The STAMPEDE2 trial: A site survey of current patterns of care, access to imaging, and treatment of metastatic prostrate cancer in Nigeria.

Abstract

e23059 Background: The STAMPEDE2 trial builds on the foundational STAMPEDE trial, which introduced innovative multi-arm 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. Methods: We mapped the radiotherapy centres and machines currently available (commissioned) and in the pipeline in Nigeria. A structured questionnaire comprising 31 questions in six sections was disseminated to clinical 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 centres across Nigeria, encompassing public and private facilities. Results: The survey identified 23 operational radiotherapy machines distributed across 12 centres, with 19 additional facilities in the pipeline. These centres were predominantly located in urban areas such as Lagos and Abuja. Prostate cancer treatment modalities are available; however, access to novel agents such as abiraterone and enzalutamide was reported in 73% of centres. There is one operational PET/CT facility in Nigeria. Clinicians expressed strong interest in participating in trials, though some gaps in infrastructure, particularly in rural areas, and limited access to advanced treatments like 177Lu-PSMA-617 were noted. Conclusions: The findings underscore Nigeria’s potential readiness for the STAMPEDE2 trial, as well as 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 (CHF) and the National Cancer Access Partnership (NCAP) represent significant steps towards equitable cancer care.