Modernized Treatment Approaches for Childhood Cancers Are a Result of COG Clinical Trials
Significant progress has been made with childhood cancer, especially with the efforts of Children's Oncology Group (COG), but some areas still need attention, Doug Hawkins, MD, COG chair, a National Cancer Institute (NCI)-funded network of researchers and hospitals, explained in a September 2022 interview (https://www.cancer.gov/news-events/cancer-currents-blog/2022/childhood-cancer-research-advances-cog-hawkins) with NCI.
Understanding of childhood cancer and treatment approaches (https://www.cancer.gov/news-events/cancer-currents-blog/2022/childhood-cancer-research-advances-cog-hawkins) has greatly improved since he began practicing in 1991, Hawkins said, citing findings from two recent COG-conducted clinical trials. The first was a study in children with relapsed acute lymphoblastic leukemia. In the trial, COG tested substituting (https://doi.org/10.1001/jama.2021.0669) an immunotherapy drug for standard treatment with chemotherapy.
“The chances of remaining in remission and being cured was much higher in children who got blinatumomab, and they had fewer side effects,” Hawkins said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/childhood-cancer-research-advances-cog-hawkins). “So, it was exactly what we hoped to achieve: more effective treatment against the cancer with fewer side effects. It was really transformative for how we think about treating what is the most common childhood cancer.”
Another study focused on tailoring treatment options for children with acute promyelocytic leukemia (http://dx.doi.org/10.1001/jamaoncol.2021.5206).
“Most patients in the study received two targeted agents, arsenic trioxide and all-trans retinoic acid, which is a vitamin,” Hawkins said (https://www.cancer.gov/news-events/cancer-currents-blog/2022/childhood-cancer-research-advances-cog-hawkins). “Most children in the study only got these two drugs, not standard chemotherapy, and the cure rate was nearly 100%.”
However, Hawkins said that more work needs to be done. He called for additional studies for cancers such as diffuse intrinsic pontine glioma, which are still treated with the same chemotherapy (https://www.cancer.gov/news-events/cancer-currents-blog/2022/childhood-cancer-research-advances-cog-hawkins) medications used decades ago.
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