Evidence map›Paper›PMID 40597097›Full record

SynthesisBMC cancer2025

Racial, ethnic, sex, and age representation in clinical trials of radiopharmaceutical tumor therapy: a systematic review and meta-analysis.

Mingye Zhao, Yunlin Jiang, Taihang Shao, Wenxi Tang

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Identifying caregiver-reported modifiable barriers to pediatric oncology clinical trial enrollment and participation.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Mingye Zhao *Center for Pharmacoeconomics and Outcomes Research & Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China.
Yunlin Jiang *Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Taihang ShaoJC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Wenxi TangCenter for Pharmacoeconomics and Outcomes Research & Department of Public Affairs Management, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China. tokammy@cpu.edu.cn.

Funding

National Natural Science Foundation of China 72174207
6 · The paper itself

Abstract

backgroundRadiopharmaceutical therapy (RPT) is an emerging precision oncology approach. However, disparities in racial, ethnic, gender, and age representation in RPT cancer clinical trials may limit trial generalizability and equity. This study aims to quantify demographic disparities in RPT cancer clinical trials compared to US population data and examine trends and trial characteristics associated with these disparities.

methodsSystematic searches of PubMed, Web of Science (via MEDLINE), and ClinicalTrials.gov were conducted through November 2024. Population-based cancer data were obtained from the Surveillance, Epidemiology, and End Results (SEER) databases. All RPT clinical trials reporting age, race, ethnicity, or gender data and recruiting entirely in the US were included. Two reviewers independently extracted trial characteristics and demographic data. Enrollment incidence ratios (EIRs; < 1 indicates underrepresentation, > 1 indicates overrepresentation) were calculated for race, ethnicity, and gender, while median-age ratios (MRs; < 1 indicates younger trial participants compared to disease median diagnosis age) were used for age. Meta-analysis and meta-regression were performed to analyze disparities and trends over time.

resultsAmong 116 trials (5317 patients), reporting rates were 36.21% for race, 22.41% for ethnicity, 98.04% for gender, and 95.69% for median age. White participants were overrepresented (EIR: 1.04, 95% CI: 1.01-1.07), while Black (EIR: 0.32, 95% CI: 0.22-0.47), Asian/Pacific Islander (EIR: 0.55, 95% CI: 0.35-0.85), and Hispanic participants (EIR: 0.35, 95% CI: 0.24-0.51) were underrepresented. Female participants were also underrepresented (EIR: 0.83, 95% CI: 0.78-0.88). Trial participants had a lower median age compared to the SEER-reported median age at cancer diagnosis (MR: 0.86, 95% CI: 0.83-0.89). Meta-regression demonstrated modest improvements in gender, age, and racial/ethnic inclusion over time, particularly for Black and Hispanic participants, though disparities persist. Notably, industry-sponsored trials showed greater underrepresentation of Asian/Pacific Islander participants, and Hispanic inclusion was lower in trials studying cancers with higher 5-year survival rates and in two-arm trials compared to single-arm designs.

conclusionsSignificant demographic disparities persist in RPT trials, limiting the generalizability of findings. Inclusive trial designs, community engagement, and diversity mandates are essential to addressing these gaps and ensuring equitable access to RPT benefits.

Indexed as

Clinical Trials as TopicEthnicityHealthcare DisparitiesNeoplasmsRadiopharmaceuticalsAge FactorsFemaleHumansMalePatient SelectionRacial GroupsSEER ProgramSex FactorsUnited StatesRadiopharmaceuticalsClinical trial diversityGender and age representationHealth equityRacial and ethnic disparitiesRadiopharmaceutical therapy

Identifiers

PMID40597097
PMCPMC12210589

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.