In This News Digest:

- Summary of a study being published online April 19, 2010 in the Journal of Clinical Oncology finding that approximately 38,000 childhood cancer-related deaths were averted between 1975 and 2006 due to substantial treatment advances, but researchers note progress has slowed in recent years.

- Authors urge researchers to take advantage of the increasing understanding of the molecular biology of cancer and develop targeted therapies.

- Quote for attribution from Lisa Diller, MD, American Society of Clinical Oncology pediatric cancers expert

- Links to additional information on Cancer, ASCO's patient Website

Study Summary

Findings from a new analysis of childhood cancer statistics show that an estimated 38,000 childhood cancer deaths have been averted in the United States between 1975 and 2006, owing to improved drugs, treatment strategies and past investments in clinical trials. Researchers caution that while substantial gains have been made against most forms of childhood cancer, progress against many cancers has slowed, and newer, targeted agents are urgently needed.

"While childhood cancer has been one of the success stories of modern medicine, with nearly 80 percent long-term survival, approximately 2,000 children still die from cancer every year," said lead author Malcolm Smith, MD, PhD, associate branch chief, pediatrics, at the National Cancer Institute's (NCI) Cancer Therapy Evaluation Program. "We continue to look for new ways to reduce that number."

The researchers examined cancer incidence and survival data from NCI's Surveillance, Epidemiology, and End Results (SEER) program registries, which cover approximately 10 percent of the United States, and death rates gleaned from reports by states to the Centers for Disease Control and Prevention. The study found that childhood cancer death rates declined by more than 50 percent from 1975 to 2006. At the same time, however, childhood cancer incidence increased significantly during that same period, with one form of leukemia, acute lymphoblastic leukemia (ALL), rising most quickly. The incidence of childhood brain cancers has been stable, while all other childhood cancers have slowly increased in incidence.

The review revealed that much of the progress against childhood cancer occurred in the two decades after 1975. The decline in death rates in leukemia, the most common type of childhood cancer, was among the highest over the 32 years, though the rate of decline in deaths slowed in the last decade of the study period to roughly 2 percent a year.

The death rates for all other childhood cancers decreased significantly between 1975 and 1996, then leveled off from 1996 to 2006. The researchers called this a critical period for childhood cancer research, citing little decline in death rates for solid tumors and brain cancers in children in the last decade of the study, and the slowed decrease in leukemia deaths. But there is little evidence that current chemotherapy drugs can improve survival numbers, and the authors said that new, innovative treatment strategies are needed.

The authors emphasized that newer, targeted agents based on the molecular biology of tumors should be emphasized in future research. They noted that several effective agents have been developed already, such as imatinib (Gleevec) for Philadelphia chromosome-positive ALL in children, and a monoclonal antibody, ch14.18, which has been shown to improve event-free survival as part of an immune therapy for high-risk neuroblastoma patients.

"Our progress has slowed, and now we need a deeper understanding of the biology of childhood cancers and the genes and pathways that drive them," Smith said. "With this understanding we can identify susceptibilities that can be therapeutically exploited so that we continue moving forward toward the goal of curative therapy for every child diagnosed with cancer."

ASCO Perspective

Lisa Diller, MD, member of ASCO's Cancer Communications Committee

"This new study points to the tremendous strides we've made against childhood cancer in the last three decades, but also to the challenges that lay ahead. We clearly need to develop newer, more effective agents that take advantage of our growing knowledge of the biology of cancer. Rather than a one size fits all approach, this will mean more personalized drugs aimed at subtypes of cancer and smaller groups of patients. We're already beginning to do this."

Helpful Links from Cancer:

- Cancer in Children
- Guide to Childhood Cancer
- Understanding Targeted Treatments
- JCO Cancer Advances - Patient Summary

The Journal of Clinical Oncology is the tri-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world's leading professional society representing physicians who treat people with cancer.

Source
ASCO

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