Addressing Ancestral Underrepresentation in Oncobiology: The Need for Sub-Saharan African-Specific In Vitro Models.

Cancer is an increasing public health burden, including in Sub-Saharan African (SSA) populations, where cancer incidence is predicted to increase by around 140% between 2022 and 2050. These rates require a better understanding of the epidemiological, clinical, and genetic/molecular characteristics of cancer in SSA populations. There is an urgent need to improve the genomic characterization of SSA tumour samples and also to establish suitable in vitro models for hypothesis testing. In fact, even though thousands of cancer cell lines (CCLs) have been established employing different methods of cell immortalization and have been included in deep molecular characterization panels, SSA ancestry is limited to only ~6% (mostly African Americans, who represent limited diversity in the context of the African continent) of publicly available CCLs. This disparity needs to be addressed by using next-generation immortalization methods such as conditional reprogramming to establish CCLs derived from SSA cancer patients that also represent the diversity within the African continent. Research in SSA oncobiology has the potential to add essential information to better understand the diverse molecular pathways leading to cancer and to find promising therapeutic avenues. We also discuss the challenges to conducting oncobiology studies with cell modelling derived from SSA patients in low-to-middle-income African countries, such as Portuguese-speaking African countries.