Pediatric Oncology Clinical Trials and Collaborative Research in Africa: Current Landscape and Future Perspectives

Abstract

PURPOSE Adequate clinical services have yet to be established in the majority of African countries, where childhood cancer survival rates vary from 8.1% to 30.3%. The aim of this review is to describe the landscape of pediatric oncology trials in Africa, identify challenges, and offer future opportunities for research collaborations. METHODS The study includes data from the International Pediatric Oncology Society (SIOP) global mapping survey, meta-research identifying trials in Africa in ClinicalTrials.gov, and a literature overview of publications on the subject of pediatric oncology clinical research supported by expert opinions on the current situation and challenges. RESULTS The SIOP global mapping survey received responses from 47 of 54 African countries, of which 23 have active clinical research programs. A preliminary search of ClinicalTrials.gov showed that only 105 (12.1%) of 868 African oncology studies included children and adolescents. Of these, 53 (50.5%) were interventional trials according to the registry’s classification. The small number of African trials for children and adolescents included palliative care and leukemia trials. In African oncology journals and international pediatric oncology journals, < 1% of the pediatric oncology publications come from Africa. Services and research were strengthened by international collaboration. National studies focused on clinical needs, local challenges, or interventional priorities. Both the literature review and the expert opinions highlight the need to expand clinical research in Africa, despite ongoing regional instability and lack of resources. CONCLUSION While a low number of pediatric clinical treatment trials are open to African children and adolescents, clinical research of high quality is being done in Africa. Several initiatives are stimulating the development of the research capacity across the continent, which should increase the publication output.

Intercontinental collaboration in clinical trials for children and adolescents with cancer—A systematic review by ACCELERATE

“…Nonetheless, intercontinental collaboration seems to facilitate research development in less economically and/or geographically favored continents, as seen by the number of mono‐continental versus intercontinental trials in South America (1 vs. 29, respectively) and Australia (1 vs. 107, respectively). This is not observed however in Africa, with multifaceted possible reasons having been pointed out by a recent work by SIOP Africa 18 . Increasing intercontinental collaboration will hopefully contribute to reduce global inequality in cancer research and care.…”

“…This is not observed however in Africa, with multifaceted possible reasons having been pointed out by a recent work by SIOP Africa. 18 Increasing intercontinental collaboration will hopefully contribute to reduce global inequality in cancer research and care.…”

Reporting Incidences of Neuroblastoma in Various Resource Settings

“…Yet this is true for Chad, a resource-limited setting, that is, a large country without services. 32 Therefore, it cannot be stated that there is a true difference in incidence between the same income-classified countries, because of a limited insight where patients are diagnosed and treated.…”

Mapping Pediatric Oncology Clinical Trial Collaborative Groups on the Global Stage

“…83,97,98 Access to specialized pediatric oncology care is a significant driver of poor outcomes, with 14 of 54 countries having no full-time pediatric oncologists and only 57% of childhood cancer cases estimated to be formally diagnosed. 1,99 However, it is encouraging that 23 of 54 countries in Africa have reported active pediatric cancer clinical research programs, five countries have fellowship programs with research training, and several clinical trial cooperative groups have emerged. 99…”

“…1,99 However, it is encouraging that 23 of 54 countries in Africa have reported active pediatric cancer clinical research programs, five countries have fellowship programs with research training, and several clinical trial cooperative groups have emerged. 99…”