{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:31:03Z","timestamp":1787671863461,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prospective pediatric oncology clinical trials remain scarce across low\u2010 and middle\u2010income countries (LMICs). We developed the first multicountry prospective clinical trial within the Pediatric Oncology East and Mediterranean (POEM) group. Localized osteosarcoma was selected due to heterogeneous real\u2010world management, including alternative regimens in settings where methotrexate administration is not feasible. This descriptive report details the feasibility of a regionally coordinated, resource\u2010adapted clinical trial across diverse LMIC settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We describe the planning, capacity assessment, training, governance, and activation of POEM\u2010OS, a pragmatic two\u2010arm prospective cohort study evaluating MAP\u2010 and OS99\u2010based therapy for localized osteosarcoma. Preparation included a structured capacity\u2010mapping exercise across regional centers to assess clinical resources, research, and regulatory structures. The approach also encompassed designing a training program and communication through a structured study coordination team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 27 centers from 10 countries expressed intent to participate. A 12\u2010week virtual training curriculum was implemented for principal investigator and clinical research coordinator dyads, followed by an in\u2010person regional workshop. Eventually, 21 centers (8 countries) proceeded to study activation. Major barriers included heterogeneity in chemotherapy administration, high staff turnover, and variability in timelines to study\u2010agreement execution. Adaptive solutions included permanently accessible online training modules, simplified chemotherapy dosing, and harmonized toxicity grading. Centralized REDCap platforms enabled regional data sharing. By February 2026, the study had opened at 16 centers, with 21 patients enrolled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>POEM\u2010OS demonstrates that a regionally directed, resource\u2010adapted clinical trial platform is feasible across diverse LMIC settings and establishes a foundation for sustainable regional clinical research infrastructure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70556","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:03:10Z","timestamp":1785481390000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Navigating the Planning and Initiation of a First Prospective Clinical Trial Through a Regional Pediatric Oncology Consortium Within the Middle East, Africa, and Asia\u2014A Roadmap"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-6280","authenticated-orcid":false,"given":"Ruzanna","family":"Papyan","sequence":"first","affiliation":[{"name":"Department of Hematology and Pediatric Oncology Yerevan State Medical University  Yerevan Armenia"},{"name":"Yeolyan Hematology and Oncology Center  Yerevan Armenia"},{"name":"Immune Oncology Research Institute  Yerevan Armenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Ghamloush","sequence":"additional","affiliation":[{"name":"Department of Anatomy Cell Biology and Physiological Sciences and POEM Central Office American University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Sidhom","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology National Cancer Institute Cairo University and Children's Cancer Hospital Egypt  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0135-7509","authenticated-orcid":false,"given":"Asim","family":"Belgaumi","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rihab","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Anatomy Cell Biology and Physiological Sciences and POEM Central Office American University of Beirut  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyad","family":"Sultan","sequence":"additional","affiliation":[{"name":"King Hussein Cancer Center  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gevorg","family":"Tamamyan","sequence":"additional","affiliation":[{"name":"Department of Hematology and Pediatric Oncology Yerevan State Medical University  Yerevan Armenia"},{"name":"Immune Oncology Research Institute  Yerevan Armenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-5816","authenticated-orcid":false,"given":"Venkatraman","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Cancer Institute (W.I.A)  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-8946","authenticated-orcid":false,"given":"Carlos","family":"Rodriguez\u2010Galindo","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2835-5869","authenticated-orcid":false,"given":"Sima","family":"Jeha","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-5776","authenticated-orcid":false,"given":"Victor M.","family":"Santana","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5776-2303","authenticated-orcid":false,"given":"Raya","family":"Saab","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","first-page":"E1","article-title":"The Most Vulnerable Paediatric Cancer Patients","volume":"1","author":"Graetz D. 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