- 7 September 2022 - 

The BIG-Asia Collaboration – an important milestone

Publication in Journal of Breast Cancer (June 2022)


We are happy to share with you that the project Disparities in Access to Systemic treatment for Breast Cancer in Thailand and Major Asian Territories has been published in the Journal of Breast Cancer [1]. This is an important achievement for the BIG-Asia Collaboration and we applaud the authors and members of the BIG-Asia network who contributed to completing the project. A warm congratulations from BIG!

Key points of the paper

The aim of the project was to provide insights on the availability and access of important targeted drugs and molecular testing applicable for early-stage breast cancer in Thailand and other members of the BIG-Asia Collaboration.
National healthcare resources were correlated with cancer incidence to mortality ratio.
A survey was conducted among five countries (Thailand, Japan, Singapore, Taiwan, Korea) and one special administrative region (SAR) (Hong Kong). There were 20 respondents from multidisciplinary specialities. Thailand is classified as upper-middle income country while all the others are high income countries.

The questionnaire addressed national health reimbursement schemes, molecular testing for early breast cancer, availability and accessibility of breast cancer drugs. They were classified either as fully, partially or not reimbursed.

Key findings:

  • Genomic tests are not reimbursed in the participating countries/SAR
  • There are variable reimbursements or co-payment schemes across Asia. For example, accessibility of HER2-targeted therapy is generally lower than endocrine treatments or chemotherapy. There were varying reimbursements of the anti-HER2 drugs across countries depending on clinical characteristics such as lymph node and hormone-receptor status.
  • In general, there are more similar reimbursements for drugs in the metastatic setting but newer drugs with proven clinical benefit have limited access: CDK 4/6 inhibitors, PARP inhibitors and TD-M1.

Impact of the manuscript
Although this was a snapshot of the access and availability of important breast cancer treatments across Asia, it could be an important guide for policy makers to push for improving healthcare resources in Asia.


Background of the BIG-Asia Collaboration

East Asian groups actively contribute to patient recruitment in BIG trials. The BIG-Asia Collaboration was initiated to develop Asian-led trials to be run under the BIG umbrella and to engage young investigators to the mission of BIG.
BIG-Asia was formed in 2016 by senior and junior members from China (BDPCC, CBCS), Hong Kong (HKBOG), Japan (JBCRG), Singapore (CTRG), Korea (KCSG), Taiwan (TCOG) and Thailand (TSCO), with the support of BIG Headquarters.
During the recent years, BIG-Asia conducted several focused group discussions (FGDs) to evaluate critical research priorities and challenges specific to the region.

1 Ithimakin S, Parinyanitikul N, Kim SB et all, and on behalf of the BIG-Asia Collaboration. Disparities in Access to Systemic Treatment for Breast Cancer in Thailand and Major Asian Territories. J Breast Cancer. 2022 Jun;25(3):207-217.