Table 1.

Published Studies Related to Diversity and Health Disparities Using COG Clinical Trial Data from 2013–2023

Disease	Study	COG Study ID	Key Findings Related to Diversity and Health Disparities
ALL	Bhatia, 201446	AALL03N1	6MP adherence during maintenance chemotherapy for ALL lower in Asian Americans and African Americans.
	Gupta, 202247	AALL0331, AALL0232, AALL0434	Boys with inferior EFS and OS of ALL attributable to increased relapses (particularly CNS relapse).
	Gupta, 202324	AALL033, AALL0932, AALL0232, AALL1131, AALL0434, AALL1231, AALL0631, AALL15P1	Black and Hispanic children had inferior EFS in B-ALL. No racial or ethnic disparities in T-ALL.
	Wadhwa, 202348	AALL03N1	Poverty associated with greater hazard of relapse and non-adherence to 6MP during maintenance chemotherapy for ALL.
CNS	Nooka, 201649	Multiple COG and PBTC phase 1 clinical trials	Sex and racial/ethnic groups are mostly proportionally represented phase 1 brain tumor trials. Subgroups of Hispanic children are underrepresented.
HOD	Kahn, 201928	AHOD0341, AHOD0031, AHOD0831	EFS did not differ by race/ethnicity in HOD. Adjusted OS was significantly worse in non-White patients, driven by increased post-relapse mortality.
NBL	Bona, 202120	ANBL0032, ANBL0931	Poverty independently associated with increased risk of relapse and death in children with NBL.
OST	Ilcesan, 202250	AOST0331	No association of poverty, race, or ethnicity with EFS or OS in children and adolescents with OST. Black children had inferior post-relapse survival.
RET	Green, 201651	ARET0332	Advanced RET disease associated with non-private insurance, non-White race, and Hispanic ethnicity.
RMS	Munnikhuysen, 202352	D9602, D9802, D9803, ARST0331, ARST0431, ARST0531, ARST08P1	Black and Hispanic patients presented with higher risk features at diagnosis of RMS, no difference in EFS or OS.
Multiple	Bitterman, 202053	Multiple solid tumor clinical trials	Black patients enrolled on COG solid tumor prospective clinical trials less likely to receive proton radiotherapy. No association with SES on proton radiotherapy.
	Faulk, 20209	Multiple	Across COG clinical trials racial and ethnic groups and county-level SES factors were represented proportionally in relation to SEER. AYA and younger patients with solid and CNS tumors were underrepresented.
	Brown, 202254	Multiple	Childhood Cancer Research Network (registry) cases represent 36% of expected childhood cancers diagnosed 2008 to 2015. Enrollment ratios highest in males, non-Hispanic patients, and ages 1–4 years.
	Puthenpura, 202326	Multiple	In patients enrolled in phase 2/3 and phase 3 COG clinical trials, highest rates of loss to follow-up in AYAs, racial and ethnic minority patients, and lower SES.

Abbreviations: 6MP – 6-mercaptopurine, ALL – acute lymphoblastic leukemia, AYA – adolescent and young adult, CNS – Brain tumors, COG – Children’s Oncology Group, EFS – event free survival, HOD – Hodgkin lymphoma, NBL – neuroblastoma, OS – overall survival, OST – osteosarcoma, PBTC- Pediatric Brain Tumor Consortium, RET -retinoblastoma, RMS – rhabdomyosarcoma, SES – socioeconomic status