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Mapping Radiotherapy Resources for Prostate Cancer Trials in Nigeria: A STAMPEDE 2-Site Survey
Omolara Fatiregun1,2,3, Nwamaka Lasebikan4, Onyeanunam Ekeke5
1Department of Radiology and Clinical Oncology, Lagos State University College of Medicine, Ikeja, Nigeria.
Purpose:
The Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE)2 trial builds on the foundational STAMPEDE trial, which introduced innovative multiarm treatment protocols for metastatic prostate cancer. This survey assessed Nigeria's readiness for the STAMPEDE2 trial by evaluating current clinical practices, radiotherapy infrastructure, systemic therapy usage, and imaging capabilities across its six geopolitical zones.
Materials And Methods:
We mapped the radiotherapy centers and machines currently available (commissioned) and in the Nigerian pipeline. A structured questionnaire comprising 31 questions in six sections was disseminated to clinical and radiation oncologists via Google Forms. The survey ran from July to September 2024, gathering data on radiotherapy availability, systemic therapies, advanced imaging, and readiness for clinical trial participation. Descriptive statistical analysis was conducted using Microsoft Excel. Responses were aggregated from 14 cancer centers across Nigeria, encompassing both public and private facilities.
Results:
The survey identified 23 operational radiotherapy machines distributed across 12 centers, with 19 additional facilities in the pipeline. These centers were predominantly located in urban areas such as Lagos and Abuja. Prostate cancer treatment modalities are available; however, access to agents such as abiraterone and enzalutamide was reported in 73% of centers. There is one operational positron emission tomography/computed tomography facility in Nigeria. Clinicians expressed strong interest in participating in trials although some gaps in infrastructure, particularly in rural areas, and limited access to advanced treatments like 177Lu-PSMA-617 were noted.
Conclusion:
The findings underscore Nigeria's potential readiness for the STAMPEDE2 trial, other clinical trials, and collaborative research, bolstered by an expanding radiotherapy infrastructure and clinician enthusiasm for advanced therapeutic approaches. Initiatives like the Cancer Health Fund and the National Cancer Access Partnership represent significant steps toward equitable cancer care.
