Transforming Pediatric Oncology Trials: How Emerging Technologies Drive Performance, Protect Staff, and Accelerate Therapies

Dr. Scott Bradfield is a clinical trial principal investigator (PI), practicing oncologist, and Medical Advisor to Yunu. His unique perspective offers valuable insight into the day-to-day realities of clinical research, patient care, and the evolving role of technology in advancing clinical trials. As both a physician and researcher, Dr. Bradfield brings firsthand knowledge of the challenges and opportunities shaping the future of clinical development.

The pressure is clear: deliver high-quality data, accelerate timelines, control costs, and improve access to innovative treatments. This is the mission for the government and other stakeholders - sponsors, CROs, and clinical research professionals committed to pediatric oncology, Yet, these goals often collide with the practical realities of complex protocols, scarce patient populations, and overburdened research teams. Over 25% of pediatric cancer patients enroll on a protocol compared to a 1-4% range for adults. These trials can be comprehensive multi-arm trials as investigators seek to gain as much information as possible from a limited cohort of children with years of quality life to be gained.

The good news? A new wave of emerging technologies is helping to solve these persistent challenges - finetuning trial execution while preserving the human and financial capital that makes research possible. In pediatric oncology especially, these innovations don’t just improve efficiency, they directly impact survival outcomes by getting effective therapies to patients faster and on on tighter budgets.

1. Streamlining Operations with Decentralized and Hybrid Models

Decentralized clinical trials (DCTs) and hybrid models are fast becoming essential strategies for optimizing operations and expanding trial access. Children’s Oncology Group (COG) has thrived in this environment. Early on in the cooperative groups, leaders understood that empowering local centers in decentralized fashion allowed children and families to get national expert-led care while remaining at home. Other tools like telemedicine, remote consent, home health visits, and digital data capture have come online to reduce site visits and logistical burdens when possible - making participation more feasible for families and reducing strain on research teams. This isn’t just about patient convenience. By minimizing site overhead and reducing missed visits, DCTs improve data completeness and reduce costly protocol deviations.

Another essential advance is workflow software that is full-service in organizing operations for essential services, for example in imaging radiology reads. Analysis shows this can reduce protocol-specific data reporting errors 30-40% and reads can be funneled from decentralized sites to specialized readers. Ordering, scheduling, interpretation, billing and auditing all flows from one place while simultaneously streamlining the captured data directly into required forms and tools. For sponsors, better data means fewer exclusions and more rapid completion times. For research professionals, the result is a more sustainable trial environment with higher retention—of both participants and staff.

2. AI and Automation: Enabling Smarter, Leaner Trials

Artificial intelligence and machine learning are powerful allies in boosting trial performance. From feasibility analysis and site selection to predictive enrollment modeling and automated safety alerts, AI is helping CROs and Pharma sponsors make faster, more informed decisions when certain trials cannot be opened nationwide through a cooperative group. Spending efforts on sites that will contribute significantly, rather than others, is a win-win for speed, cost, and patients.

"These tools significantly reduce the manual workload on clinical research teams who are often stretched thin. Fewer redundant tasks mean lower burnout and turnover, better compliance, and more bandwidth for high-value activities like patient engagement and protocol optimization. And when experienced professionals stay, trial quality stays high."

3. Leveraging Real-World Data to Shorten Development Cycles

Integrating real-world data (RWD) and real-world evidence (RWE) into early-phase pediatric oncology trials can bring speed and agility. By mining EHRs, claims data, and patient registries, Pharma sponsors and CROs can design smarter protocols, simulate control arms, and support regulatory submissions with broader, more representative evidence.

This approach reduces reliance on large sample sizes and long timelines—critical in rare pediatric cancers—and helps mitigate risks associated with low enrollment. For research teams, it also means reduced data collection burdens and less manual reconciliation work, improving staff satisfaction and operational efficiency.

4. Digital Biomarkers and Remote Monitoring Drive Quality at Scale

Wearables and digital health tools are enabling continuous, passive data collection for endpoints like sleep, mobility, and vital signs throughout healthy society. These digital biomarkers offer CROs and sponsors a scalable way to collect high-resolution, real-time data while reducing patient site visits and staff burden.

For research professionals, remote monitoring reduces data lag, flags safety issues earlier, and improves trial continuity, especially when in-person visits aren’t feasible. The result: improved protocol compliance, reduced adverse event fallout, and fewer missed opportunities to intervene. This will be the future of pediatric oncology trials as knowledge catches up with technology and full incorporation of this capture comes to fruition.

5. Supporting Workforce Resilience and Retention

An often overlooked benefit to emerging technologies is the lifeline they offer to overburdened research professionals. Burnout, turnover, and workforce shortages are rising across the research landscape—particularly in pediatric oncology, where trials are high-stakes and emotionally demanding while smaller staffs and budgets limit cross-coverage. Estimates place turnover at 25% per year for clinical research associates, higher than most roles in healthcare.

Digital software workflows, intelligent automation, and reduced administrative friction help retain experienced coordinators, project managers, and even investigators - people whose institutional knowledge and relationships directly impact trial performance. When staff stay engaged, protocols run smoother, data stays cleaner, and timelines stay on track.

The Strategic Payoff: Faster Therapies, Better Outcomes

For government, pharma sponsors, institutions, and CROs, investing in innovation isn’t a luxury - it’s a strategic imperative. Trials that are faster, leaner, and more resilient drive better ROI, meet regulatory expectations, and most importantly, accelerate the delivery of new therapies to children with cancer.

For research professionals, these technologies protect what matters most: the integrity of the science, the well-being of the team, and the hope of a cure for every patient. Research has accomplished not just extended and additional quality years, but 85% survival overall in pediatric cancer. Further improvements will necessarily be at the margins. In pediatric oncology, every opportunity matters and no patient data can be wasted. Emerging technologies are the key to transforming not just how trials are run, but how quickly we can change lives.