When Dr. Alejandro Mohar took on the role of SWOG executive officer for international affairs earlier this year, I considered it a coup.


From 2003 to 2013, Dr. Mohar served as the director of the Instituto Nacional de Cancerologia (INCan), the Mexican version of our National Cancer Institute. His work there was high impact. He opened a state-of-the-art building for cancer clinical care and research, one which tripled the size of the former facility. He championed a new publicly-funded scheme that, for the first time, covered the full cost of certain treatments for breast, cervical, prostate and other common cancers through Mexico’s Social Security program. Finally, Dr. Mohar forged major connections between INCan and the United States, creating a cross-border current of young investigators and public health and oncology experts at places such as the Harvard T.H. Chan School of Public Health, where Mohar had earned his doctoral degree.

The 61-year-old pathologist with a specialty in oncology now runs the public health program at INCan – and he leads SWOG international efforts broadly and our SWOG Latin America Initiative (SLAI) specifically. He has a strong foundation to build on.
In 2010, INCan became the first Latin American cancer institute to join SWOG – a partnership Mohar forged with my predecessor, Dr. Larry Baker, and former Group Statistician Dr. John Crowley. Eight years later, the cancer institutes of Colombia and Peru are members. Next year, we hope to see Brazil and Chile to sign on. Also, in just the last three years, we have tutored more than 400 cancer physicians and researchers across Latin America, through formal statistical and clinical trials courses. In November, we head back to Bogota for another program and, in 2019, return to Chile for another program.
Dr. Mohar’s goal is to amplify these efforts – adding more members, training more staff, and opening more trials in Latin America. Right now, for example, there are two SWOG trials open at INCan, one for gastric cancer and one for cervical cancer. He would like to at least double that. With a breast cancer trial using the OncoType DX breast cancer recurrence score test in development, he’s getting there.
But Dr. Mohar also wants to see that staff training pay off, with more Latin American members devising and launching their own (SWOG) trials in their countries.
For Alejandro, it’s just fine that growth comes slowly. He knows that developing expertise, building a culture for research, and overcoming significant scientific, legal, and logistical barriers to run international trials is a long game. It will take years, perhaps decades really, to develop a robust international cancer trials network that runs up, down, and all around the Americas. While the barriers to running international trials are real, and high, Mohar says the core problem lies much deeper.
“The problem isn’t opening trials here,” he says from Mexico City. “It is slowly getting easier to get investigational drugs from the U.S. to other countries, and the costs, gratefully, for those study drugs are usually covered by the drug companies. The real problem is the cost of the drugs once they’re approved and ready for use. Latin America is not wealthy, and people cannot afford expensive cancer drugs. And our Social Security system does not cover them. So we can run the trials, but how will we actually give people economic access to the new drugs we’ve tested? This is the challenge – the important one – and that will take a lot of talking with drug companies and policy makers.”
Mohar is a man with a foot in two worlds – North America and Latin America, NCI and INCan, English and Spanish, policy and practice. To see such inequality in these worlds is difficult. What keeps him going, what keeps him fighting, are patients.
“About 20 percent of people in Mexico who get cancer are under the age of 40,” he says. “They have children and careers ahead of them. I want to give them good therapies that will help them live their life. They need resources. And that’s what much of our international work will come down to – finding resources.”
We are lucky to have him.

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