The Utilisation of Endocrine and Immunotherapy: Retrospective Study at a Tertiary Hospital in South Africa

Why It Matters

The findings highlight a treatment gap where patients who could benefit from immunotherapy are excluded due to financial barriers, underscoring equity challenges in emerging markets’ oncology care.

Key Takeaways

• Endocrine therapy used in 29% of patients.
• Immunotherapy administered to only five patients.
• Age, stage, receptor status linked to endocrine use.
• No immunotherapy given as first‑line treatment.
• Cost constraints limit immunotherapy access in public hospitals.

Pulse Analysis

Cancer mortality in sub‑Saharan Africa remains high, driven by limited diagnostic capacity and constrained treatment options. While endocrine therapy has long been a cornerstone for hormone‑receptor‑positive breast and prostate cancers, newer immunotherapies promise durable responses across multiple tumor types. However, the high acquisition cost and need for specialized infrastructure often place these agents beyond the reach of publicly funded hospitals in low‑ and middle‑income countries, creating a stark disparity compared with high‑income markets.

The Limpopo study examined 82 records from 2019‑2025, revealing that endocrine therapy was employed in roughly one‑third of patients, primarily as an adjunct to chemotherapy. Statistical analysis showed that older patients, those diagnosed at advanced stages, and individuals with positive receptor status were more likely to receive endocrine treatment. In contrast, immunotherapy was absent from first‑line protocols and limited to five cases overall, indicating systemic barriers rather than clinical contraindications. These patterns suggest that therapeutic decisions are heavily influenced by resource availability rather than solely by tumor biology.

For policymakers and health system leaders, the data signal an urgent need to reassess oncology funding models. Negotiating price‑based agreements, leveraging pooled procurement, and investing in local manufacturing could lower immunotherapy costs, expanding access for eligible patients. Additionally, integrating biomarker testing into routine care would ensure that those most likely to benefit are identified early. Future research should track outcomes of patients denied immunotherapy to quantify the clinical and economic impact of current limitations, guiding evidence‑based reforms in South Africa’s public cancer treatment landscape.