February 20, 2013 | by Roberta Nichols
Each year, nearly 100,000 children under 15 die from cancer worldwide. That’s almost 250 children a day – a startling statistic given that about 80 percent of childhood cancers are potentially curable with existing treatments.
More than 90 percent of these deaths occur in underdeveloped countries. Yet, even in prosperous nations like the United States, improvements in child cancer survival rates are threatened by a lack of new drug development.
These are just some of the pediatric cancer issues explored in a new series of studies in Lancet Oncology. In the series, cancer specialists from around the world address the educational, research and care needs of children and young adults with cancer – and propose solutions for the upcoming decade.
The series focuses on proposed new policies to deal with the global burden of childhood cancers, ways to sustain innovation and improvement in treatment, and the need for novel drug development pathways for children and adolescents with cancer.
“The experiences and needs of children with cancer and their families in all settings, whether a high-income or a developing country, need to be better understood,” wrote series leader Professor Kathy Pritchard-Jones, Institute of Child Health, University College London, London, U.K., in one of the studies in the series.
During the past half-century, greater participation in international clinical trials has yielded improvements in five-year survival rates for many childhood cancers. In high-income countries, that rate soared from 30 percent in the 1960s to 80 percent in the 2000s.
Yet, increased collaboration is urgently needed, researchers said.
The series' authors called for increased international cooperation in clinical trials and for sharing research tissue samples and data. To expedite the development of innovative, less toxic, more targeted therapies, they recommended increased participation from the biopharmaceutical industry, regulatory agencies, public health authorities, advocacy groups and philanthropic organizations.
Researchers also called for each nation to develop a national cancer plan recognizing the unique demographic and care needs of children and young adults with cancer.
An estimated one in 1,000 adults in high-income countries had cancer as a child, and 40 percent of these survivors deal with adverse side effects throughout their lives. Researchers recommended that academic programs and trial investigators continue to follow the cases of survivors to address complications they may face later in life.
Advancements can be made in the next decade if these recommendations are adopted, said Pritchard-Jones. “In 2023, we should be able to look back and see real improvements in all the issues raised in this series; although many goals are ambitious, none are out of reach,” she said.
“The articles summarize a situation that we encounter on a daily basis,” said Joseph Rosenthal, Barron Hilton Chair in Pediatrics and chief of the Division of Pediatric Hematology/Oncology at City of Hope, who was not involved in the series.
“It is a global issue that is not unique for City of Hope or to our patients,” he continued.
“On one hand, we have experienced tremendous improvements in some childhood cancer; on the other hand, further improvement is increasingly difficult due to the low access to newer, targeted therapies due to the limited marketplace of childhood cancer and, therefore, the small incentive for pharmaceutical industries to get involved.”
“The articles describe well both the issues in the gap between developing and developed countries and the universal gap between pediatrics and adult medical oncology,” Rosenthal said.
“One point, which is local: Some of the ‘rich-poor’ gaps are not limited to developing countries. Some groups in our society, such as young adults, biologically and emotionally closer to the pediatric age group, do not enjoy the advances that have been made and are described in the analysis,” he added.
For more information on childhood cancers, visit City of Hope’s Pediatric Cancers Program.