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Forty-nine percent of all trials were multicenter (69% if exclusively for patients ≤18years). There was an increase in trials exclusively focused on patients with central nervous system (CNS) tumors over the study period (P≤.02). No other temporal trends were seen. The median times from first-in-adult to first-in-pediatric for monotherapy and combination trials were 5.7 and 3.3years, respectively. The paucity of clear temporal trends highlights the need for innovation in early drug development for young people. Our analysis serves as a
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