Cross-sectional study of the global clinical trial landscape for children and adolescents with cancer

The improvement of childhood cancer outcomes has relied on clinical trials, primarily from high-income countries. Inconsistent access to clinical trial contributes to disparate care and limits the generalizability of conclusions of these trials. A cross-sectional study, using the World Health Organization’s International Clinical Trials Registry Platform, inventarized clinical trials for pediatric patients (< 18 years old) with an active cancer diagnosis. Among 5645 identified trials, 81.2% were conducted in high-income countries. Trials in low- and middle-income countries were more often conducted by single institutions and concentrated on supportive care, while a similar rate of publications was seen across all country income groups. The authors conclude that systematic efforts to strengthen the research capacity in low- and middle-income countries may improve care and expand the generalizability of conclusions from interventional studies for children and adolescents with cancer globally.