{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:15:18Z","timestamp":1793042118529,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Childhood cancer outcomes in low\u2010 and middle\u2010income countries (LMICs), where over 80% of the world's children reside, remain drastically lower than in high\u2010income countries (HICs). This vast disparity stems from pervasive challenges, including limited healthcare access, inadequate resources, delayed diagnosis, and differences in disease biology influenced by varied genetic ancestries. The direct translation of intensive HIC protocols often results in elevated treatment\u2010related mortality (TRM) in resource\u2010constrained settings, highlighting the critical need for locally validated regimens. Current barriers to establishing robust research capacity include minimal research training, overwhelmed specialists, excessive and misaligned ethical\/regulatory oversight\u2014even for low\u2010risk studies\u2014and pharmaceutical industry strategies that favor trials in HICs. To bridge this survival gap, a paradigm shift is required, moving from protocol translation to context\u2010specific clinical research. This strategy must prioritize Implementation and Comparative Effectiveness studies to validate adapted treatments. Key initiatives must include local genomic characterization for equitable risk allocation and an innovative \u201crepurposing\u201d of novel agents by adjusting dosages and schedules to enhance feasibility and reduce toxicity within local supportive care capacity. Strengthening international cooperative research groups and fostering a multi\u2010stakeholder dialogue among regulators, industry, and civil society are essential to expedite the generation of robust, locally relevant evidence that can inform public health policy and ensure every child has access to the best chance of cure at their local site.<\/jats:p>","DOI":"10.1002\/1545-5017.70254","type":"journal-article","created":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T12:15:18Z","timestamp":1775391318000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scaling\u2010Up Research in Childhood Cancer in Low\u2010 and Middle\u2010Income Countries"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-5980","authenticated-orcid":false,"given":"Jaume","family":"Mora","sequence":"first","affiliation":[{"name":"Pediatric Cancer Center Barcelona Hospital Sant Joan De D\u00e9u  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Howard","sequence":"additional","affiliation":[{"name":"Pediatric Cancer Center Barcelona Hospital Sant Joan De D\u00e9u  Barcelona Spain"},{"name":"Resonance Inc.  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Moreira","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Chinnaswami","sequence":"additional","affiliation":[{"name":"Tata Memorial Centre  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidnei","family":"Epelman","sequence":"additional","affiliation":[{"name":"Hospital Santa Marcelina  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Allen","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine and Milton and Allene Nirken Chair in Pediatric Oncology Texas Children's Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-9336","authenticated-orcid":false,"given":"Guillermo L.","family":"Chantada","sequence":"additional","affiliation":[{"name":"Pediatric Cancer Center Barcelona Hospital Sant Joan De D\u00e9u  Barcelona Spain"},{"name":"Fundaci\u00f3n P\u00e9rez Scremini  Montevideo Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32947"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29416"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29345"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010025\u201003926\u2010x"},{"key":"e_1_2_15_6_1","article-title":"The Global Clinical Trial Landscape for Children and Adolescents With Cancer","author":"Mikkelsen M. 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