New oncology drugs undergo detailed review prior to public funding in a single-payer healthcare system. The aim of this study was to assess how cancer drug review times impact funding recommendations. Drugs reviewed by the pan-Canadian Oncology Drug Review (pCODR) between the years 2012 and 2020 were included. Data were collected including Health Canada approval dates, initial and final funding recommendations, treatment intent, drug class, clinical indications, and incremental cost-effectiveness ratios (ICER). Univariable and multivariable analyses were used to determine the association between funding recommendations and review times. Of the 164 applications submitted, 130 received a positive final recommendation. Median time from Health Canada (HC) approval to final recommendation was longer for drugs indicated for the treatment of gastrointestinal (GI) and lung cancer compared to breast, genitourinary (GU), and other tumours (205 vs. 198 vs. 111 vs. 129 vs. 181 days, respectively; Kruskal–Wallis p = 0.0312). Drugs with longer review times were more likely to receive a negative pCODR recommendation, even when adjusting for tumour type, drug class, and intent of therapy (157 vs. 298 days; Wilcoxon p = 0.0003, OR 1.002 95% CI [1.000–1.004].). There was no association between funding recommendation and tumour type or class of drug. The exploration of factors associated with variance in review times will be important in ensuring timely patient access to cancer drugs.

Background: Diversity in academia promotes research that can reduces health disparities and addresses equity issues for marginalized populations. This study aims to examine the effect of visible minority status on academic achievements in cancer physicians and scientists. Methods: Faculty at the tertiary cancer center in Calgary, Alberta, Canada, completed a survey in 2023 to evaluate demographics, academic rank, leadership positions, number of trainees mentored, number of publications, and amount of grant funding. Chi-square tests and regression analyses examined the impact of race and ethnicity on these academic achievements. Results: The survey was completed by 74 faculty members (47% male, 43% female, 9% gender fluid or providing no answer) with a response rate of 26%. Seven percent were Black or Latin American, 18% East Asian or Southeast Asian, 19% West or South Asian, 39% Caucasian, 6% mixed race, and 11% not providing an answer. Visible minorities were underrepresented in the full professor rank (19%) compared to non-visible minorities (38%) and were overrepresented in assistant/associate professors (28% and 53%, respectively), with 41% of non-visible minorities having the title of assistant professor and 21% as associate professor (p = 0.02). Visible minorities were less likely to have both parents college-educated (OR 0.30, 95% CI 0.09–0.92, p = 0.042) and also less likely to have been raised in a home with household income above $100,000 (OR 0.26, 95% CI 0.07–0.90, p = 0.040). Discussion: Visible minorities are underrepresented in the full professor academic rank. Larger studies are needed to evaluate whether race and ethnicity significantly impact achievements in oncology academics.

In the era of rapid development of new, expensive cancer therapies, value frameworks have been developed to quantify clinical benefit (CB). We assessed the evolution of CB since the 2015 introduction of The American Society of Clinical Oncology and The European Society of Medical Oncology value frameworks. Randomized clinical trials (RCTs) assessing systemic therapies for solid malignancies from 2010 to 2020 were evaluated and CB (Δ) in 2010–2014 (pre-value frameworks (PRE)) were compared to 2015–2020 (POST) for overall survival (OS), progression-free survival (PFS), response rate (RR), and quality of life (QoL). In the 485 studies analyzed (12% PRE and 88% POST), the most common primary endpoint was PFS (49%), followed by OS (20%), RR (12%), and QoL (6%), with a significant increase in OS and decrease in RR as primary endpoints in the POST era (p = 0.011). Multivariable analyses revealed significant improvement in ΔOS POST (OR 2.86, 95% CI 0.46 to 5.26, p = 0.02) while controlling for other variables. After the development of value frameworks, median ΔOS improved minimally. The impact of value frameworks has yet to be fully realized in RCTs. Efforts to include endpoints shown to impact value, such as QoL, into clinical trials are warranted.