Challenges and Opportunities for Novel Therapeutic Strategies in Pediatric Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 6 July 2025 | Viewed by 3596

Special Issue Editors


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Guest Editor
Pediatric Hematology & Oncology, Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Republic of Korea
Interests: cancer immunotherapy; translational research; childhood cancer; sarcoma; bispecific antibody; T cell immunotherapy; leukemia; neuroblastoma; osteosarcoma
Pediatric Oncologist, Scientific Director of the Pediatric Cancer Center Barcelona (PCCB), Barcelona, Spain
Interests: developmental tumors: neuroblastoma, Ewing sarcoma, Wilm's tumor, brain stem glioma; translational research
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Special Issue Information

Dear Colleagues,

The last decade has seen a revolution in our understanding of the molecular and genetic basis of pediatric cancers. With this advance, molecular and genetic characterization is being integrated into cancer diagnosis, revealing subgroups of pediatric cancers with both prognostic and therapeutic relevance. This enables risk-adoptive therapy, focusing intensive therapy on the most aggressive cancers while refining the treatment for low-risk diseases, resulting in a significant reduction in serious long-term complications.

Cancer immunotherapy changed the prognosis of high-risk malignancies. By targeting cell surface antigens, immunotherapeutic strategies, such as monoclonal antibody, antibody-drug conjugates, T cell engaging bispecific antibody (BsAb), and chimeric antigen receptor (CAR) T cells, shifted the treatment paradigm of high-risk neuroblastoma and relapsed/refractory leukemia and lymphoma in pediatric patients. However, immunotherapy has not lived up to its promise in most pediatric solid tumors. How to define which tumors are more likely to respond to immunotherapy and how to activate the immune system via either cell-based or antibody-based strategies remain major challenges.

This Special Issue will highlight the advances in our understanding of pediatric malignancies and in the development of treatments including small-molecular-targeted therapies, BsAb, CART, transplant, radioisotope or drug conjugates, radiotherapy, and photoimmunotherapy and address current challenges and future prospects for a more personalized therapy for pediatric cancer patients.

Dr. Jeong A Park
Dr. Jaume Mora
Guest Editors

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Keywords

  • antibody-drug conjugate
  • bispecific antibody
  • cancer predisposition
  • CAR T cell
  • immunotherapy
  • leukemia
  • monoclonal antibody
  • neuroblastoma
  • pediatric cancer
  • photoimmunotherapy
  • precision medicine
  • sarcoma
  • translational research
  • tyrosine kinase inhibitor

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Published Papers (3 papers)

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Research

12 pages, 1434 KiB  
Article
Disease Control and Toxicity Outcomes after Stereotactic Ablative Radiation Therapy for Recurrent and/or Metastatic Cancers in Young-Adult and Pediatric Patients
by Rituraj Upadhyay, Brett Klamer, Jennifer Matsui, Vikram B. Chakravarthy, Thomas Scharschmidt, Nicholas Yeager, Bhuvana A. Setty, Timothy P. Cripe, Ryan D. Roberts, Jennifer H. Aldrink, Raj Singh, Raju R. Raval, Joshua D. Palmer and Sujith Baliga
Cancers 2024, 16(11), 2090; https://doi.org/10.3390/cancers16112090 - 30 May 2024
Cited by 1 | Viewed by 833
Abstract
Background: Pediatric patients with metastatic and/or recurrent solid tumors have poor survival outcomes despite standard-of-care systemic therapy. Stereotactic ablative radiation therapy (SABR) may improve tumor control. We report the outcomes with the use of SABR in our pediatric solid tumor population. Methods: This [...] Read more.
Background: Pediatric patients with metastatic and/or recurrent solid tumors have poor survival outcomes despite standard-of-care systemic therapy. Stereotactic ablative radiation therapy (SABR) may improve tumor control. We report the outcomes with the use of SABR in our pediatric solid tumor population. Methods: This was a single-institutional study in patients < 30 years treated with SABR. The primary endpoint was local control (LC), while the secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity. The survival analysis was performed using Kaplan–Meier estimates in R v4.2.3. Results: In total, 48 patients receiving 135 SABR courses were included. The median age was 15.6 years (interquartile range, IQR 14–23 y) and the median follow-up was 18.1 months (IQR: 7.7–29.1). The median SABR dose was 30 Gy (IQR 25–35 Gy). The most common primary histologies were Ewing sarcoma (25%), rhabdomyosarcoma (17%), osteosarcoma (13%), and central nervous system (CNS) gliomas (13%). Furthermore, 57% of patients had oligometastatic disease (≤5 lesions) at the time of SABR. The one-year LC, PFS, and OS rates were 94%, 22%, and 70%, respectively. No grade 4 or higher toxicities were observed, while the rates of any grade 1, 2, and 3 toxicities were 11.8%, 3.7%, and 4.4%, respectively. Patients with oligometastatic disease, lung, or brain metastases and those who underwent surgery for a metastatic site had a significantly longer PFS. LC at 1-year was significantly higher for patients with a sarcoma histology (95.7% vs. 86.5%, p = 0.01) and for those who received a biological equivalent dose (BED10) > 48 Gy (100% vs. 91.2%, p = 0.001). Conclusions: SABR is well tolerated in pediatric patients with 1-year local failure and OS rates of <10% and 70%, respectively. Future studies evaluating SABR in combination with systemic therapy are needed to address progression outside of the irradiated field. Full article
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13 pages, 1013 KiB  
Article
Prevalence and Treatment Outcomes of Childhood Acute Lymphoblastic Leukemia in Kosovo
by Flaka Pasha, Dunja Urbančič, Rufadie Maxhuni, Shaip Krasniqi, Violeta Grajçevci Uka and Irena Mlinarič-Raščan
Cancers 2024, 16(11), 1988; https://doi.org/10.3390/cancers16111988 - 23 May 2024
Viewed by 1048
Abstract
Advances in research, including novel biomarker identification and patient stratification, have significantly improved the therapy for childhood acute lymphoblastic leukemia (ALL), though access to improved healthcare services varies across geographical regions. In an effort to evaluate the advances in therapeutic approaches, we performed [...] Read more.
Advances in research, including novel biomarker identification and patient stratification, have significantly improved the therapy for childhood acute lymphoblastic leukemia (ALL), though access to improved healthcare services varies across geographical regions. In an effort to evaluate the advances in therapeutic approaches, we performed a retrospective analysis of childhood ALL in Kosovo. Our retrospective analysis included 225 cases diagnosed between 2008 and 2023, representing 52% of 429 diagnosed childhood cancers. The average annual incidence was 14, with a median age diagnosis of seven years, and a male predominance (59.54%). Patients were categorized into risk groups, with the majority (43%) in the standard-risk category. We identified five different treatment protocols for this study period. Over 61% of patients achieved remission after the first chemotherapy cycle and we observed a 20% mortality rate. Survival analysis showed that 55% and 40% of patients achieved 2-year and 5-year event-free survival (EFS), respectively, with significant differences across risk groups. Treatment advancements significantly correlated with improved survival rates, achieving a 5-year overall survival (OS) of 88% in the currently used standardized AIEOP-BFM-2009 protocol. Our study emphasizes the need for continued research and customized care strategies to enhance clinical outcomes. Full article
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13 pages, 578 KiB  
Article
Multilevel Social Determinants of Patient-Reported Outcomes in Young Survivors of Childhood Cancer
by Jin-ah Sim, Madeline R. Horan, Jaesung Choi, Deo Kumar Srivastava, Gregory T. Armstrong, Kirsten K. Ness, Melissa M. Hudson and I-Chan Huang
Cancers 2024, 16(9), 1661; https://doi.org/10.3390/cancers16091661 - 25 Apr 2024
Viewed by 1149
Abstract
In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving [...] Read more.
In this study, the social determinants of patient-reported outcomes (PROs) in young survivors of childhood cancer aged <18 years are researched. This cross-sectional study investigated social determinants associated with poor PROs among young childhood cancer survivors. We included 293 dyads of survivors receiving treatment at St. Jude Children’s Research Hospital who were <18 years of age during follow-up from 2017 to 2018 and their primary caregivers. Social determinants included family factors (caregiver-reported PROs, family dynamics) and county-level deprivation (socioeconomic status, physical environment via the County Health Rankings & Roadmaps). PROMIS measures assessed survivors’ and caregivers’ PROs. General linear regression tested associations of social determinants with survivors’ PROs. We found that caregivers’ higher anxiety was significantly associated with survivors’ poorer depression, stress, fatigue, sleep issues, and reduced positive affect (p < 0.05); caregivers’ sleep disturbances were significantly associated with lower mobility in survivors (p < 0.05). Family conflicts were associated with survivors’ sleep problems (p < 0.05). Residing in socioeconomically deprived areas was significantly associated with survivors’ poorer sleep quality (p < 0.05), while higher physical environment deprivation was associated with survivors’ higher psychological stress and fatigue and lower positive affect and mobility (p < 0.05). Parental, family, and neighborhood factors are critical influences on young survivors’ quality of life and well-being and represent new intervention targets. Full article
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