Scotland's world-leading cancer research in jeopardy WE UNDERSTAND that the Scottish Government is working in a climate of financial constraint, but this is no different from many other European countries, and therefore this alone cannot be used as an excuse for cancer patients to be placed at a disadvantage from those in other countries. One example illustrates the situation for Scottish cancer patients. Malignant melanoma is a skin cancer whose incidence has risen dramatically over the past 30 years, particularly in Scotland, where world- leading research has been conducted. The treatment of advanced melanoma has been revolutionised with the licensing of B-raf inhibitors and ipiluminab to treat this previously drug-resistant disease. These drugs, welcomed worldwide as a significant breakthrough, are not available to people in Scotland. The refusal to approve these medicines is totally demoralising for res­earchers and patients alike. These decisions attract worldwide attention to the Scottish NHS cancer services for all the wrong reasons. The 2011 Scottish life science strategy "Creating Wealth, Promoting Health" 2020 vision aims to double the economic contribution made by the life science industry by 2020. If the situation remains with reg­ard to poorer access to new medicines, it will negatively impact on this aspiration, due to a drift in oncologists from within Scotland conducting less innovative research. In addition, due to Scotland in many situations no longer treating patients with the standard of care used in other parts of the world, Scotland may not be able to take the lead or take part in global clinical research studies, NCRN clinical trials or many other commercial trials which require the standard therapy in such trials to be what is approved by the regulators, but which is increasingly not the standard of care in Scotland. Inability to partake in such studies will deprive the NHS of the financial savings from company-funded drug supply, as well as the overall loss of investment in the Scottish economy. This risks a knock-on effect in terms of international funders reviewing investment across the whole of science, including Scotland's strongholds in areas such as basic science and translational medicine. Prof David Cameron, professor of oncology, University of Edinburgh and director NHS Cancer Services, NHS Lothian; Prof Jeff Evans, professor of translational cancer research and director of Institute of Cancer Sciences, University of Glasgow; Dr Marianne Nicholson, consultant medical oncologist and research lead, North of Scotland Cancer Network