Title : Discontinuation and nonpublication of osteosarcoma clinical trials: A cross-sectional analysis of clinicaltrials.gov data
Abstract:
Background: Osteosarcoma is a rare and aggressive bone cancer. Despite the urgent need for new treatments, clinical trials in this field are frequently discontinued or left unpublished, resulting in significant research waste and stalling therapeutic progress. This study evaluates the rates and key predictors of trial discontinuation and nonpublication.
Methods: We conducted a cross-sectional analysis of 210 interventional osteosarcoma trials registered on ClinicalTrials.gov up to July 1, 2025. Logistic regression was used to identify factors associated with trial discontinuation and nonpublication.
Results:
Discontinuation & Nonpublication: Nearly one-third of the trials (29.5%, n=62) were discontinued prematurely. Of the 148 completed trials, only 17.6% (n=26) were published, leaving 82.4% (n=122) unpublished.
Risk Factors: Trials with fewer than 100 participants were significantly more likely to be discontinued (95.2% vs. 81.6%, p=0.011) and unpublished (85.5% vs. 65.4%, p=0.017).
Collaboration Benefits: Multicenter trials had significantly higher publication rates than single-center studies (73.9% vs. 26.1%, p=0.006). Multivariable analysis confirmed that a multicenter design independently predicted lower odds of nonpublication ("OR"=0.291, 95%" CI" : 0.098"--" 0.859, p=0.025).
Non-factors: Trial phase, funding source, and intervention type did not significantly influence these outcomes.
Conclusions: A high rate of trial discontinuation and nonpublication exists in osteosarcoma research, primarily driven by small sample sizes and single-center limitations. To prevent valuable data loss and honor patient participation, the oncology community must prioritize collaborative multicenter trials and strictly enforce timely results reporting.
