Childhood Cancer Research Roundup: January 2024
To keep families and advocates well-informed of new developments in pediatric oncology and survivorship research, we’re bringing you a roundup of some of the studies and articles we’ve been digesting lately.
2024 Cancer Outlook: The American Cancer Society released its 2024 Cancer Facts & Figures report this month, and their numbers estimate that approximately 9,620 children ages 0-14 and 5,290 adolescents (15-19) will be diagnosed with cancer in 2024. Incidence rates in children have stabilized since 2015 but continue to increase for adolescents by about 1 percent per year. The mortality rate has declined by more than half since 1970 in both children and adolescents but “progress lags for some cancer types, such as diffuse midline glioma, a type of brain cancer.” The overall 5-year survival rate between 2013-2019 was 85 percent among children and 87 percent among adolescents.
This year’s report also includes a special section on cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender-nonconforming. We’ll be discussing this section with our Survivorship Advisory Council in an upcoming meeting to ensure that we’re well-informed around barriers to quality survivorship care and screening that these individuals may face.
Heart Health: St Jude researchers have discovered two common biomarkers that can predict cardiomyopathy better and earlier in high-risk, asymptomatic childhood cancer survivors. (Journal of Clinical Oncology, January 2024)
Another recent study found that the blood pressure medication carvedilol is safe for childhood cancer survivors but did not significantly improve its targeted cardiac measures (LVWT/Dz). However, there was improvement seen in the left ventricular end-systolic wall stress, which is an early biomarker of worsening heart health, setting the stage for future trials. (The Lancet, January 2024 / Commentary)
“The greatest benefit was seen in participants who were very long-term survivors, as well as in those who were highly adherent to the study medication,” said researcher Dr. Saro Armenian, chair of pediatrics at City of Hope.
City of Hope's Childhood, Adolescent and Young Adult (AYA) Cancer Survivorship Program received the Children's Cancer Cause Survivorship Champion’s Prize last year, and Dr. Armenian presented research during our Externally-led Patient-Focused Drug Development (EL-PFDD) meeting on reducing cardiac late effects in 2022.
Hodgkin’s Survivors: This study looked at barriers to long-term survivorship care among childhood Hodgkin lymphoma (HL) survivors and the reasons that some survivors stopped attending follow-up care visits. “Insurance status and awareness of the need for long-term follow-up care are key factors,” the study authors concluded. “Targeted education and low-cost options for survivorship care are potential strategies for improving adherence to long-term follow-up care in HL survivors.” (Pediatric Blood & Cancer, January 2024)
Financial Hardship: We know that childhood cancer families and survivors are more likely to experience financial hardship compared with the general population, and a new study now shows that financial hardship into adulthood may also extend to siblings of childhood cancer survivors. Siblings were more likely than the general public to report worries about medical bills, affording healthy food, and forgoing needed medical or dental care because of cost. (Cancer, January 2024)
Another new study looked at the impact of high-deductible health plans among cancer families and survivors, finding that the high out-of-pocket cost for these plans caused patients to make fewer visits to primary care doctors and noncancer specialists. (JAMA Oncology, January 2024)
Diabetes Risk: New research shows that childhood cancer survivors have twice the odds of developing prediabetes (a precursor to full-blown diabetes) compared to peers without any history of cancer.
By the time they reached their 40s, almost half of childhood cancer survivors had prediabetes, while 14% had diabetes, the study found. (Journal of Clinical Oncology, December 2023)
Neuroblastoma: The U.S. Food and Drug Administration approved eflornithine (Iwilfin) in December, its first approval of a therapy intended to reduce the risk of relapse in adult and pediatric patients with high-risk neuroblastoma.
Quality of Life: Researchers sought to better understand how adolescents and young adults (AYAs) with advanced cancer define quality of life (QoL) through interviews with patients, caregivers, and health care providers. “The opportunity to maintain and deepen relationships with family and friends was the most frequently referenced domain of QoL,” the study authors wrote. Along with personal and family relationships, the interviews delved into psychosocial and physical well-being, dignity, and normalcy. The findings indicate that quality of life concerns among this population of AYAs with advanced cancer likely differ from cancer-free AYA survivors and that further research is warranted to assess best practices of provider communications for these patients. (Journal of the National Comprehensive Cancer Network, December 2023)
B-cell ALL: Blinatumomab (Blincyto) was found to be a safe and effective front-line treatment of chemotherapy-intolerant B-cell acute lymphoblastic leukemia (ALL), paving the way for a less toxic treatment option for these children and young adults. (Journal of Clinical Oncology, November 2023)
Survivorship Myths: A recent study delves into some of the commonly-held myths and presumptions about survivorship care that might be counter-productive toward efforts to improve long-term care. For example, there’s a presumption that primary care providers (PCPs) feel unable to care for survivors but available evidence suggests this is a more nuanced issue and that while PCPs do experience challenges in addressing certain cancer-related care needs, most feel confident about managing late effects and addressing chronic comorbidities. (Journal of Clinical Oncology, November 2023)