in drug discovery is necessary to advance on this field.Areas covered: This perspective provides a summary of research areas where cheminformatics has played a key role in drug discovery, including of the available resources as well as a personal perspective of the challenges still faced in the field.Expert opinion: Although great strides have been made in the handling and analysis of biological and pharmacological data, more must be done to link the data to biological pathways. This is crucial if one is to understand how drugs modify disease phenotypes, although this will involve a shift from the single drug/single target paradigm that remains a mainstay of drug research. Moreover, such a shift would require an increased awareness of the role of physiology in the mechanism of drug action, which will require the introduction of new mathematical, computer, and biological methods for chemoinformaticians to be trained in.

Why should the pharmaceutical industry claim for the implementation of second-order chemometric models-A critical review.

Today, pharmaceutical products are submitted to a large number of analytical tests, planned to either ensure or construct their quality. The official methods of analysis used to perform these determinations are very different in nature, but almost all demand the intensive use of reagents and manpower as major drawbacks. Thus, analytical development is continuously evolving to find fast and smart approaches. First-order chemometric models are well-known in the pharmaceutical industry, and are extensively used in many fields. Such is the impact of chemometric models that regulatory agencies include them in guidelines and compendia. However, the mention or practical application of higher-order models in the pharmaceutical industry is rather scarce. Herein, we try to bring a brief introduction to chemometric models and useful literature references, focusing on higher-order chemometric models (HOCM) applied to reduce manpower, reagent consumption, and time of analysis, without sacrificing accuracy or precision, while gaining selectivity and sensitivity. The advantages and drawbacks of HOCM are also discussed, and the comparison to first-order chemometric models is also analyzed. Along the work, HOCM are evidenced as a powerful tool for the pharmaceutical industry; moreover, its implementation is shown during several steps of production, such as identification, purity test and assay, and other applications as homogeneity of API distribution, Process Analytical Technology (PAT), Quality by Design (QbD) or natural product fingerprinting. Among these topics, qualitative and quantitative applications were covered. Experimental approaches of chemometrics coupled to several analytical techniques such as UV-vis, fluorescence and vibrational spectroscopies (NIR, MIR and Raman), and other techniques as hyphenated-chromatography and electrochemical techniques applied to production and analysis are discussed throughout this work.

Near-infrared spectroscopic applications in pharmaceutical particle technology.

Near-infrared spectroscopy (NIRS) is nowadays an established analytical technique in the pharmaceutical industry. The aim of this review is to present the progress of NIRS in providing useful information for pharmaceutical particle technology. NIR methods are now developed to characterize a wide variety of materials (active pharmaceutical ingredients, excipients, co-processed powders, and physical mixtures) and pharmaceutical dosage forms (conventional, modified drug release technologies, and phytomedicines). This review also provides a number of spectra to illustrate the fundamental understanding of NIRS which has been gained. The sampling that must occur prior to the acquisition of near-infrared spectra is also discussed, as well as developments in monitoring mixing, tableting, and coating. This review will be valuable for product formulation and process engineering specialists.

Biosimilars: An Approach to some Current Worldwide Regulation Frameworks.

Developing new biologics has led to regulations and norms aimed at guaranteeing their safety, quality and effectiveness, in terms of marketing, prescription, use, interchangeability and switching. Biologics are of great importance in treating patients suffering from rheumatic, autoimmune, inflammatory and neoplastic diseases. The expiry/lapse of reference biologics or originators' patents has meant that developing biosimilars involves accompanying legal requirements for their approval in countries worldwide. This paper has thus approached the situation of biosimilar regulation worldwide, the pertinent technical concepts and regulatory differences in some countries of interest.

Trends on the Rapid Expansion of Supercritical Solutions Process Applied to Food and Non-food Industries.

BACKGROUND: The supercritical fluids applied to particle engineering over the last years have received growing interest from the food and non-food industries, in terms of processing, packaging, and preservation of several products. The rapid expansion of supercritical solutions (RESS) process has been recently reported as an efficient technique for the production of free-solvent particles with controlled morphology and size distribution. OBJECTIVE: In this review, we report technological aspects of the application of the RESS process applied to the food and non-food industry, considering recent data and patent survey registered in literature. METHODS: The effect of process parameters cosolvent addition, temperature, pressure, nozzle size among others, during RESS on the size, structure and morphology of the resulted particles, and the main differences about recent patented RESS processes are reviewed. RESULTS: Most of the experimental works intend to optimize their processes through investigation of process parameters. CONCLUSION: RESS is a feasible alternative for the production of particles with a high yield of bioactive constituents of interest to the food industry. On the other hand, patents developed using this type of process for food products are very scarce, less attention being given to the potential of this technique to develop particles from plant extracts with bioactive substances.

Corporate social responsibility to improve access to medicines: the case of Brazil.

BACKGROUND: Access to medicines and the development of a strong national pharmaceutical industry are two longstanding pillars of health policy in Brazil. This is reflected in a clear emphasis by Brazil's Federal Government on improving access to medicine in national health plans and industrial policies aimed at promoting domestic pharmaceutical development. This research proposes that such policies may act as incentives for companies to pursue a strategic Corporate Social Responsibility (CSR) agenda. CSR that supports Governmental priorities could help companies to benefit significantly from the Governmental industrial policy. We sought to determine whether CSR activities of Brazilian pharmaceutical firms are currently aligned with the Federal Government's health prioritization. To do so we examined key Brazilian health related policies since 2004, including the specific priorities of Brazil's 2012-2015 Health Plan, and compared these with CSR initiatives that are reported on the websites of select pharmaceutical firms in Brazil. RESULTS: Brazil's national health plans and industrial policies demonstrated that the Federal Government has followed diverse approaches for improving access to medicines, including strengthening health care infrastructure, increasing transparency, and supporting product development partnerships. Case studies of six pharmaceutical firms, representing both public and private companies of varying size, support the perspective that CSR is a priority for firms. However, while many programs target issues such as health infrastructure, health care training, and drug donation, more programs focus on areas other than health and do not seem to be connected to Governmental prioritization. CONCLUSION: This research suggests that there are loose connections between Governmental priorities and pharmaceutical firm CSR. However, there remains a significant opportunity for greater alignment, which could improve access to medicines in the country and foster a stronger relationship between the Government and industry.

Gestión de desarrollo de productos en la industria biotecnológica / Products development management in the biotechnological industry

El crecimiento de las empresas en un mundo altamente competitivo depende del rendimiento superior del proceso de desarrollo de sus productos. En este artículo se sistematizan los elementos teóricos relacionados con la gestión de desarrollo de productos en empresas de alta tecnología, particularmente en la industria biofarmacéutica. Se evidencian las particularidades de la gestión de desarrollo de productos en la industria biotecnológica, que se fundamentan principalmente por la duración y el costo del desarrollo, así como los requisitos regulatorios que inciden. Se profundiza en las funciones y competencias del gerente de proyectos para este tipo de industria(AU)

The growth of companies in a highly competitive world depends on the superior performance of the development process of their products. The theoretical elements associated to product development management in high-tech companies are systematized in this paper, particularly in the biopharmaceutical industry. The particularities of the product development management in the biotechnological industry are evidenced that are based mainly on the duration and the cost of the development, as well as the regulatory requirements that they affect. It deepens the functions and competencies of the project manager for this type of industry(AU)

The "mild-torture economy": exploring the world of professional research subjects and its ethical implications / "A tortura da economia moderada": explorando o mundo dos sujeitos de pesquisa profissionais e suas implicações éticas

AbstractThis paper documents the emergence of the subject of professional research in Phase I clinical trials that test the safety of drugs in development. Based on ethnographic research among subjects self-identified as "professional guinea pigs" in Philadelphia, USA, it examines their experiences and opinions on the conduct of trials and risks they take. The author argues that the risks posed by the continued participation, such as exposure to potentially dangerous drug interactions are minimized or ignored by research subjects because of the prospect of financial gain. Risks to the professional guinea pigs are also ignored by the pharmaceutical industry, which has become dependent on the usual participation of experienced research subjects. Arguing that financial incentives undermine the ethical imperative of informed consent to be given freely by volunteers, this research confirms the need to reform the policies governing the participation of paid subjects in Phase I clinical trials.

ResumoEste artigo documenta o surgimento do sujeito da pesquisa profissional na Fase I de ensaios clínicos que testam a segurança de medicamentos em desenvolvimento. Baseado em pesquisas etnográficas entre sujeitos autoidentificados "cobaias profissionais" na Filadélfia, EUA, o estudo examina suas experiências e opiniões sobre a condução dos ensaios e os riscos que assumem na participação. O autor argumenta que os riscos apresentados pela participação contínua, como a exposição às interações medicamentosas potencialmente perigosas, são minimizados ou ignorados pelos sujeitos de pesquisa devido à perspectiva de ganhos financeiros. Os riscos para as cobaias profissionais também são ignorados pela indústria farmacêutica, que se tornou dependente da participação habitual de sujeitos de pesquisa experientes. Argumentando que os incentivos financeiros comprometem o imperativo ético de consentimento informado a ser dado livremente pelos voluntários, esta pesquisa confirma a necessidade de reformar as políticas que regulam a participação de sujeitos pagos na Fase I de ensaios clínicos.

Nanocarriers for photodynamic therapy-rational formulation design and medium-scale manufacture.

The development and manufacture of novel nanocarriers for drug delivery has proved challenging with regards to scale-up and pharmaceutical quality. Polymeric nanocarriers composed of poly(lactic-co-glycolic acid)-b-poly(ethylene glycol) (PLGA-PEG) were prepared and the photosensitizer meso-tetrakis(3-hydroxyphenyl) chlorin (mTHPC) was effectively encapsulated. Furthermore, the interplay of various process and formulation parameters and their impact on the most important product specifications were investigated by using a factorial design and a central composite design in a microfluidic manufacturing process. These nanoparticles for intravenous administration with a size of 97 ± 0.13 nm, narrow size distribution, and an encapsulation efficiency of more than 80% were produced at high throughput. In vitro stability and in vitro drug release testing were applied for quality control purposes. Finally, the toxicity of the photosensitizer was tested in vitro. The cytotoxicity was successfully reduced while the efficacy of the formulation was maintained. First observations using in vivo imaging suggest effective distribution of the nanocarrier system after injection into rodents. Thus, further in vivo testing of the beneficial effects of nanoencapsulation into the matrix system and its formulation will be considered for the delivery of mTHPC to tumor tissues during photodynamic therapy.

Nonconsensual clinical trials: a foreseeable risk of offshoring under global corporatism.

This paper explores the connection of offshoring and outsourcing to nonconsensual global pharmaceutical trials in low-income countries. After discussing reasons why the topic of nonconsensual offshored clinical trials may be overlooked in bioethics literature, I suggest that when pharmaceutical corporations offshore clinical trials today, nonconsensual experiments are often foreseeable and not simply the result of aberrant ethical conduct by a few individuals. Offshoring of clinical trials is structured so that experiments can be presented as health care in a unique form of outsourcing from the host country to pharmaceutical corporations. Bioethicists' assessments of the risks and potential benefits of offshore corporate pharmaceutical trials should therefore systematically include not only the hoped for benefits and the risks of the experimental drug but also the risk that subjects will not have consented, as well as the broader international consequences of nonconsensual experimentation.

Quantifying the magnitude and cost of collecting extraneous protocol data.

Although most research professionals believe that protocol designs contain a growing number of unnecessary and redundant procedures generating unused data, incurring high cost, and jeopardizing study success, there are no published studies systematically examining this issue. Between November 2011 and May 2012, Tufts Center for the Study of Drug Development conducted a study among a working group of 15 pharmaceutical companies in which a total of 25,103 individual protocol procedures were evaluated and classified using clinical study reports and analysis plans. The results show that the typical later-stage protocol had an average of 7 objectives and 13 end points of which 53.8% are supplementary. One (24.7%) of every 4 procedures performed per phase-III protocol and 17.7% of all phase-II procedures per protocol were classified as "Noncore" in that they supported supplemental secondary, tertiary, and exploratory end points. For phase-III protocols, 23.6% of all procedures supported regulatory compliance requirements and 15.9% supported those for phase-II protocols. The study also found that on average, $1.7 million (18.5% of the total) is spent in direct costs to administer Noncore procedures per phase-III protocol and $0.3 million (13.1% of the total) in direct costs are spent on Noncore procedures for each phase-II protocol. Based on the results of this study, the total direct cost to perform Noncore procedures for all active annual phase-II and phase-III protocols is conservatively estimated at $3.7 billion annually, not including the indirect costs associated with collecting and managing Noncore procedure data and the ethical costs of exposing study volunteers to unnecessary risks associated with conducting extraneous procedures.

Gemifloxacin mesylate (GFM): dissolution test based on in vivo data.

Gemifloxacin mesylate (GFM) is a synthetic, broad-spectrum, fluoroquinolone antibacterial agent. It is different from other class members because it achieves adequate plasma concentrations to inhibit both topoisomerase IV and gyrase. The aim of this study was to develop and validate a dissolution test for GFM in coated tablets, using a simulated absorption profile based on in vivo data obtained from the literature. The fraction and percentage of the dose absorbed were calculated using model-dependent Loo-Riegelman approach for two compartments. The best in vitro dissolution profile was obtained using 900 mL of pH 6.0 phosphate buffer as a dissolution medium at 37 °C ± 0.5 °C and paddles at 50 rpm. The in vitro dissolution samples were analyzed using a liquid chromatography method, and the validation was performed according to USP 34 (2011). The method showed specificity, precision, accuracy, robustness and linearity. Under these conditions, a level-A in vitro-in vivo correlation was suggested (r = 0.9926). The prediction errors were calculated to determine the validity and accuracy of the suggested correlation. The dissolution test can be used to evaluate the dissolution profile of GFM-coated tablets and minimize the number of bioavailability studies as part of new formulation development.

Análise de resíduos no processo de blistagem de comprimidos através do Controle Estatístico de Processo / Application of Statistical Process Control (SPC) to the analysis of blister waste produced in the blister packaging process

No processo de blistagem, a formação de resíduos é quase inevitável devido à própria dinâmica e o tipo de matéria prima usada no sistema. Neste trabalho, foi realizada uma análise de resíduos de blister no processo de blistagem na Divisão de Sólidos multipropósito, abordando o tipo de equipamento utilizado no processo, as características do produto formado, os principais fatores envolvidos na geração dos resíduos, e sua quantidade gerada nos lotes analisados. Foi empregada a ferramenta CEP para a análise dos resultados. Apesar de todas as variações encontradas, que avaliaram estabilidade e capacidade dos processos, todos os lotes foram aprovados frente às especificações farmacopeicas. No entanto, há provas de que o processo precisa ser melhorado e pode tornar-se mais eficiente, gerando uma economia para empresa.

In the blister packaging process, the formation of waste is almost inevitable, given the dynamics and type of raw material used in the system. In this study, an analysis of blister waste in the blistering process was carried out in the multipurpose solids Division of a pharmaceutical laboratory, with respect to the type of blister-packing machine used in the process, the characteristics of the product manufactured, the main factors involved in the generation of waste and the amount of waste in the batches analyzed. The SPC tool was used to analyze the results. Despite all the variations found in the graphical analysis of stability and process capacity, all batches complied with the pharmacopeial specifications. However, there is evidence that the process should be improved and could be made more efficient, generating savings for the company.

Chlamydomonas reinhardtii as a viable platform for the production of recombinant proteins: current status and perspectives.

Chlamydomonas reinhardtii has many advantages compared with traditional systems for the molecular farming of recombinant proteins. These include low production costs, rapid scalability at pilot level, absence of human pathogens and the ability to fold and assemble complex proteins accurately. Currently, the successful expression of several proteins with pharmaceutical relevance has been reported from the nuclear and the chloroplastic genome of this alga, demonstrating its usefulness for biotechnological applications. However, several factors affect the level of recombinant protein expression in Chlamydomonas such as enhancer elements, codon dependency, sensitivity to proteases and transformation-associated genotypic modification. The present review outlines a number of strategies to increase protein yields and summarizes recent achievements in algal protein production including biopharmaceuticals such as vaccines, antibodies, hormones and enzymes with implications on health-related approaches. The current status of bioreactor developments for algal culture and the challenges of scale-up and optimization processes are also discussed.

Cuba's National Clinical Trials Coordinating Center: emergence, evolution, and main results. Translated from the Spanish and reprinted with permission from the Revista Cubana de Farmacia. Vol. 44 No. 2 (special supplement), Apr-Jun 2010.

The rapid development of Cuba's pharmaceutical industry in the 1990s created a need for structures to ensure clinical evaluation of products before their introduction into medical practice and subsequent marketing. One of the centers founded for this purpose was the National Clinical Trials Coordinating Center. This paper summarizes the factors that motivated the creation of the Center and presents a brief history of its organizational development over the last 17 years. It also describes the main components of the system for designing and conducting clinical trials, and the most significant contributions of each toward achieving the Center's objectives.

Controle estatístico de processo univariado: monitoramento da produção de comprimidos de dipirona / Univariate Statistical Process Control: monitoring the production of dipyrone tablets

Investigou-se, através de histogramas e cartas de controle X e S, a ferramenta do Controle Estatístico de Processo (CEP) univariado e os parâmetros físicos dureza, peso médio e friabilidade da produção de dez lotes de dipirona sódica comprimidos. Por sua complexidade e influência no processo, a etapa de granulação de cada lote foi concomitantemente caracterizada através de determinações de densidade bruta, densidade compactada, índice de compressibilidade e fator de Hausner, além dos ângulos de repouso, tempos de escoamento e repartições granulométricas. As caracterizações dos granulados serviram como base na investigação da possível influência da etapa de granulação como uma das prováveis causas que poderiam levar o processo a se apresentar fora de controle estatístico. Os resultados da caracterização indicaram certa uniformidade entre os granulados, o que pode significar que não há ligação aparente entre a etapa de granulação e a falta de controle estatístico do processo, demonstrada na avaliação das cartas de controle. Na medida em que permitiu uma maior compreensão do processo, o CEP univariado mostrou sua importância no monitoramento da produção de comprimidos.

In this study, by means of histograms and and s control charts, the production control tool, univariate Statistical Process Control (SPC), was assessed for monitoring the physical variables hardness, weight and friability during the production of ten batches of sodium dipyrone tablets. In view of its complexity and influence on the process, the granulation step was concurrently characterized by determining the gross density, compacted density, compressibility index and Hausner factor, plus the angle of repose, flow time and particle size distributions of each batch. The properties of the granules were used as a basis for testing the hypothesis that the granulation step is probably the cause when the process runs out of statistical control. The results of the characterization indicated a degree of uniformity among the granules, which may mean that the lack of statistical process control demonstrated in the control charts does not arise from the granulation step. To the extent that it enabled a greater understanding of the process, univariate SCP proved its importance in the monitoring of tablet production.

Discurso médico y estrategias de marketing de la industria farmacéutica en los procesos de medicación de la infancia en Argentina / Medical discourse and marketing strategies of the pharmaceutical industry in the process of medicalization of childhood in Argentina / Discurso médico e estratégias de marketing da indústria farmacêuticanos processos de medicalização da infância na Argentina

Este artículo explora procesos de medicación incluso medicamentosa en la infancia, utilizando como analizador el Trastorno del Déficit de Atención con o sin Hiper- actividad (TDA/H). Se presentan los resultados de un estudio cualitativo realizado por un equipo interdisciplinario durante 2008 en cuatro jurisdicciones argentinas: Región Metropolitana de Buenos Aires , Corrientes, Salta y Tierra del Fueg. Se exploran los discursos del discursos campo médico - pediatras, psiquiatras infanto- juveniles y neurólogos infantiles - en torno de la construcción diagnóstica del TDH/A y su planteamiento terapéutica en los sistemas públicos y en el privado. De modo complementario se indaga acerca de los mecanismos de marketing de la industria farmacéutica. A través de la construcción de diagnóstico TDA/H es posible observar como determinadas conductas y/o situaciones que antes no eran medicadas hoy forman parte del tratamiento médico, cuyo principal énfasis se encuentra en la prescripción de fármacos como terapéutica.

This paper explores at the processes of medicalization and medicinalization of childhood, using attention deficit disorder with or without hyperactivity (ADD/H) as the analyzer. The results from a qualitative study carried out by an interdisciplinary team during 2008 in four Argentine jurisdictions (Buenos Aires Metropolitan Area, Corrientes, Salta and Tierra del Fuego) are presented. Discourse from the field of medicine (pediatricians, childhood- adolescence psychiatrists and pediatric neurologists) regarding the diagnostic construct of ADD/H and its therapeutic approach are explored, in relation to the public and private systems. In a complementary manner, the marketing mechanisms of pharmaceutical industry are investigated. Through the diagnostic construct of ADD/H, it can be seen how certain conducts and/or situations that had not been medicalized in the past have now become part of medical treatment, in which the main emphasis is on prescribing drugs as therapy.

Neste artigo exploram- se processos de medicalização e medicamentalização na infância, utilizando como analisador o Transtorno de Déficit de Atenção com ou sem Hiperatividade (TDA/H). Apresentam- se os resultados de um estudo qualitativo realizado por uma equipe interdisciplinar durante 2008, em quatro jurisdições argentinas: Região Metropolitana de Buenos Aires, Corrientes, Salta e Tierra del Fuego. Exploram- se os discursos do campo médico - pediatras, psiquiatras infanto- juvenis e neurologistas infantis - em torno da construção diagnóstica do TDH/A e da sua abordagem terapêutica, nos sistemas público e privado. De modo complementar, indaga- se acerca dos mecanismos de marketing da indústria farmacêutica. Por meio da construção de diagnósticoTDA/H, é possível observar como determinadas condutas e/ou situações, que antes não eram medicalizadas, hoje são parte do tratamento médico, cuja principal ênfase encontra- se na prescrição de fármacos como terapêutica.

The prince and the pauper. A tale of anticancer targeted agents.

Cancer rates are set to increase at an alarming rate, from 10 million new cases globally in 2000 to 15 million in 2020. Regarding the pharmacological treatment of cancer, we currently are in the interphase of two treatment eras. The so-called pregenomic therapy which names the traditional cancer drugs, mainly cytotoxic drug types, and post-genomic era-type drugs referring to rationally-based designed. Although there are successful examples of this newer drug discovery approach, most target-specific agents only provide small gains in symptom control and/or survival, whereas others have consistently failed in the clinical testing. There is however, a characteristic shared by these agents: -their high cost-. This is expected as drug discovery and development is generally carried out within the commercial rather than the academic realm. Given the extraordinarily high therapeutic drug discovery-associated costs and risks, it is highly unlikely that any single public-sector research group will see a novel chemical "probe" become a "drug". An alternative drug development strategy is the exploitation of established drugs that have already been approved for treatment of non-cancerous diseases and whose cancer target has already been discovered. This strategy is also denominated drug repositioning, drug repurposing, or indication switch. Although traditionally development of these drugs was unlikely to be pursued by Big Pharma due to their limited commercial value, biopharmaceutical companies attempting to increase productivity at present are pursuing drug repositioning. More and more companies are scanning the existing pharmacopoeia for repositioning candidates, and the number of repositioning success stories is increasing. Here we provide noteworthy examples of known drugs whose potential anticancer activities have been highlighted, to encourage further research on these known drugs as a means to foster their translation into clinical trials utilizing the more limited public-sector resources. If these drug types eventually result in being effective, it follows that they could be much more affordable for patients with cancer; therefore, their contribution in terms of reducing cancer mortality at the global level would be greater.