NCI Celebrates a Decade of Innovation: NCI's Affordable Cancer Technologies Program
The National Cancer Institute (NCI) recently celebrated 10 years of the Affordable Cancer Technologies (ACTs) program and its
Fabio Ynoe de Moraes, M.D., Ph.D., M.B.A., and Paul Pearlman, Ph.D.
impact on advancing cancer care in low- and middle-income countries. Since its launch in 2014, the program has supported 38 research project grants and developed a strong portfolio of technology-driven research aimed at expanding access to high-quality cancer services worldwide. The grants have resulted in highly cited publications, patents and further licensing of developed technologies, data-informed guidelines, and adoption of new approaches for cancer control.
To mark this milestone, JCO Global Oncology has published a Special Series highlighting the past and ongoing work of ACTs-supported investigators and the multisectoral partnerships driving a new generation of cancer technologies. The series spans a range of topics, from point-of-care diagnostics and portable treatment devices to implementation science and drug quality in resource-limited settings, reflecting the breadth of the program's impact.
The guest editor for the series is Paul C. Pearlman, Ph.D., Program Director and Lead for Global Health Technology at the NCI Center for Global Health. The associate editor is Fabio Ynoe de Moraes, MD., Ph.D., M.B.A., Director of Global Oncology at Queen’s University in Kingston, ON, Canada.
| Article | Authors | Overview |
|---|---|---|
| Automated Detection of Kaposi Sarcoma–Associated Herpesvirus–Infected Cells in Immunohistochemical Images of Skin Biopsies | Iftak Hussain, PhD, Juan Boza, PhD, Robert Lukande, MMed, Racheal Ayanga, MD, Aggrey Semeere, MMed, Ethel Cesarman, MD, Jeffrey Martin, MD, Toby Maurer, MD, and David Erickson, PhD | This study presents an automated framework for detecting and quantifying KSHV-infected cells in immunohistochemical images of skin biopsies, using machine learning to improve diagnostic accuracy for Kaposi sarcoma. The approach shows particular promise for resource-limited settings where access to trained pathologists is scarce. |
| Improving the Sensitivity-Specificity Balance of Human Papillomavirus Testing on Self- and Clinician-Collected Samples in South Africa | Gbenankpon M. Houvessou, PhD, Rakiya Saidu, MD, PhD, Rosalind Boa, MBChB, Nomonde Mbatani, MBChB, FCP, Jennifer Moodley, PhD, MBChB, and Louise Kuhn, PhD | This study examines how HPV testing on self-collected samples can be optimized to expand cervical cancer screening coverage in South Africa. Researchers investigate strategies to address the lower specificity observed in self-collected versus clinician-collected samples, with particular attention to differences among HIV-positive and HIV-negative women. |
| Use of Thermal Ablation in Low-Resource Settings: Experience from Three Multicenter Noninferiority Randomized Clinical Trials | Gabriel Conzuelo Rodriguez, MD, PhD, Miriam L. Cremer, MD, MPH, Richard Muwonge, PhD, and Partha Basu, MD, PhD | Drawing on data from three multicenter randomized clinical trials conducted in low-resource settings, this study evaluates the efficacy, safety, and acceptability of thermal ablation devices for the treatment of cervical precancer. The authors compare outcomes against previously established standard methods, offering evidence to support the broader adoption of accessible, affordable treatment options. |
| Emerging Trends in Point-of-Care Technology Development for Oncology in Low- and Middle-Income Countries | Wenting Gao, MSc, Jason C. Manning, BSc, Kirtana Devaraj, BSc, Rebecca R. Richards-Kortum, PhD, Sally M. McFall, PhD, Robert L. Murphy, PhD, Aggrey Semeere, PhD, and David Erickson, PhD | This article explores recent advances in point-of-care technologies and their potential to reduce cancer diagnostic disparities in low- and middle-income countries. The authors highlight both current innovations and remaining challenges in bringing affordable, accessible diagnostic tools to resource-limited settings. |
| First Decade of the National Cancer Institute's Affordable Cancer Technologies Program: Accelerating Translational Technology Research and Development for Cancer Globally | Paul C. Pearlman, PhD, Rao Divi, PhD, Rebecca Huppi, PhD, Elise Garton, MSc, Srivatsan Kidambi, PhD, Pushpa Tandon, PhD, Miguel Ossandon, PhD, Ophira Ginsburg, MD, MSc, and Satish Gopal, MD, MPH | NCI program directors and leaders reflect on the first ten years of the NCI's Affordable Cancer Technologies (ACTs) Program, tracing its evolution from early-stage technology development to a broad research portfolio aimed at improving cancer control in low-resource settings globally. The authors highlight key milestones, lessons learned, and the multisectoral partnerships that have driven progress, while looking ahead to the program's next decade. |
| Point-of-Care Urine Metabolomics Test to Diagnose Colorectal Cancers in Low- and Middle-Income Countries: A Pilot Controlled Trial in Southwestern Nigeria | Adeleye A. Adeomi, MD, PhD, Olusegun I. Alatise, MD, David Wishart, PhD, Scott MacKay, PhD, Olalekan Olasehinde, MD, Funmilola Wuraola, MD, Adewale Adisa, MD, Tajudeen Mohammed, MD, Adewale Aderounmu, MD, Omolade Adefolabi Betiku, MD, Oluwatosin Zainab Omoyiola, MD, Adeoluwa Oluwaseyi Adeleye, PhD, Samson Oluwagbemiga Ogunleye, MSc, Olusegun Joshua Babatunde, BSc, Oluwabusayomi Roseline Ademakinwa, PhD, Israel Adeyemi Owoade, MD, Jacob Mobolaji, PhD, Cristina Olcese, BSc, Rivka Kahn, BSc, Naqiya Rahil Choonawala, BSc, Grace Fitzgerald, BSc, H. Dean Hosgood, PhD, and T. Peter Kingham, MD | This pilot-controlled trial evaluates the feasibility and diagnostic accuracy of a point-of-care urine metabolomics test for colorectal cancer among at-risk patients in southwestern Nigeria. The study also assesses patient willingness to use and pay for the test, offering a promising low-cost alternative to colonoscopy in a setting where colorectal cancer rates are rising and endoscopic resources remain scarce. |
| Adoption and Implementation of Affordable Cancer Technologies in El Salvador: Identifying Implementation Strategies for Successful Cervical Cancer Prevention in Resource-Limited Settings | Montserrat Soler, PhD, MPH, Karla Alfaro, MD, MPH, Juan Carlos Rauda, MD, Elizabeth Torres, MD, José Roberto Pérez, MD, Freddy Méndez, MD, Gabriel Conzuelo Rodriguez, MD, PhD, Marina A. Chacon, MD, Mayra Patricia Erazo, MD, Rachel Masch, MD, MPH, Eveline Mumenthaler, BSc, and Miriam Cremer, MD, MPH | This article traces the journey of a portable thermal ablation technology from clinical research to national implementation in El Salvador, examining the strategies that enabled its adoption within the country's cervical cancer screen-and-treat program. The authors identify key implementation lessons applicable to other resource-limited settings working to close the gap between scientific innovation and clinical practice. |
| Diagnostic Translational Considerations for Global Health Settings: Portable Detection of Human Papillomavirus for Cervical Cancer Screening in India | Vi T. Nguyen, MSc, Siril Arockiam, MSc, Pankaj Kumar, PhD, Joshua Eger, BSc, Kirk Herman, BSc, Shachi Vashist, BHMS, Neerja Bhatla, MD, Lalit Dar, MD, Dean E. Brenner, MD, Karen S. Anderson, MD, PhD, and Jennifer Blain Christen, PhD | This article documents the development and field testing of a portable point-of-care system for HPV detection, designed for cervical cancer screening in India, and shares translational lessons encountered along the way. The authors reflect on the iterative process of adapting laboratory-developed diagnostic technology for real-world global health settings, offering practical guidance for others working to deploy similar tools in resource-limited environments. |
| Special Content: 10 Years of the National Cancer Institute's Affordable Cancer Technology Program | Paul C. Pearlman, PhD, and Fabio Y. Moraes, MD, PhD, MBA | Guest Editor, Paul Pearlman and Associate Editor, Fabio Y. Moraes, This special content piece introduces the JCO Global Oncology Special Series marking ten years of the NCI's Affordable Cancer Technologies Program, outlining the scope and significance of the series. The authors highlight the program's broad impact, from research and technology development to multisectoral partnerships, and underscore the importance of translating scientific innovation into improved cancer outcomes for underserved populations worldwide. |
| Chemotherapy Medications in Sub-Saharan Africa: Availability, Pricing, Affordability, and Predictors of Quality | Colleen R. Higgins, MSPH, Maximilian J. Wilfinger, BSc, Jack Doohan, Ekezie Okorigwe, BSc, Ayenew Ashenef, MSc, Atalay Mulu Fentie, MSc, Ibrahim Chikowe, MPhil, Hanna S. Kumwenda, BPharm, Paul Ndom, MD, Yauba Saidu, MD, PhD, Jesse Opakas, MD, Sonak Pastakia, PhD, PharmD, MPH, Phelix Makoto Were, BSc, Benyam Muluneh, PharmD, Marya Lieberman, PhD, and Sachiko Ozawa, PhD, MHS | This study examines the availability, pricing, affordability, and quality of chemotherapy medications across sub-Saharan Africa, finding that cancer medicines remain out of reach for most patients without government subsidies. The authors also highlight that conventional indicators such as price, registration status, and public versus private sourcing are unreliable predictors of drug quality, underscoring the need for chemical testing through post-market surveillance and stronger government policies to improve the supply chain. |