Evidence map›Paper›PMID 41493780›Full record

ArticleJAMA network open2026

The Global Clinical Trial Landscape for Children and Adolescents With Cancer.

Margit K Mikkelsen, Linh T D Pham, Catrian Sotelo, Mackenzie Kelley, Michael Edwards, Ryan R Lion, Hanna Ravi, Guillermo Chantada, John T Lucas, Giles W Robinson and 4 more

Abstract read
In one paragraph

Article in JAMA network open, 2026. 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. Review
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

14 authors.

Margit K MikkelsenDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Linh T D PhamDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Catrian SoteloPediatric Hematology and Oncology, Hospital de Pediatría J.P. Garrahan, Buenos Aires, Argentina.
Mackenzie KelleyEastern Virginia Medical School, Norfolk.
Michael EdwardsCenter for Cancer and Blood Disorders, Children's Hospital of Colorado, Aurora.
Ryan R LionDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Hanna RaviCenter for Cancer and Blood Disorders, Children's Hospital of Colorado, Aurora.
Guillermo ChantadaPediatric Hemato-Oncology, Fundacion Pérez Scremini-Hospital Pereira Rossell, Montevideo, Uruguay.
John T LucasDepartment of Radiation Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.
Giles W RobinsonDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.
Victor SantanaDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Meenakshi DevidasDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Carlos Rodriguez-GalindoDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.
Daniel C MoreiraDepartment of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The improvement of childhood cancer outcomes has relied on clinical trials, primarily from high-income countries (HICs). Inconsistent access to clinical trials, especially in low-income countries (LICs) and middle-income countries, contributes to disparate care and limits the generalizability of conclusions from trials conducted in HICs. Objective: To describe the global availability of clinical trials for children and adolescents with cancer in different economic settings. Design, Setting, and Participants: In this cross-sectional study, the World Health Organization's International Clinical Trials Registry Platform was used to search for clinical trials on May 8, 2024. Trials were included if they were interventional studies for pediatric patients (<18 years old) with an active cancer diagnosis. Main Outcomes and Measures: Clinical trials were analyzed based on geographic location, World Bank country income classification, and trial characteristics, including study phase, sponsor type, intervention type, and inclusion criteria. The main outcome was differences between HICs and low- and middle-income countries in the availability, design, and results of clinical trials for children and adolescents with cancer. Results: Of 138 595 oncology trials, 5645 met the inclusion criteria. Of these, 3149 (55.8%) were pediatrics-only trials. Most pediatrics-only trials (2558 of 3149 [81.2%]) were conducted by sponsors in HICs. Among identified trials, 12.5% (394 of 3149) were open for accrual in upper-middle-income countries (UMICs), 8.9% (281 of 3149) in lower-middle-income countries (LMICs), and 0.2% (7 of 3149) in LICs. Compared with HICs, LMICs or LICs registered fewer early-phase trials (28.8% [42 of 146] vs 81.4% [1709 of 2100]; P < .001), trials with cancer-directed treatments (17.6% [46 of 262] vs 76.8% [1964 of 2558]; P < .001), and multi-institutional trials (6.5% [17 of 262] vs 54.2% [1386 of 2558]; P < .001). LMICs or LICs registered more supportive care-based trials (81.7% [214 of 262] vs 19.9% [509 or 2558]; P < .001). Supportive care trials, later-phase trials, and trials from UMICs, LMICs, and LICs were more likely to publish clinical trial results within 10 years. Conclusions and Relevance: In this cross-sectional study of global pediatric oncology clinical trials, low- and middle-income countries were underrepresented. These data illustrate the need to improve the clinical research infrastructure in low- and middle-income countries and foster inclusive collaborations to promote equity in global pediatric cancer clinical trials.

Indexed as

Clinical Trials as TopicNeoplasmsAdolescentChildCross-Sectional StudiesDeveloped CountriesDeveloping CountriesFemaleGlobal HealthHumansMale

Identifiers

PMID41493780
PMCPMC12776201

What OpenQuestion holds

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LicenceCC BY
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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.