# Assessing patterns of authorship of low- and middle-income countries in global commercial clinical trials in oncology

## TL;DR

This paper examines authorship patterns in global cancer trials, finding underrepresentation of researchers from low- and middle-income countries.

## Contribution

The study is the first to analyze authorship in industry-sponsored oncology trials involving low- and middle-income countries.

## Key findings

- 63% of publications had at least one author from a middle-income country.
- Only 14% of articles had a middle-income country researcher as the first author.
- 37% of articles had no authors from middle-income countries, despite trial involvement.

## Abstract

Poor authorship practices in global health research may be a sign of unequal partnerships. Previous studies have shown that authors from low- and middle-income countries (LMICs) are frequently underrepresented in publications from global research collaborations between LMICs and high-income countries (HICs). To the best of our knowledge, the patterns of authorship from LMICs in international industry-sponsored clinical research on breast, lung and colon cancer have not yet been investigated. Therefore, as a spin-off to broader research on globalization of commercial clinical trials in oncology, we conducted an analysis of authorship in the publications from completed industry-sponsored therapeutic trials in breast, lung and colon cancer (from phase I to IV) that involved LMICs. Only articles published in a peer-reviewed journal in English by March 30, 2024 were included. A total of 302 publications from 173 trials were analysed. 63% (n = 191) of them have at least one author from a middle-income country (MIC); 14% (n = 42) articles have the first author from a MIC; and 13% (n = 39) articles have the last author from a MIC. Conversely, 37% (n = 111) of articles had no author from MIC, including two trials conducted only in MICs. In conclusion, our study found an imbalance in authorship, suggestive of significant inequalities, in collaborative research in industry-sponsored clinical trials for breast, lung and colon cancer. Industry sponsors need to work towards greater equity in authorship when collaborating with researchers in (L)MICs, and oncology researchers and opinion leaders in HICs should actively advocate for greater fairness to their colleagues in (L)MICs.

The online version contains supplementary material available at 10.1186/s12992-025-01167-8.