Lay Summary Brain tumors are the leading cause of cancer-related death in children, yet clinical trials face major challenges, including small patient numbers and complex treatment plans that often lead to early termination. We analyzed all U.S. pediatric brain tumor trials listed on ClinicalTrials.gov from 2010–2024 to understand design trends and reasons for failure. Trial openings declined over time, and poor accrual was the most common reason for discontinuation. Trials with more hospitals involved were much more likely to finish successfully. These findings show that future trials should include more sites and use collaborative designs to ensure every child has access and every trial has the best chance to succeed.
Gampel et al. (Thu,) studied this question.