Efficacy of dabrafenib plus trametinib in first-line treatment for children and adolescents with low-grade glioma with BRAF V600 mutations

 A recently completed randomized phase II study at the Hospital for Sick Children in Toronto indicates "superiority of dabrafenib plus trametinib as first systemic treatment for pediatric patients with low-grade glioma with BRAF V600 mutations as compared with carboplatin plus vincristine, the standard chemotherapy approach."  Following randomization amongst 110 patients, follow-up after a median of 18.9 months indicated overall response in 47% of patients treated with dabrafenib plus trametinib compared to a 11% overall response in those patients treated with chemotherapy.  Other benefits included longer progression-free survival and a lower rate of discontinuing treatment due to side effects. 

To learn more about this study, click here. 

Source mentioned: Bouffet E, Hansford JR, Garrè ML, et al. Dabrafenib plus Trametinib in Pediatric Glioma with BRAF V600 Mutations. N Engl J Med 2023;389:1108-1120.

American Cancer Society announces new funding for hospital therapy dogs to support children with cancer and their families

The American Cancer Society recently expanded its PAWS (Pups Assisting with Support) program to six children's hospitals across the United States.  PAWS is a "pilot grant program that aims to improve the quality of life for hospitalized children with cancer through support from specially trained therapy dogs."  The $8000 funding grant for each of the hospitals participating in the program covers veterinary costs, adoption, training, food, grooming, beds, toys, and improving/maintaining dog facilities for a 12-month period.  Animal-assisted therapy for hospitalized children aids in decreasing anxiety, stress, depression, pain, as well as increasing quality of life.  

Click here to learn more about the PAWS program. 

  

Newly developed International Childhood Cancer Core Outcome Set represents physical, psychosocial, and neurocognitive outcomes for 17 common childhood cancer subtypes

 A recently completed International Childhood Cancer Outcome Project has resulted in the creation of 24 physical, psychosocial, and neurocognitive outcomes for childhood cancers. According to a joint international consensus statement created for measuring quality of survival among patients with childhood cancer, "most children and adolescents receiving modern cancer treatment survive at least 5 years beyond diagnosis...despite these promising results, survival rates remain poor for specific childhood, adolescent, and young adult cancer types."  The study authors also caution that patient and provider reports, together with frequent communication of results "are crucial facilitators for the adoption of these core sets in clinical practice and the subsequent initiation of quality improvement efforts." 

To read more about this study, click here. 

Study mentioned: van Kalsbeek RJ, Hudson MM, Mulder RL, … & the International Childhood Cancer Outcome Project participants. A joint international consensus statement for measuring quality of survival for patients with childhood cancer. Nature Medicine 2023;29:1340-1348.

Survivors of childhood cancer are at excess risk of late mortality even 40 years from diagnosis

 According to the Childhood Cancer Survivor Study (CCSS) cohort, "long-term survivors of childhood cancer are at four times the risk of death compared with the general, ageing population."  Particularly in the 5-9 year survival period after diagnosis, health-related causes of death include heart disease, cerebrovascular disease, influenza, pneumonia, sepsis, and kidney failure, conditions normally attributable to a diagnosis during middle age.  

To learn more about this study, click here.  

Sources mentioned:  

• Dixon SB, Liu Q, Chow EJ, et al. Specific causes of excess late mortality and association with modifiable risk factors among survivors of childhood cancer: a report from the Childhood Cancer Survivor Study cohort. The Lancet; Published online 5 April 2023. DOI: https://doi.org/10.1016/S0140-6736(22)02471-0 
• Tonorezos ES, Marcil V. Childhood cancer survivors: healthy beahviours and late mortality. The Lancet; Published online 5 April 2023. DOI: https://doi.org/10.1016/S0140-6736(22)02632-0

NGS is effective in identifying actionable genetic alterations for investigational targeted therapies in paediatric and young adult patients with refractory cancers

A recent study published by the Texas Children's Cancer and Hematology Center recently published findings regarding "the feasibility of a nationwide screening and centralized testing Protocol to select patients with tumours harbouring actionable alterations for enrolment in clinical studies of molecularly targeted therapies."   Following completed testing for 94.7% of tumours, actionable alternations were detected in 31.5% of the first 1,000 tumours screened, with "treatment arm assignment and enrolment occurring in 28.4% and 13.1% of patients." 

To read more about this study, click here. 

Source mentioned: Parsons DW, Janeway KA, Patton DR, et al. Actionable Tumor Alterations and Treatment Protocol Enrollment of Pediatric and Young Adult Patients With Refractory Cancers in the National Cancer Institute–Children's Oncology Group Pediatric MATCH Trial. JCO; Published online 30 March 2022. DOI: 10.1200/JCO.21.02838

Children of patients with cancer more likely to experience medical financial hardship and emotional and educational challenges following parental diagnosis

 A new study conducted by researchers at the American Cancer Society indicates that children "living in families with a history of parental cancer were more likely to face financial, emotional, and educational challenges."  According to Dr. Zhiyuan Zheng, lead author of the study, 3.4% of children between 5-17 are living in families with a parental history of cancer.  As a result, these children may miss school and may be less likely to receive medical care due to lack of family financial resources.  Further, the study states that these children "were particularly vulnerable and began to experience psychosocial and behavioral challenges that often went unaddressed." 

To read more about this study, click here. 

Source mentioned: Zheng Z, Zhao J, Nogueira L, Han X, Fan Q, Yabroff KR. Associations of Parental Cancer With School Absenteeism, Medical Care Unaffordability, Health Care Use, and Mental Health Among Children. JAMA Pediatr. Published online April 11, 2022. doi:10.1001/jamapediatrics.2022.0494

 

New trial alert: drug combination helps children with acute promyelocytic leukemia avoid conventional chemotherapy

The results of a new clinical trial has determined that "the combination of all-trans retinoic acid, ...a metabolite of vitamin A and arsenic trioxide is highly effective in children with standard- and high-risk acute promyelocytic leukemia, or APL."   The trial, conducted on 154 children between 1-22 years old who were recently diagnosed with standard or high-risk APL, showed 2-year event-free survival rates of 96%-98%, with fewer than 10% experiencing severe side effects. 

To learn more about this trial, click here. 

Study mentioned: Kutny MA, Alonzo TA, Abla O, et al. Assessment of Arsenic Trioxide and All-trans Retinoic Acid for the Treatment of Pediatric Acute Promyelocytic Leukemia A Report From the Children’s Oncology Group AAML1331 Trial. JAMA Oncology November 11, 2021. DOI: 10.1001/jamaoncol.2021.5206.

New trial suggests radiation can be tailored for children with medulloblastoma

A new clinical trial conducted at the Washington University School of Medicine in St. Louis has determined that customizing radiation levels in children with medulloblastoma, by either "lowering the dose of radiation or delivering radiation to a smaller area of the brain" could result in a higher rate of survival without the negative adverse events associated with radiation therapy.   

Study results conducted on the 464 of 549 children that were able to be evaluated determined that 85% of children were alive beyond 5 years after treatment, and 81% did not experience a cancer-related event during those 5 years.  

To read more about this trial, click here. 

Brentuximab for children and teens with Hodgkin lymphoma

 A new study conducted at St. Jude Children's Research Hospital indicates that "it may be possible to reduce or eliminate the need for radiation to treat advanced cancer in children and teens with Hodgkin lymphoma.  According to study lead investigator Dr. Monika Metzger, 27 (35%) of the 77 patients involved in the trial did not require radiation treatments, thus suggesting that the findings "are an important first step in moving forward using even less radiation to treat high-risk pediatric Hodgkin lymphoma." 

To read more about this study, click here. 

Fusion proteins in childhood cancers

The National Cancer Institute (NCI) recently launched the Fusion Oncoproteins in Childhood Cancers (FusOnC2) Consortium, consisting of a group of researchers with expertise in cancer biology, proteomics, genomics, computational biology, and pharmacology.  The purpose of Fu OnC2 is to investigate difficult-to-treat "cancers driven by fusion proteins in children and young adults", with emphasis on soft tissue cancers such as synovial sarcoma, rhabdomyosarcoma, as well as ependymoma, a type of brain cancer.

Too read more about this study, click here.   

First baby born to cancer patienst from eggs matured in lab and frozen

The Department of Reproductive Medicine and Fertility Preservation at the Antoine Béclère University Hospital near Paris, France have "announced the birth of the first baby to be born to a cancer patient from an immature eff that was matured in the laboratory, frozen, then thawed and fertilized five years later."  According to the announcement, the 34-year old mother of the baby boy was infertile due to the chemotherapy she underwent for breast cancer.  Prior to beginning her cancer treatment, her immature eggs were removed and allowed to fully develop via in vitro maturation (IVM).  This study is believed to be the first successful pregnancy in cancer patients following IVM and vitrification.

To read more about this study, click here.

Risk of adult lung disease death my be increased by childhood exposure to secondhand smoke

A new study in the American Journal of Preventative Medicine suggests that long-term exposure to secondhand smoke during childhood increases the risk of chronic obstructive pulmonary disease (COPD) death in adulthood. The study also suggests secondhand smoke exposure as an adult increases the risk of death not only from COPD but also several other conditions.

To read more about this study, click here.

A new study suggests some children with wilms tumor can receive less therapy

Findings from an NCI-sponsored clinical trial, led by the Children’s Oncology Group (COG), suggests that some children with advanced Wilms tumor, a form of kidney cancer, may be able to skip radiation therapy. Researchers believe that nearly half of children whose cancer has spread to their lungs can be spared lung radiation therapy without harming their long-term survival. The study results were published April 16 in the Journal of Clinical Oncology.

To read more about this study, click here.

Inflammatory bowel disease may raise cancer risk in children

A new study conducted at the Karolinska Institute in Stockholm, Sweden indicates that children afflicted with inflammatory bowel disease (IBD) are at greater risk for developing gastrointestinal cancers as adults.  The international research team, lead by Dr. Ola Olen, a pediatric gastroenterologist at Karolinska found that "the risk of cancer up to an average age of 30 was 3.3 cases per 1,000 person years among those with IBD...compared with 1.5 cases per 1,000 person years in the control group."

To read more about this study, click here.

Double stem cell transplant may help fight childhood cancer

A new study conducted at the University of Washington School of Medicine indicates that children afflicted with neuroblastoma hay have a better chance of survival upon receiving a double stem cell transplant.  According to lead researcher Dr. Julie Park, 61% of children receiving the double transplant remained alive 3 years after diagnosis, compared to 48% who received only a single transplant.

To read more about this study, click here.

Newer treatment may be easier on children with brain tumors

On January 29, 2016 A new type of treatment called proton radiotherapy is as effective as standard photon (X-ray) radiation therapy in treating a common type of brain tumor in children, a new study reports.

The new therapy causes fewer long-term side effects, the researchers said. Read more here.

Childhood cancer survivors hospitalized frequently years after cancer treatment

Survivors of childhood cancers were hospitalized more often and for longer durations because of blood disorders and other problems, many years after cancer treatment was completed, compared with the general population, according to a recent study. "Our findings demonstrate that childhood cancer survivors face ongoing problems that can lead to hospitalization, even for those who are decades past their original cancer diagnosis. This can negatively impact their quality of life," said Anne C. Kirchhoff, PhD, MPH, assistant professor of pediatrics at the Huntsman Cancer Institute of the University of Utah in Salt Lake City. Read more here.

Lifetime cancer risk from heart imaging low for most children, but rises with more complex tests

Children with heart disease are exposed to low levels of radiation during X-rays, which do not significantly raise their lifetime cancer risk. However, children who undergo repeated complex imaging tests that deliver higher doses of radiation may have a slightly increased lifetime risk of cancer, according to researchers at Duke Medicine. The findings, published in Circulation, represent the largest study of cumulative radiation doses in children with heart disease and associated predictions of lifetime cancer risk. Read more here.

Study calls for revisiting cardiac screening guidelines for survivors of childhood cancer

One of the first studies to analyse the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure (CHF) finds improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The researchers utilised a simulation-based model to estimate the long-term benefits associated with routine screening. The study's findings suggest that the current CHF screening guidelines for survivors of paediatric cancer should be re-examined. Read more here.

Gene sequencing project discovers mutations tied to deadly brain tumors in young children

The St. Jude Children’s Research Hospital-Washington University Pediatric Cancer Genome Project has identified new mutations in pediatric brain tumors known as high-grade gliomas (HGGs), which most often occur in the youngest patients. The discoveries stem from the most comprehensive effort yet to identify the genetic missteps driving these deadly tumors. The results provide desperately needed drug development leads, particularly for agents that target the underlying mutations. Read more here.