Evidence map›Paper›PMID 38400668›Full record

ArticleCancer medicine2024

Access to innovative therapies in pediatric oncology: Report of the nationwide experience in Canada.

Sandra Judd, Gabriel Revon-Riviere, Stephanie A Grover, Rebecca J Deyell, Magimairajan Issai Vanan, Victor A Lewis, Lucie Pecheux, Alexandra P Zorzi, Catherine Goudie, Raoul Santiago and 10 more

Open access · goldAbstract read
In one paragraph

Article in Cancer medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
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

20 authors at 15 institutions in 1 country.

Sandra JuddDepartment of Pharmacy, Hospital for Sick Children, Toronto, Ontario, Canada.
Gabriel Revon-RiviereDivision of Haematology/Oncology, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-6512-1004
Stephanie A GroverGenetics and Genome Biology, Hospital for Sick Children, Toronto, Ontario, Canada.
Rebecca J DeyellDivision of Pediatric Hematology Oncology BMT, BC Children's Hospital and Research Institute, Vancouver, British Columbia, Canada.ORCID 0000-0003-3315-4383
Magimairajan Issai VananPediatric Neuro-Oncology, Division of Pediatric Hematology-Oncology, Cancer Care Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0003-2015-0615
Victor A LewisUniversity of Calgary, Alberta, Canada.
Lucie PecheuxStollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
Alexandra P ZorziDepartment of Pediatrics, Children's Hospital London Health Sciences Centre, Western University, London, Ontario, Canada.
Catherine GoudieDepartment of Pediatrics, Division of Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, Québec, Canada.
Raoul SantiagoDepartment of Pediatrics, CHU de Québec, Laval University, Québec, Canada.
Thai Hoa TranDivision of Pediatric Hematology-Oncology, Charles-Bruneau Cancer Center, CHU Sainte-Justine, Montreal, Québec, Canada.
Lesleigh S AbbottDivision of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Josee BrossardDepartment of Pediatrics, CHU de Sherbrooke, Univesité de Sherbrooke, Sherbrooke, Québec, Canada.
Paul MooreheadDepartment of Pediatrics, Janeway Children's Health and Rehabilitation Centre, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
Saima AlviPediatric Hematology/Oncology, Jim Pattison Children's Hospital, Saskatoon, Saskatchewan, Canada.
Carol PortwineMcMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
Avram DenburgDivision of Haematology/Oncology, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0003-0039-0742
James A WhitlockDivision of Haematology/Oncology, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-7887-0634
Sarah Cohen-GogoDivision of Haematology/Oncology, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-8852-1104
Daniel A MorgensternDivision of Haematology/Oncology, Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-4859-1108
University of Toronto · CAHospital for Sick Children · CABC Children's Hospital · CACancerCare Manitoba · CACentre Hospitalier Universitaire de Sherbrooke · CACentre Hospitalier Universitaire Sainte-Justine · CAChildren's Hospital of Eastern Ontario · CAMcMaster Children's Hospital · CAMemorial University of Newfoundland · CAMontreal Children's Hospital · CASaskatoon City Hospital · CAUniversité Laval · CAUniversity of Alberta · CAUniversity of Calgary · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe need for new therapies to improve survival and outcomes in pediatric oncology along with the lack of approval and accessible clinical trials has led to "out-of-trial" use of innovative therapies. We conducted a retrospective analysis of requests for innovative anticancer therapy in Canadian pediatric oncology tertiary centers for patients less than 30 years old between 2013 and 2020.

methodsInnovative therapies were defined as cancer-directed drugs used (a) off-label, (b) unlicensed drugs being used outside the context of a clinical trial, or (c) approved drugs with limited evidence in pediatrics. We excluded cytotoxic chemotherapy, cellular products, and cytokines.

resultsWe retrieved data on 352 innovative therapy drug requests. Underlying diagnosis was primary CNS tumor 31%; extracranial solid tumor 37%, leukemia/lymphoma 22%, LCH 2%, and plexiform neurofibroma 6%. RAS/MAP kinase pathway inhibitors were the most frequently requested innovative therapies in 28% of all requests followed by multi-targeted tyrosine kinase inhibitors (17%), inhibitors of the PIK3CA-mTOR-AKT pathway (8%), immune checkpoints inhibitors (8%), and antibody drug conjugates (8%). In 112 out of 352 requests, innovative therapies were used in combination with another anticancer agent. 48% of requests were motivated by the presence of an actionable molecular target. Compassionate access accounted for 52% of all requests while public insurance was used in 27%. Mechanisms of funding varied between provinces.

conclusionThis real-world data collection illustrates an increasing use of "out-of-trial" innovative therapies in pediatric oncology. This new field of practice warrants further studies to understand the impact on patient trajectory and equity in access to innovative therapies.

Indexed as

Antineoplastic AgentsNeoplasmsAdultCanadaChildHumansMedical OncologyRetrospective StudiesTherapies, InvestigationalAntineoplastic Agentsimmunotherapyprecision oncologyreal-world datatargeted therapy

Identifiers

PMID38400668
PMCPMC10891445
OpenAlexW4392131538

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

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 Socratic graph.