Can we wipe out childhood cancer? Possibly

There is nothing more heartbreaking than hearing your child diagnosed with a serious disease like cancer. When such a crisis happens, parents want to find the best care and treatment and get their child back to being a kid as quickly as possible.

As a pediatric oncologist, I have seen many forms of cancer in children from newborns to young adults. I have seen the most common conditions, like leukemia, and very rare childhood cancers like adrenocortical tumors. The Centers for Disease Control says about 12,500 children and adolescents under age 20 are diagnosed with cancer nationwide each year.

New treatments, announced only in the past two months, are giving us enormous hope that we are closer to eradicating this dreadful disease. New advancements in research and treatment are bringing hope. We have come a long way in fighting the battle against cancer and improving outcomes.

As we plan a conference for pediatric cancer survivors on Oct. 7 at the Valley Children’s Healthcare’s main facility in Madera, we are hopeful that some day soon we’ll need to send out many, many more invitations to such an event. Already, we’ve seen tremendous strides.

Half a century ago, many childhood cancers were simply incurable. Now the average cure rates for certain pediatric cancers have increased to 75-80 percent; for some conditions it’s 98 percent. This is incredible progress. More children are surviving cancer now than at any other time in history.

One organization that has made a big impact in boosting survival rates is the Children’s Oncology Group, the world’s largest organization devoted exclusively to childhood cancer research and treatment. COG has made great strides in developing advanced treatments to improve quality of care and outcomes. The organization continually develops clinical trials, including front-line therapies, studies for understanding the hidden biology of pediatric cancers, evaluation of emerging treatments, supportive care, stem-cell transplantation and survivorship.

At Valley Children’s we care for about 120-150 children newly diagnosed with cancer every year along with several hundred previously diagnosed, ranging from common to extremely rare conditions. As a member of COG, we provide patients access to 90 open protocols for treating childhood cancer.

But cancer treatments such as chemotherapy and radiation carry the risk of adverse reactions. Treatments designed to destroy fast-growing cancer cells can also kill normal body tissues and cells – blood cells, cells in the mouth, hair and many more.

In the past few years, innovative treatments called “targeted therapies” have launched a new era in medicine. These therapies are designed to precisely identify and attack cancer cells and minimize effects to healthy tissues.

The latest developments in “precision medicine” such as DNA sequencing and gene therapy are revolutionary. Remarkably, we are now able to see detailed sequencing of a patient’s genes, identify where a gene has mutated and provide a solution for specific treatments that are safe and effective.

Imagine for a minute a subspecialist knowing your child’s genetic information and prescribing a drug smart enough to home in on a specific gene mutation. This particular medication hinders the cancer cell growth by cutting off supply that feeds the cancerous cell and/or kills it entirely without affecting normal cells around it.

Just recently, the FDA approved the first gene-therapy treatment for acute lymphoblastic leukemia. Called Chimeric Antigen Receptor T-cell therapy, this transformational treatment uses the power of a patient’s immune system to fight cancer cells – making it “a living drug.”

The therapy involves collecting a type of white blood cell called T-cells from a patient, which are genetically modified to recognize a specific protein on the cancer cell. It is then infused back in the patient to destroy the cancer cells. For now, it has been approved primarily for children, adolescents and young adults who have not responded to conventional cancer treatments and relapsed multiple times.

The results are wonderful!

Of the children who received early-stage clinical trials, more than 90 percent achieved a complete remission within one month. Research efforts are now in place to use the same type of technology to attack other childhood cancers – solid tumors and lymphoma.

These are exciting times. CAR T-cell therapy has the potential to completely change the way cancers are treated and possibly become the new standard of care.

Our team at Valley Children’s looks forward to offer this treatment within a few years.

No doubt we will see childhood cancer cure rates improve even more as medicine gets more precise and more personalized. Ultimately, that means providing tremendous hope for our children’s health and future.

This story was originally published September 29, 2017 at 12:36 PM with the headline "Can we wipe out childhood cancer? Possibly."