{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:36:50Z","timestamp":1786113410415,"version":"build-2736575974"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Latin America bears a growing burden of genitourinary (GU) and cutaneous malignancies but remains underrepresented in clinical trials that shape global standards of care. This underrepresentation raises ethical concerns and limits the generalizability of trial findings. We evaluated Latin American (LATAM) representation in pivotal GU and skin cancer trials and explored barriers to equitable inclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We reviewed pivotal phase II and III trials in advanced GU and cutaneous malignancies (melanoma and non-melanoma skin cancers) published between 2015 and 2024. Extracted data included trial site distribution, geographic representation, and ethnicity reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 46 pivotal trials (29 GU and 17 skin cancer trials), representing 38\u00a0900 patients, were included. LATAM trial sites were present in 44 studies; however, only 25 trials reported enrollment of Hispanic\/Latino patients, totaling 1303 patients (3.35%). Representation across LATAM was highly concentrated in a small number of countries, including Brazil (16 trials), Argentina (14), Chile (13), Mexico (12), and Colombia (6). Participation was greater in GU trials compared with skin cancer trials. Reporting transparency was limited: Hispanic\/Latino representation was reported in only 2 main publications, 5 supplementary appendices, and 23 ClinicalTrials.gov records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Only 6.3% of participants in pivotal GU and skin cancer trials were from Latin America. Limited infrastructure, regulatory barriers, and restricted research investment likely contribute to this disparity. Improving equitable representation will require intentional trial design, stronger regional investment, and policies that move beyond nominal participation toward meaningful inclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag259","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:03:04Z","timestamp":1785585784000},"source":"Crossref","is-referenced-by-count":0,"title":["A silent gap: underrepresentation of Latin American patients in pivotal genitourinary and skin cancer trials"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0853-8640","authenticated-orcid":false,"given":"Erika Adriana","family":"Martinez-Castaneda","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto , Toronto, ON M5G 2C4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava Isabella","family":"De Pellegrin Overgaard","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto , Toronto, ON M5G 2C4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2509-3592","authenticated-orcid":false,"given":"Jean Henri","family":"Maselli-Schoueri","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto , Toronto, ON M5G 2C4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A H","family":"Bell","sequence":"additional","affiliation":[{"name":"Princess Margaret, Department of Supportive Care Research Division Toronto, M5G 2C4,","place":["Canada"]},{"name":"UHN Department of Clinical and Organizational Ethics; University of Toronto, Department of Psychiatry Toronto, M5G 2C4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikala S","family":"Sridhar","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto , Toronto, ON M5G 2C4,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026080515014590500_oyag259-B1","author":"Cancer Tomorrow [Internet]","year":"2025"},{"key":"2026080515014590500_oyag259-B2","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1001\/jamaoncol.2020.7478","article-title":"An analysis of contemporary oncology randomized clinical trials from low\/middle-income vs high-income countries","volume":"7","author":"Wells","year":"2021","journal-title":"JAMA Oncol"},{"key":"2026080515014590500_oyag259-B3","doi-asserted-by":"publisher","first-page":"5996","DOI":"10.1038\/s41598-025-90485-3","article-title":"Global, regional, and national trends in the burden of melanoma and non-melanoma skin cancer: insights from the global burden of disease study 1990-2021","volume":"15","author":"Zhou","year":"2025","journal-title":"Sci Rep"},{"key":"2026080515014590500_oyag259-B4","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.eururo.2024.11.013","article-title":"Recent patterns and trends in global prostate cancer incidence and mortality: an update","volume":"87","author":"Schafer","year":"2025","journal-title":"Eur Urol"},{"key":"2026080515014590500_oyag259-B5","doi-asserted-by":"publisher","first-page":"e2500411","DOI":"10.1200\/GO-25-00411","article-title":"Evolving trends in Latin American participation in global oncology clinical trials: a decade of phase III activity (2013-2022)","volume":"12","author":"Paredes de la Fuente","year":"2026","journal-title":"JCO Glob Oncol."},{"key":"2026080515014590500_oyag259-B6","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1136\/medethics-2014-102540","article-title":"Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees","volume":"42","author":"Li","year":"2016","journal-title":"J Med Ethics"},{"key":"2026080515014590500_oyag259-B7","doi-asserted-by":"publisher","first-page":"4107","DOI":"10.1002\/cam4.3031","article-title":"Gatekeeping in cancer clinical trials in Canada: the ethics of recruiting the \u201cideal\u201d patient","volume":"9","author":"Bell","year":"2020","journal-title":"Cancer Med"}],"container-title":["The Oncologist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/oncolo\/advance-article-pdf\/doi\/10.1093\/oncolo\/oyag259\/70468140\/oyag259.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/31\/8\/oyag259\/70468140\/oyag259.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/oncolo\/article-pdf\/31\/8\/oyag259\/70468140\/oyag259.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T19:01:57Z","timestamp":1785956517000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/oncolo\/article\/doi\/10.1093\/oncolo\/oyag259\/8750118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":7,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,7,8]]}},"URL":"https:\/\/doi.org\/10.1093\/oncolo\/oyag259","relation":{},"ISSN":["1083-7159","1549-490X"],"issn-type":[{"value":"1083-7159","type":"print"},{"value":"1549-490X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,8]]},"article-number":"oyag259"}}