肿瘤细胞治疗研究
英文原题：Geographic distribution of CAR T-cell therapy clinical trials for childhood cancer: Scientific coherence and persistent needs.
Geographic distribution of CAR T-cell therapy clinical trials for childhood cancer: Scientific coherence and persistent needs.
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本研究旨在评估儿童癌症嵌合抗原受体（CAR）T细胞疗法临床试验的地理分布，并评估其与全球健康需求的匹配程度。采用定量方法，我们分析了来自WHO全球健康研发观察站（2007-2022年）的317项临床试验数据以及全球健康指标，并按WHO区域进行分层。
我们的结果显示存在严重的地理失衡：56.7%的试验发生在西太平洋区域，27.7%在美洲区域，而非洲、东地中海和东南亚等区域几乎未开展任何试验。学术机构是主要申办方（69.2%）。相关性分析显示，试验频率与儿童癌症死亡率之间无统计学显著关联。唯一发现显著相关性的是试验数量与5-14岁儿童酒精相关死亡之间（r = 0.67；p = 0.04）。这些发现表明，科学研究与儿童肿瘤负担最重的地区之间存在明显错位，凸显了重大的科学不公平。
我们得出结论，结构性障碍和资金配置错位使脆弱人群无法获得这些变革性疗法，需要全球政策进行战略性转变以确保研究分布的公平性。
This study aimed to evaluate the geographic distribution of Chimeric Antigen Receptor (CAR) T-cell therapy clinical trials for childhood cancer and assess their alignment with global health needs. Using a quantitative approach, we analyzed data on 317 clinical trials from the WHO's Global Observatory on Health Research and Development (2007-2022) alongside global health metrics, stratified by WHO region.
Our results show a profound geographic imbalance: 56. 7 % of trials occurred in the Western Pacific and 27. 7 % in the Americas, while regions like Africa, the Eastern Mediterranean, and South-East Asia hosted almost none. Academic institutions were the primary sponsors (69. 2 %). Correlational analysis revealed no statistically significant link between trial frequency and childhood cancer mortality rates. The only significant correlation found was between the number of trials and alcohol-related deaths in children aged 5-14 (r = 0. 67; p = 0. 04).
These findings indicate a stark misalignment between scientific research and the regions with the greatest pediatric oncology burden, highlighting significant scientific inequity.
We conclude that structural barriers and misaligned funding prevent vulnerable populations from accessing these transformative therapies, necessitating a strategic shift in global policy to ensure equitable research distribution.
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