A cancer diagnosis that forecasts a premature end to a patient’s life is often described as unfair. When that patient is a child who has not yet fully experienced life, the diagnosis is not just unfair—it is tragic. The good news is that the cure rate for pediatric cancer in high-income countries is greater than 80%. But global statistics are more sobering: In low- and middle-income countries, the average cure rate is less than 30%.
Each year 429,000 children and adolescents aged 0 to 19 years are expected to develop cancer. Five-year survival rates exceed 80% for the 45,000 children with cancer in high-income countries (HICs) but are less than 30% for the 384,000 children in lower-middle-income countries (LMICs).
Improved survival rates in HICs have been achieved through multidisciplinary care and research, with treatment regimens using mostly generic medicines and optimized risk stratification.
Children’s outcomes in LMICs can be improved through global collaborative partnerships that help local leaders adapt effective treatments to local resources and clinical needs, as well as address common problems such as delayed diagnosis and treatment abandonment.
Together, these approaches may bring within reach the global survival target recently set by the World Health Organization: 60% survival for all children with cancer by 2030.
A key discussion point is why most pediatric cancer patients have not yet benefited from the new “targeted therapies” that have shown promise for adult cancers. There are several underlying reasons. The genetics and biology of pediatric cancers are distinct from those of adult cancers.
The design and pace of clinical trials that evaluate new therapies in adult cancer patients are not optimal for pediatric cancer patients. Additionally, because many pediatric cancer sub-types are rare, they do not attract the attention of drug companies. Researchers are working vigorously to address these challenges. They are also studying adult survivors of pediatric cancer who are experiencing adverse health effects caused by the aggressive treatments they received decades earlier.
Finally, researchers around the world are exploring the reasons for the global disparities in pediatric cancer outcomes.
Although the challenges facing the pediatric oncology community are diverse, a common theme in proposed solutions is the requirement for collaboration—be it through sharing of data, expertise, or resources. Making progress will take a village.