{"entity":{"id":"global-access-roadmap","kind":"roadmap","name":"Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation","aka":[],"tldr":"Seven in ten cancer deaths happen in countries with almost no cancer care, and even rich systems cannot afford every new drug. The roadmap is the set of levers that already work, from generics and biosimilars to trials that cut the dose, and the ones being built: regulators trusting each other's reviews, pooled purchasing, and drugs and cell therapies made where patients live.","summary":"The first levers were policy: the WHO Essential Medicines List, generic manufacturing in India, and compulsory licensing when a patent priced a drug out of reach (Natco v Bayer, 2012). Biosimilars of trastuzumab and rituximab, on the market since 2017, cut the price of HER2 and lymphoma treatment by large fractions, and India's National Cancer Grid showed that pooled procurement across hundreds of hospitals lowers prices further.\n\nThe second lever is frugal evidence. Tata Memorial's trials showed that a twentieth of a nivolumab dose added to cheap metronomic chemotherapy improves survival in head and neck cancer, that oral metronomic tablets match intravenous cisplatin, and that a single cheap progesterone injection before breast surgery helps; INTERLACE, PERSEPHONE and FAST-Forward showed that cheaper schedules of existing treatments are as good. India and China now develop their own: India's first CAR-T (NexCAR19) at a fraction of the Western price, an Indian HPV vaccine, and Chinese PD-1 antibodies and ADCs that have gone from domestic approval to beating Western standards head to head.\n\nThe next levers are institutional: regulators accepting each other's reviews (Project Orbis, reliance pathways), WHO prequalification and pooled demand for biosimilars, patent pools for essential cancer drugs, public cell-therapy manufacturing, pooled procurement of radiotherapy, and prices anchored to measured clinical benefit. The pace is set by pricing power, regulatory divergence, workforce, and the near-absence of pain relief where most people die of cancer.","asOf":"2026-09-10","links":[{"label":"OnCo: getting the cost of cancer care down","url":"https://onco.cc/costs/"},{"label":"WHO Model Lists of Essential Medicines","url":"https://www.who.int/groups/expert-committee-on-selection-and-use-of-essential-medicines/essential-medicines-lists"},{"label":"Lancet Oncology Commission: cancer care in India (Pramesh et al.)","url":"https://doi.org/10.1016/S1470-2045(14)70117-2"},{"label":"Patil et al., low-dose nivolumab with triple metronomic chemotherapy (JCO 2023)","url":"https://doi.org/10.1200/JCO.22.01015"}],"tags":[],"related":["nice-guidance","paper-pramesh-ncg-pooled-procurement-2023","paper-patil-low-dose-nivolumab-jco-2023","csco-guidelines","esmo-guidelines","src-nice-ta","idea-reg-orbis-work-sharing","idea-reg-reliance-90-day-lmic","idea-acc-biosimilar-prequalification-pool","idea-reg-pd1-biosimilar-advance-commitment","idea-reg-biosimilar-no-efficacy-trial","idea-reg-patent-pool-oncology-eml","idea-acc-eml-listing-price-commitments","idea-reg-tiered-pricing-for-exclusivity","idea-acc-pooled-procurement-radiotherapy","idea-acc-linac-uptime-contracts","idea-acc-frugal-hdr-brachytherapy","idea-acc-hypofractionation-default-lmic","idea-reg-lmic-public-cart-manufacturing","idea-fund-public-car-t-manufacturing","idea-fund-global-cancer-fund","idea-tr1-low-dose-immunotherapy-for-lmic","idea-reg-metronomic-lmic-phase3-to-label","idea-acc-metronomic-lmic-platform-trial","idea-reg-price-anchored-to-mcbs","idea-reg-indication-specific-pricing","idea-reg-public-deescalation-trials-for-cost","idea-reg-biosimilar-first-default-switching","idea-reg-nonprofit-generic-chemo-manufacturer","idea-reg-financial-toxicity-vital-sign","idea-cost-shorter-course-trials","idea-reg-middle-income-negotiation-bloc","idea-acc-community-health-workers-oncology","idea-acc-echo-tele-mentoring-oncology","idea-acc-remote-planning-hubs","idea-acc-balanced-opioid-policy-reform","idea-acc-registries-as-aid-condition","idea-prev-lmic-five-cancer-methylation-test","idea-fund-lmic-burden-match","idea-tr1-lmic-sites-in-pivotal-trials","idea-acc-hpv-self-sample-same-day-ablation","prevention-roadmap","chemotherapy-roadmap","radiation-roadmap","trial-modernisation-roadmap"],"cancers":[],"sections":[],"technologies":["global-oncology-access","generic-drug-shortage-response","palliative-radiotherapy","hpv-testing","precancer-ablation","telemedicine-teleoncology","oral-visual-screening"],"targets":[],"drugs":["trastuzumab-biosimilars","talicabtagene-autoleucel","varnimcabtagene-autoleucel","cervavac","sintilimab","camrelizumab","relmacabtagene-autoleucel","trastuzumab-rezetecan"],"companies":["cipla","natco","dr-reddys","sun-pharma","biocon","biocon-biologics","intas","zydus","immunoact","immuneel","serum-institute-of-india","hengrui","innovent","junshi"],"institutions":["who","uicc","tata-memorial","national-cancer-grid","tata-trusts","nhsa","fda-oce","ema","iarc"],"pathways":[],"terms":["biosimilar","who-essential-medicines","project-orbis","hta","hypofractionation"],"trials":["low-dose-nivolumab-tmh","metronomic-vs-cisplatin-tmh","metro-plus-varanasi","progesterone-preop-tmh","elective-neck-dissection-tmh","interlace","persephone","talicel-phase-1-2","imagine-varnimcabtagene","orient-11","harmoni-2","reliance","osmanabad-hpv-screening","kerala-oral-screening","mumbai-via-screening","iarc-india-hpv-dose-study","ken-she"],"people":[],"bottlenecks":["b-global-access","b-drug-pricing","b-regulatory-fragmentation","b-workforce","b-palliative","b-generic-repurposing","b-trial-diversity"],"keyPapers":["paper-pramesh-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"steps":[{"era":"1977-2012","title":"Essential medicines, generics and the compulsory licence","description":"The WHO Essential Medicines List, first published in 1977, told health systems what to buy first; India's process-patent regime and companies such as Cipla, Natco and Dr Reddy's supplied the generics; and when a patented liver cancer drug was priced beyond reach, India issued its first compulsory licence (Natco v Bayer, 2012). Tobacco control, hepatitis B vaccination and cheap curative chemotherapy for childhood leukaemia and testicular cancer were the interventions that travelled.","refs":["who-essential-medicines","who","cipla","natco","dr-reddys","sun-pharma","global-oncology-access","b-global-access"],"status":"historic"},{"era":"2012-2020","title":"Biosimilars and pooled procurement","description":"Trastuzumab biosimilars, approved from 2017 with Biocon and Mylan's first, and rituximab biosimilars cut the price of two of the most important cancer antibodies by large fractions where they were adopted; in Europe, biosimilar-first defaults did most of the work. India's National Cancer Grid, run from Tata Memorial and linking more than 360 centres, showed that pooled procurement across hospitals lowers prices further and standardises what is bought.","refs":["trastuzumab-biosimilars","biosimilar","biocon","biocon-biologics","intas","zydus","national-cancer-grid","tata-memorial","tata-trusts","paper-pramesh-ncg-pooled-procurement-2023","idea-reg-biosimilar-first-default-switching"],"status":"historic"},{"era":"2015-2026","title":"Frugal evidence: less drug, cheaper schedules, same result","description":"Tata Memorial randomised the questions no company would fund: about a twentieth of a nivolumab dose added to cheap oral metronomic chemotherapy improved survival in head and neck cancer, oral metronomic tablets matched intravenous cisplatin, a single depot progesterone injection before breast surgery helped, and elective neck dissection was proven over watchful waiting. In the UK, PERSEPHONE showed six months of trastuzumab is nearly as good as twelve with half the heart toxicity, FAST-Forward cut breast radiotherapy to one week, and INTERLACE cut cervical cancer deaths with six weeks of generic chemotherapy. Each is usable anywhere; the task is getting them into labels and guidelines.","refs":["low-dose-nivolumab-tmh","paper-patil-low-dose-nivolumab-jco-2023","metronomic-vs-cisplatin-tmh","metro-plus-varanasi","progesterone-preop-tmh","elective-neck-dissection-tmh","persephone","hypofractionation","interlace","idea-tr1-low-dose-immunotherapy-for-lmic","idea-reg-metronomic-lmic-phase3-to-label","idea-acc-metronomic-lmic-platform-trial","idea-cost-shorter-course-trials","idea-reg-public-deescalation-trials-for-cost"],"status":"current"},{"era":"2018-2026","title":"Homegrown innovation in India and China","description":"India approved its first CAR-T, NexCAR19, developed at IIT Bombay and Tata Memorial and priced at a fraction of Western products; Immuneel ran the first industry CAR-T trial in India; the Serum Institute launched an Indian HPV vaccine. China's PD-1 antibodies (sintilimab, camrelizumab, toripalimab) were approved domestically at prices set by national negotiation and then taken global; its CAR-Ts and HER2 ADCs followed; and ivonescimab became the first drug to beat pembrolizumab head to head (HARMONi-2). The centre of gravity of affordable innovation is moving.","refs":["talicabtagene-autoleucel","talicel-phase-1-2","immunoact","varnimcabtagene-autoleucel","imagine-varnimcabtagene","immuneel","cervavac","serum-institute-of-india","sintilimab","innovent","orient-11","camrelizumab","hengrui","junshi","relmacabtagene-autoleucel","reliance","trastuzumab-rezetecan","harmoni-2","nhsa","csco-guidelines"],"status":"current"},{"era":"2000s-2026","title":"Screening and prevention that fit the budget","description":"One round of HPV testing in rural Indian villages cut cervical cancer deaths (Osmanabad); trained health workers with a torch found mouth cancers early in tobacco users (Kerala); vinegar and a lamp screened women in Mumbai slums. A single HPV vaccine dose proved almost fully protective (an interrupted Indian trial, then KEN SHE), and self-collected swabs with same-day thermal ablation let nurses run cervical programmes without colposcopy. These are the interventions with the highest return per dollar in oncology.","refs":["osmanabad-hpv-screening","kerala-oral-screening","oral-visual-screening","mumbai-via-screening","iarc-india-hpv-dose-study","ken-she","hpv-testing","precancer-ablation","idea-acc-hpv-self-sample-same-day-ablation","iarc","prevention-roadmap"],"status":"current"},{"era":"2026-2030","title":"Reliance, pooling and public manufacturing","description":"Project Orbis lets the FDA and partner regulators review together; the proposals extend it to a shared assessment report and a 90-day reliance approval for drugs cleared by two stringent regulators. WHO prequalification plus pooled demand could push biosimilar prices below a tenth of the originator; an advance market commitment could do the same for PD-1 biosimilars; Medicines Patent Pool licences for every patented drug on the essential list and tiered-price pledges tied to listing would formalise it. Public-sector CAR-T manufacturing in India, Brazil and South Africa, pooled procurement of radiotherapy machines with uptime contracts, and a Global Fund for cancer are the capital-intensive versions.","refs":["project-orbis","idea-reg-orbis-work-sharing","idea-reg-reliance-90-day-lmic","idea-acc-biosimilar-prequalification-pool","idea-reg-pd1-biosimilar-advance-commitment","idea-reg-biosimilar-no-efficacy-trial","idea-reg-patent-pool-oncology-eml","idea-acc-eml-listing-price-commitments","idea-reg-tiered-pricing-for-exclusivity","idea-reg-lmic-public-cart-manufacturing","idea-fund-public-car-t-manufacturing","idea-acc-pooled-procurement-radiotherapy","idea-acc-linac-uptime-contracts","idea-acc-frugal-hdr-brachytherapy","idea-acc-hypofractionation-default-lmic","idea-fund-global-cancer-fund","idea-reg-middle-income-negotiation-bloc"],"status":"emerging"},{"era":"2026-2030","title":"Paying for value in rich countries too","description":"New cancer drugs routinely cost more than a house per year, often for months of benefit, and systems cannot afford them without rationing. The levers: prices anchored to the ESMO and ASCO benefit scales and revisited when survival data mature, a different price for the same drug in different indications, publicly funded de-escalation trials of expensive drugs, biosimilar-first defaults, a non-profit manufacturer for generics in shortage, and screening every patient for financial toxicity as a vital sign. The costs page on this site pairs each driver with what is already being done.","refs":["b-drug-pricing","hta","nice-guidance","src-nice-ta","esmo-guidelines","idea-reg-price-anchored-to-mcbs","idea-reg-indication-specific-pricing","generic-drug-shortage-response","idea-reg-nonprofit-generic-chemo-manufacturer","idea-reg-financial-toxicity-vital-sign","chemotherapy-roadmap"],"status":"emerging"},{"era":"2030+","title":"Workforce, pain relief and the data to steer by","description":"Drugs do not treat patients; people do, and most of the world has too few oncologists, pathologists, physicists and nurses. Community health workers trained in triage, navigation and home palliative care, Project ECHO tele-mentoring for district clinicians, remote radiotherapy planning hubs, diaspora tumour boards, and opioid quota reform so morphine reaches people dying of cancer are the workforce answers. A population registry as a condition of every aid programme, burden-matched trial funding and pivotal-trial sites in Africa, South Asia and Latin America would make progress measurable. A ten-dollar blood test for the five cancers that kill most people in poorer countries is the diagnostic bet.","refs":["b-workforce","b-palliative","idea-acc-community-health-workers-oncology","idea-acc-echo-tele-mentoring-oncology","idea-acc-remote-planning-hubs","telemedicine-teleoncology","idea-acc-balanced-opioid-policy-reform","idea-acc-registries-as-aid-condition","idea-fund-lmic-burden-match","idea-tr1-lmic-sites-in-pivotal-trials","idea-prev-lmic-five-cancer-methylation-test","uicc","radiation-roadmap"],"status":"speculative"},{"era":"What sets the pace","title":"Pricing power, divergence and the absence of care","description":"Seven in ten cancer deaths happen where radiotherapy, pathology and essential drugs are scarce or absent. Prices are set by what the richest payer will bear, regulators duplicate each other's reviews so approvals lag by years, old cheap drugs have no sponsor to test them, trials rarely include the populations that carry the burden, and most people who die of cancer worldwide do so without adequate pain relief. Every lever above attacks one of these.","refs":["b-global-access","b-drug-pricing","b-regulatory-fragmentation","b-generic-repurposing","b-trial-diversity","b-palliative","b-workforce"],"status":"current"}],"watch":[]},"route":"/roadmaps/global-access-roadmap/","neighbours":{"collection":[{"id":"csco-guidelines","kind":"collection","name":"CSCO guidelines (China)","route":"/collections/csco-guidelines/"},{"id":"esmo-guidelines","kind":"collection","name":"ESMO Clinical Practice Guidelines & MCBS","route":"/collections/esmo-guidelines/"},{"id":"nice-guidance","kind":"collection","name":"NICE cancer guidance and technology appraisals (UK)","route":"/collections/nice-guidance/"},{"id":"src-nice-ta","kind":"collection","name":"NICE technology appraisals","route":"/collections/src-nice-ta/"}],"paper":[{"id":"paper-pramesh-ncg-pooled-procurement-2023","kind":"paper","name":"A National Cancer Grid pooled procurement initiative, India","route":"/key-papers/paper-pramesh-ncg-pooled-procurement-2023/"},{"id":"paper-pramesh-lancet-oncol","kind":"paper","name":"Delivery of affordable and equitable cancer care in India","route":"/key-papers/paper-pramesh-lancet-oncol/"},{"id":"paper-patil-low-dose-nivolumab-jco-2023","kind":"paper","name":"Low-dose immunotherapy in head and neck cancer: a randomised study (Tata Memorial)","route":"/key-papers/paper-patil-low-dose-nivolumab-jco-2023/"},{"id":"paper-forrest-socioeconomic-inequalities-lung-cancer-treatment-plos-med-2013","kind":"paper","name":"Socioeconomic inequalities in lung cancer treatment: systematic review and meta-analysis","route":"/key-papers/paper-forrest-socioeconomic-inequalities-lung-cancer-treatment-plos-med-2013/"}],"idea":[{"id":"idea-reg-reliance-90-day-lmic","kind":"idea","name":"90-day reliance approval for cancer drugs cleared by two stringent regulators","route":"/ideas/idea-reg-reliance-90-day-lmic/"},{"id":"idea-acc-pooled-procurement-radiotherapy","kind":"idea","name":"A Gavi-style pooled purchaser for radiotherapy equipment and service","route":"/ideas/idea-acc-pooled-procurement-radiotherapy/"},{"id":"idea-fund-global-cancer-fund","kind":"idea","name":"A Global Fund for cancer care in low- and middle-income countries","route":"/ideas/idea-fund-global-cancer-fund/"},{"id":"idea-reg-middle-income-negotiation-bloc","kind":"idea","name":"A joint price negotiation bloc for middle-income countries, modelled on Beneluxa","route":"/ideas/idea-reg-middle-income-negotiation-bloc/"},{"id":"idea-reg-nonprofit-generic-chemo-manufacturer","kind":"idea","name":"A non-profit manufacturer for generic cancer drugs in chronic shortage","route":"/ideas/idea-reg-nonprofit-generic-chemo-manufacturer/"},{"id":"idea-acc-metronomic-lmic-platform-trial","kind":"idea","name":"A platform trial of very-low-cost metronomic chemotherapy in LMIC common cancers","route":"/ideas/idea-acc-metronomic-lmic-platform-trial/"},{"id":"idea-prev-lmic-five-cancer-methylation-test","kind":"idea","name":"A ten-dollar blood test for the five cancers that kill most people in poorer countries","route":"/ideas/idea-prev-lmic-five-cancer-methylation-test/"},{"id":"idea-reg-pd1-biosimilar-advance-commitment","kind":"idea","name":"An advance market commitment for PD-1 biosimilars for lower-income countries","route":"/ideas/idea-reg-pd1-biosimilar-advance-commitment/"},{"id":"idea-reg-biosimilar-no-efficacy-trial","kind":"idea","name":"Approve cancer biosimilars on analytics and pharmacokinetics, no efficacy trials","route":"/ideas/idea-reg-biosimilar-no-efficacy-trial/"},{"id":"idea-reg-biosimilar-first-default-switching","kind":"idea","name":"Biosimilar-first defaults and payment parity in every cancer day unit","route":"/ideas/idea-reg-biosimilar-first-default-switching/"},{"id":"idea-fund-lmic-burden-match","kind":"idea","name":"Burden-matched funding for trials led in low- and middle-income countries","route":"/ideas/idea-fund-lmic-burden-match/"},{"id":"idea-reg-price-anchored-to-mcbs","kind":"idea","name":"Cap public prices for new cancer drugs to tiers of the ESMO and ASCO value scales","route":"/ideas/idea-reg-price-anchored-to-mcbs/"},{"id":"idea-acc-community-health-workers-oncology","kind":"idea","name":"Community health workers trained in cancer triage, navigation and home palliative care","route":"/ideas/idea-acc-community-health-workers-oncology/"},{"id":"idea-tr1-low-dose-immunotherapy-for-lmic","kind":"idea","name":"Confirm ultra-low-dose immunotherapy so it can be afforded where most patients live","route":"/ideas/idea-tr1-low-dose-immunotherapy-for-lmic/"},{"id":"idea-cost-shorter-course-trials","kind":"idea","name":"Fund trials that test shorter courses of the most expensive adjuvant drugs","route":"/ideas/idea-cost-shorter-course-trials/"},{"id":"idea-reg-tiered-pricing-for-exclusivity","kind":"idea","name":"Grant extra exclusivity only in exchange for binding low prices in poorer countries","route":"/ideas/idea-reg-tiered-pricing-for-exclusivity/"},{"id":"idea-fund-public-car-t-manufacturing","kind":"idea","name":"Hospital-based CAR-T manufacturing at cost through a public network","route":"/ideas/idea-fund-public-car-t-manufacturing/"},{"id":"idea-acc-hpv-self-sample-same-day-ablation","kind":"idea","name":"HPV self-testing with same-day treatment as the national cervical programme","route":"/ideas/idea-acc-hpv-self-sample-same-day-ablation/"},{"id":"idea-acc-frugal-hdr-brachytherapy","kind":"idea","name":"Low-cost cobalt-60 brachytherapy for cervical cancer in every regional centre","route":"/ideas/idea-acc-frugal-hdr-brachytherapy/"},{"id":"idea-acc-registries-as-aid-condition","kind":"idea","name":"Make a population cancer registry a condition of every cancer aid programme","route":"/ideas/idea-acc-registries-as-aid-condition/"},{"id":"idea-acc-hypofractionation-default-lmic","kind":"idea","name":"Make one-week radiotherapy the default in overloaded systems","route":"/ideas/idea-acc-hypofractionation-default-lmic/"},{"id":"idea-reg-patent-pool-oncology-eml","kind":"idea","name":"Medicines Patent Pool licences for every patented cancer drug on the WHO list","route":"/ideas/idea-reg-patent-pool-oncology-eml/"},{"id":"idea-acc-balanced-opioid-policy-reform","kind":"idea","name":"National opioid quota reform so morphine reaches cancer patients","route":"/ideas/idea-acc-balanced-opioid-policy-reform/"},{"id":"idea-reg-indication-specific-pricing","kind":"idea","name":"Pay a different price for the same cancer drug depending on the indication","route":"/ideas/idea-reg-indication-specific-pricing/"},{"id":"idea-acc-linac-uptime-contracts","kind":"idea","name":"Pay for radiotherapy machine uptime, not for the machine","route":"/ideas/idea-acc-linac-uptime-contracts/"},{"id":"idea-tr1-lmic-sites-in-pivotal-trials","kind":"idea","name":"Pivotal trials include sites in Africa, South Asia and Latin America, sponsor-funded","route":"/ideas/idea-tr1-lmic-sites-in-pivotal-trials/"},{"id":"idea-acc-echo-tele-mentoring-oncology","kind":"idea","name":"Project ECHO tele-mentoring for district clinicians managing cancer","route":"/ideas/idea-acc-echo-tele-mentoring-oncology/"},{"id":"idea-reg-lmic-public-cart-manufacturing","kind":"idea","name":"Public-sector CAR-T manufacturing in India, Brazil and South Africa under $50,000","route":"/ideas/idea-reg-lmic-public-cart-manufacturing/"},{"id":"idea-reg-public-deescalation-trials-for-cost","kind":"idea","name":"Publicly funded trials of lower and less frequent doses of expensive cancer drugs","route":"/ideas/idea-reg-public-deescalation-trials-for-cost/"},{"id":"idea-acc-remote-planning-hubs","kind":"idea","name":"Round-the-clock remote treatment-planning hubs for clinics without physicists","route":"/ideas/idea-acc-remote-planning-hubs/"},{"id":"idea-reg-financial-toxicity-vital-sign","kind":"idea","name":"Screen every cancer patient for financial toxicity as a vital sign, with navigation","route":"/ideas/idea-reg-financial-toxicity-vital-sign/"},{"id":"idea-acc-eml-listing-price-commitments","kind":"idea","name":"Tie WHO essential-medicines listing to a published tiered price and supply pledge","route":"/ideas/idea-acc-eml-listing-price-commitments/"},{"id":"idea-lung-deprivation-gradient-treated-as-a-defect-in-delivery","kind":"idea","name":"Treat the deprivation gradient in lung cancer as a defect in delivery that can be fixed and measured","route":"/ideas/idea-lung-deprivation-gradient-treated-as-a-defect-in-delivery/"},{"id":"idea-reg-orbis-work-sharing","kind":"idea","name":"Turn Project Orbis into a work-sharing review with one shared assessment report","route":"/ideas/idea-reg-orbis-work-sharing/"},{"id":"idea-reg-metronomic-lmic-phase3-to-label","kind":"idea","name":"Validate low-cost metronomic oral regimens in phase 3 and carry them into guidelines","route":"/ideas/idea-reg-metronomic-lmic-phase3-to-label/"},{"id":"idea-acc-biosimilar-prequalification-pool","kind":"idea","name":"WHO prequalification plus pooled demand to push biosimilar prices below 10% of the originator","route":"/ideas/idea-acc-biosimilar-prequalification-pool/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},{"id":"chemotherapy-roadmap","kind":"roadmap","name":"Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs","route":"/roadmaps/chemotherapy-roadmap/"},{"id":"radiation-roadmap","kind":"roadmap","name":"Radiotherapy roadmap: X-rays → shaped beams → fewer fractions, particles and FLASH","route":"/roadmaps/radiation-roadmap/"},{"id":"trial-modernisation-roadmap","kind":"roadmap","name":"Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on","route":"/roadmaps/trial-modernisation-roadmap/"}],"technology":[{"id":"generic-drug-shortage-response","kind":"technology","name":"Generic oncology drug supply and shortage mitigation","route":"/technologies/generic-drug-shortage-response/"},{"id":"global-oncology-access","kind":"technology","name":"Global oncology and access in low- and middle-income countries","route":"/technologies/global-oncology-access/"},{"id":"hpv-testing","kind":"technology","name":"HPV DNA testing and self-sampling","route":"/technologies/hpv-testing/"},{"id":"oral-visual-screening","kind":"technology","name":"Oral cancer visual screening","route":"/technologies/oral-visual-screening/"},{"id":"palliative-radiotherapy","kind":"technology","name":"Palliative radiotherapy","route":"/technologies/palliative-radiotherapy/"},{"id":"telemedicine-teleoncology","kind":"technology","name":"Telemedicine, teleoncology, and telepathology","route":"/technologies/telemedicine-teleoncology/"},{"id":"precancer-ablation","kind":"technology","name":"Thermal ablation and cryotherapy for cervical precancer","route":"/technologies/precancer-ablation/"}],"drug":[{"id":"camrelizumab","kind":"drug","name":"Camrelizumab","route":"/drugs/camrelizumab/"},{"id":"cervavac","kind":"drug","name":"CERVAVAC (quadrivalent HPV vaccine, India)","route":"/drugs/cervavac/"},{"id":"relmacabtagene-autoleucel","kind":"drug","name":"Relmacabtagene autoleucel","route":"/drugs/relmacabtagene-autoleucel/"},{"id":"sintilimab","kind":"drug","name":"Sintilimab","route":"/drugs/sintilimab/"},{"id":"talicabtagene-autoleucel","kind":"drug","name":"Talicabtagene 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