World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Review

Volume 12, Number 2-3, June 2021, pages 50-60

Personalized Medicine in Oncology in the Developing World: Barriers and Concepts to Improve Status Quo

**Table 1.** Response of Malignancies to TKI and IO Compared to Chemotherapy
Drugs	Cancer type
TKI: tyrosine kinase inhibitor; IO: immuno-oncology.
Afatinib and erlotinib [9, 10]	Non-small cell lung cancer	Progression-free survival was significantly higher than with chemotherapy in patients with well differentiated adenocarcinoma of the lungs.

Imatinib [11]	Gastrointestinal stromal tumor	Overall and progression-free survival was significantly higher than with chemotherapy.
Cetuximab [12]	Colorectal cancer	Overall and disease progression survival is better with RAS wild type colorectal cancer.
Pembrolizumab [13, 14]	Colorectal and lung cancer	Pembrolizumab shows better overall and disease progression-free survival in colorectal and lung cancer with high tumor mutational burden than with chemotherapy.
Nivolumab and ipilimumab [15, 16]	Renal cell cancer and advanced non small cell lung cancer	This combination show better outcome compared to the conventional chemotherapy in renal cell cancer and advanced non-small cell lung cancer.
Atezolizumab [17, 18]	Triple-negative breast cancer and liver cancer	Shows better outcome compare to chemotherapy in triple-negative breast cancer with PDL1 expression and liver cancer.

Table 1. Response of Malignancies to TKI and IO Compared to Chemotherapy

Drugs

Cancer type

TKI: tyrosine kinase inhibitor; IO: immuno-oncology.

Afatinib and erlotinib [9, 10]

Non-small cell lung cancer

Progression-free survival was significantly higher than with chemotherapy in patients with well differentiated adenocarcinoma of the lungs.

Imatinib [11]

Gastrointestinal stromal tumor

Overall and progression-free survival was significantly higher than with chemotherapy.

Cetuximab [12]

Colorectal cancer

Overall and disease progression survival is better with RAS wild type colorectal cancer.

Pembrolizumab [13, 14]

Colorectal and lung cancer

Pembrolizumab shows better overall and disease progression-free survival in colorectal and lung cancer with high tumor mutational burden than with chemotherapy.

Nivolumab and ipilimumab [15, 16]

Renal cell cancer and advanced non small cell lung cancer

This combination show better outcome compared to the conventional chemotherapy in renal cell cancer and advanced non-small cell lung cancer.

Atezolizumab [17, 18]

Triple-negative breast cancer and liver cancer

Shows better outcome compare to chemotherapy in triple-negative breast cancer with PDL1 expression and liver cancer.

**Table 2.** Comparing Gross National Income per Capita ($) of Nepal and Nigeria With Some Developed Countries [31]
Year	Country
2016	770	2,470	39,390	42,980	53,020	57,180
2017	860	2,100	38,170	41,370	54,320	59,060
2018	970	1,970	41,100	41,730	57,900	63,200
2019	1,090	2,030	42,670	42,370	59,590	65,760

Table 2. Comparing Gross National Income per Capita ($) of Nepal and Nigeria With Some Developed Countries [31]

Year

Country

Nepal

Nigeria

New Zealand

Singapore

USA

2016

770

2,470

39,390

42,980

53,020

57,180

2017

860

2,100

38,170

41,370

54,320

59,060

2018

970

1,970

41,100

41,730

57,900

63,200

2019

1,090

2,030

42,670

42,370

59,590

65,760

**Table 3.** Comparing Health Expenditure per Capita PPP ($) of Nepal and Nigeria With China, Singapore, UK and USA [32]
Year	Country
2011	137.42	192.85	438.56	2,404.66	3,255.07	8,523.83
2012	126.94	178.31	508.17	2,647.31	3,322.94	8,789.77
2013	127.47	208.46	574.7	3,068.61	3,374.14	8,987.9
2014	137.4	216.87	634.7	3,358.09	3,376.87	9,402.54
2015	151.32	215.62	705.56	3,696.38	4,125.03	9,507.62
2016	156.34	218.79	762.98	4,020.69	4,192.53	9,892.72
2017	150.07	221.1	841.11	4,269.96	4,126.3	10,212.7

Table 3. Comparing Health Expenditure per Capita PPP ($) of Nepal and Nigeria With China, Singapore, UK and USA [32]

Year

Country

Nepal

Nigeria

China

Singapore

USA

2011

137.42

192.85

438.56

2,404.66

3,255.07

8,523.83

2012

126.94

178.31

508.17

2,647.31

3,322.94

8,789.77

2013

127.47

208.46

574.7

3,068.61

3,374.14

8,987.9

2014

137.4

216.87

634.7

3,358.09

3,376.87

9,402.54

2015

151.32

215.62

705.56

3,696.38

4,125.03

9,507.62

2016

156.34

218.79

762.98

4,020.69

4,192.53

9,892.72

2017

150.07

221.1

841.11

4,269.96

4,126.3

10,212.7

**Table 4.** Comparing Health Expenditure Contributors in Nigeria and Nepal
Countries	Out-of-pocket payment	Government contribution	Health insurance contribution
Nigeria [48]	65%	30%	5%
Nepal [49]	23%	70%	7%

Table 4. Comparing Health Expenditure Contributors in Nigeria and Nepal

Countries

Out-of-pocket payment

Government contribution

Health insurance contribution

Nigeria [48]

65%

30%

Nepal [49]

23%

70%