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Recent progress in the treatment of cancer in children.
Literature Information
| DOI | 10.3322/caac.21665 |
|---|---|
| PMID | 33793968 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2021 |
| Times Cited | 54 |
| Keywords | cancer of childhood, chemotherapy, clinical trials, pediatrics |
| Literature Type | Journal Article, Review |
| ISSN | 0007-9235 |
| Pages | 315-332 |
| Issue | 71(4) |
| Authors | Erin Butler, Kathleen Ludwig, Holly L Pacenta, Laura J Klesse, Tanya C Watt, Theodore W Laetsch |
TL;DR
This review highlights the need for innovative treatments in pediatric oncology as traditional therapies reach their limits and long-term side effects become more evident among survivors. It discusses recent advancements in molecularly targeted agents and immunotherapies that aim to enhance outcomes for children with cancer who do not respond to conventional chemotherapy while minimizing adverse effects.
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cancer of childhood · chemotherapy · clinical trials · pediatrics
Abstract
Although significant improvements have been made in the outcomes of children with cancer, the pace of improvement has slowed in recent years as the limits of therapy intensification may have been reached for many pediatric cancers. Furthermore, with increasing numbers of pediatric cancer survivors, the long-term side effects of treatment have become increasingly apparent. Therefore, attention has shifted to the use of molecularly targeted agents and immunotherapies to improve the outcomes of children who are not cured by traditional cytotoxic chemotherapies and to decrease exposure to cytotoxic chemotherapy and reduce late effects. This review describes the recent progress in the treatment of children with cancer, focusing in particular on diseases in which targeted and immunotherapeutic agents have made an impact.
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Primary Questions Addressed
- What specific molecularly targeted agents have shown the most promise in pediatric cancer treatment recently?
- How do the long-term side effects of traditional chemotherapy compare to those of newer immunotherapies in children?
- In what ways are treatment protocols for pediatric cancers being adapted to address the unique challenges faced by survivors?
- What role does genetic profiling play in the development of personalized treatment plans for children with cancer?
- How can the integration of immunotherapy into existing treatment regimens enhance outcomes for children with resistant cancers?
Key Findings
Key Insights
1. Research Background and Purpose: The treatment of childhood cancers has historically seen significant advancements, leading to improved survival rates for many pediatric patients. However, recent trends indicate a deceleration in these improvements, suggesting that the intensification of traditional therapies may have reached a saturation point for numerous types of pediatric cancers. Moreover, as the population of childhood cancer survivors grows, the long-term side effects associated with conventional cytotoxic treatments are becoming increasingly recognized and problematic. This review aims to synthesize recent developments in the treatment landscape for pediatric cancers, particularly emphasizing the emergence of molecularly targeted therapies and immunotherapies as alternatives to traditional approaches.
2. Main Methods and Findings: The review examines recent literature and clinical studies focusing on the application of targeted agents and immunotherapies in pediatric oncology. It highlights the limitations of conventional chemotherapies in terms of both efficacy for certain cancers and the adverse long-term effects they produce. It further details specific pediatric cancers that have benefitted from these newer treatment modalities, providing insights into the mechanisms by which targeted therapies and immunotherapies operate, including their ability to hone in on molecular markers specific to certain tumors or to engage the immune system in attacks against cancer cells. The analysis indicates a growing body of evidence supporting the effectiveness of these innovative approaches, particularly for patients who have not responded favorably to traditional treatments.
3. Core Conclusions: The review underscores a paradigm shift in pediatric cancer treatment, where reliance on traditional cytotoxic chemotherapy is being reevaluated in light of its limitations and the associated long-term health implications for survivors. Molecularly targeted therapies and immunotherapies represent a promising avenue for improving treatment outcomes while mitigating harmful side effects. The findings suggest that these approaches may not only enhance survival rates for children with previously hard-to-treat cancers but also significantly improve their quality of life post-treatment.
4. Research Significance and Impact: This review is crucial for advancing the field of pediatric oncology by highlighting the need for innovative treatment strategies that align with the unique biological behaviors of childhood cancers. The shift towards targeted and immunotherapeutic approaches could redefine standard care protocols, emphasizing personalized medicine in pediatric oncology. Additionally, by addressing the long-term side effects of treatments, this research supports the development of more holistic care strategies for childhood cancer survivors, ultimately leading to better health outcomes and enhanced quality of life. The insights provided here may guide future research directions and clinical practices, ensuring that the evolving landscape of cancer treatment is both effective and patient-centered.
Literatures Citing This Work
- N-of-1 Trials in Pediatric Oncology: From a Population-Based Approach to Personalized Medicine-A Review. - Michal Kyr;Adam Svobodnik;Radka Stepanova;Renata Hejnova - Cancers (2021)
- Identification and Validation of Inflammatory Response-Related Gene Signatures to Predict the Prognosis of Neuroblastoma. - Jiye Song;Liang Song;Zhenmei Lv;Jianke Liu;Xuan Feng;Song Zhang;Aiqin Song - International journal of genomics (2022)
- Gaps and Opportunities of Artificial Intelligence Applications for Pediatric Oncology in European Research: A Systematic Review of Reviews and a Bibliometric Analysis. - Alberto Eugenio Tozzi;Francesco Fabozzi;Megan Eckley;Ileana Croci;Vito Andrea Dell'Anna;Erica Colantonio;Angela Mastronuzzi - Frontiers in oncology (2022)
- Global incidence, mortality and temporal trends of cancer in children: A joinpoint regression analysis. - Junjie Huang;Sze Chai Chan;Chun Ho Ngai;Veeleah Lok;Lin Zhang;Don Eliseo Lucero-Prisno;Wanghong Xu;Zhi-Jie Zheng;Edmar Elcarte;Mellissa Withers;Martin C S Wong; - Cancer medicine (2023)
- Hepcidin in Children and Adults with Acute Leukemia or Undergoing Hematopoietic Cell Transplantation: A Systematic Review. - Artur Słomka;Monika Łęcka;Jan Styczyński - Cancers (2022)
- A Descriptive and Phenomenological Exploration of the Spiritual Needs of Chinese Children Hospitalized with Cancer. - Qi Liu;Ka-Yan Ho;Katherine-Ka-Wai Lam;Winsome-Yuk-Yin Lam;Eileen-Hui-Lin Cheng;Shirley-Siu-Yin Ching;Frances-Kam-Yuet Wong - International journal of environmental research and public health (2022)
- Safety of Anti-Angiogenic Drugs in Pediatric Patients with Solid Tumors: A Systematic Review and Meta-Analysis. - Andrea Spini;Valerio Ciccone;Pietro Rosellini;Marina Ziche;Ersilia Lucenteforte;Francesco Salvo;Sandra Donnini - Cancers (2022)
- Virtual reality for pain and anxiety of pediatric oncology patients: A systematic review and meta-analysis. - Zhi Cheng;Shanzhen Yu;Wen Zhang;Xinxin Liu;Yijin Shen;Hong Weng - Asia-Pacific journal of oncology nursing (2022)
- Alarming Upward Trend in Multidrug-Resistant Bacteria in a Large Cohort of Immunocompromised Children: A Four-Year Comparative Study. - Ana-Raluca Mihalcea;Nathalie Garnier;Cécile Faure-Conter;Nicolas Rama;Cécile Renard;Sarah Benezech;Yves Bertrand;Christine Fuhrmann;Carine Domenech - Cancers (2023)
- Soluble Hemojuvelin and Ferritin: Potential Prognostic Markers in Pediatric Hematopoietic Cell Transplantation. - Jan Styczyński;Artur Słomka;Monika Łęcka;Katarzyna Albrecht;Michał Romiszewski;Monika Pogorzała;Małgorzata Kubicka;Beata Kuryło-Rafińska;Barbara Tejza;Grażyna Gadomska;Ewelina Kolańska-Dams;Małgorzata Michalska;Ewa Żekanowska - Cancers (2023)
... (44 more literatures)
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