The role of relative advantage for development of sequencing-based diagnostics for pediatric cancer in low- and middle-income countries

Efforts to address limitations in cancer diagnostics in low- and middle-income countries should follow an approach that avoids two extremes: unproductive attempts to require implementation of high-income country gold standards or acquiescence to the diagnostic status quo. The relative advantage of implementing new diagnostic tests (including sequencing-based approaches) should be determined through comparison to local standards of care, with context-specific clinical utility determined using locally available therapeutic options.