Purpose: To overview interventional cancer clinical trials in Brazil, assessing distribution, phase, sponsorship and alignment with national cancer epidemiology and disparities.
Methods: Data on ongoing cancer trials in Brazil were extracted from ClinicalTrials.gov (9 October 2024) using filters for interventional, recruiting or not-yet-recruiting studies. Information from the Brazilian Registry of Clinical Trials and Plataforma Brasil was reviewed for contextual comparison. Descriptive and geospatial analyses used Looker Studio and Tableau. Epidemiological data from the Instituto Nacional do Câncer, Instituto Brasileiro de Geografia e Estatística and Global Cancer Observatory were correlated with trial distribution and compared with selected high-income countries.
Results: A total of 272 ongoing cancer clinical trials were identified, representing 2.55% of global cancer studies. Late-phase trials predominated (54.8% Phase III; 77.6% Phases II–IV), and industry sponsorship accounted for 78.7%. Trials were heavily concentrated in the Southeast (48.3%) and South (26.4%) regions, with site densities of 1.46 and 1.98 per million people, respectively; in contrast, the North had only 0.37. Lung (18.8%) and breast (16.9%) cancers were the most frequent focus, while paediatric trials comprised only 1.1%. Underrepresentation of cervical, gastric and penile cancers – tumour types linked to socioeconomic vulnerability – was notable.
Conclusion: Brazil’s oncology research ecosystem shows strong industry engagement but remains regionally imbalanced and heavily focused on late-phase studies. Addressing these disparities requires strategic expansion of research capacity and equitable access initiatives. Democratizing access to clinical trials – through interoperable national registries, public policies and digital platforms that connect patients, physicians and research centres – is essential to ensure that innovation reaches all populations across Brazil. Strengthening academic leadership, fostering early-phase research and integrating digital and governmental efforts can bridge structural gaps and align national oncology research with global standards of equity and inclusion.