ECC 2015: Childhood Cancers in Europe: Progress Has Been Made, but Much Still to Do
Each year in Europe, 6,000 young people die from cancer, and two-thirds of those who survive suffer from treatment-related side effects. Although there has been considerable progress in the treatment of childhood cancers over the past few decades, and cancer in childhood is rare, these are major problems that need to be overcome, said a report from SIOPE, the European Society for Pediatric Oncology, presented at the 2015 European Cancer Congress in Vienna, Austria.
“The SIOPE Strategic Plan: A European Cancer Plan for Children and Adolescents” sets out the plans of the European Community of Pediatric Hematology Oncology to improve both the cure rate and the quality of life for survivors of childhood cancers over the forthcoming 10 years, with the ultimate aim of increasing disease-free and late effect–free survival.
Cancer is still the first cause of death by disease in children aged 1 year and over in Europe, and more than 300,000 European citizens are pediatric cancer survivors. In addition to the side effects of treatment, 5 years after diagnosis, these survivors still have a risk of death that is higher than that of the general population.
“This is a serious problem, for patients, their families, and for health services, with major inequalities existing across Europe,” said Gilles Vassal, MD, PhD, of the Institut Gustave Roussy and President of SIOPE. “Add to this the fact that 35% of such cancers normally occur before the child is 5 years old, and that many pediatric cancers are difficult to treat, and you will understand why we thought it essential to try to tackle this problem in a practical way.”
Issues and Goals
The report, drawn up after widespread consultation—including discussions with parents, patients, and survivors—sets out existing problems and proposes solutions to tackle them. Among these problems are poor access to new drugs for patients; lack of funding; disparities across Europe in access to treatment; and the fact that pediatric oncology is relatively isolated from the adult oncology community.
The report also outlines the worrying tendency for politicians to think that the 80% cure rate seen in pediatric cancer means that it is not a major issue, and that therefore, efforts should only be concentrated on cancer prevention in adults and on transforming cancer into a chronic disease in an aging population.
To try to move this situation forward, the report sets out a number of goals and lists the key factors that will be necessary to achieve them. They include a commitment of all funding bodies to finance projects and structures of relevance to pediatric oncology; a strong partnership with patients, parents, and survivors, including better communication and dissemination of information; better collaboration with adult oncology; and intelligent and transparent partnerships with industry.
“One of the most important objectives focuses on increasing our knowledge of the biology of pediatric tumors,” said Martin Schrappe, MD, of the University of Kiel, and SIOPE President-Elect. “Cancers in adults result from a multistep process, usually after exposure to external carcinogens such as tobacco, alcohol, and diet, and often progress over many years. Pediatric malignancies develop early in life and over a much shorter time period; this suggests that fewer and stronger events are required for them to progress. Compared with adult cancers, most of them show fewer genetic defects and have a lower genetic complexity.”
“Major progress has been made in understanding pediatric tumor biology, and this has led to the discovery of some unique cancer hallmarks. Now we need to use modern, innovative technologies to further decipher the mechanisms of pediatric tumor development, progression, and relapse and speed up its translation to the clinic.”
To do this effectively and fairly, said the report, interactions need to be strengthened at several levels—between networks of basic research teams, between basic scientists and clinical researchers, and by increasing the involvement of patients and parents in the search for personalized medicines. SIOPE will monitor progress through research into outcomes.
Another important issue for SIOPE is improving the quality of life for survivors. “We believe that in 2020, there will be nearly half a million European pediatric cancer survivors, and many of them will have side effects that are severe enough to affect their daily lives. While the fact that so many survive is a cause for rejoicing, we have a duty to provide them with optimal long-term care so that the rest of their lives may be as normal as possible. One way of doing this would be the creation of a ‘survivorship passport’ for each child and adolescent cured of a cancer. This would contain a history of their disease and treatment together with relevant follow-up measures aimed at improving their quality of life and a database for storing the clinical data,” said Dr. Schrappe.
“We are proud to have achieved consensus on the important steps that need to be taken to tackle the issue of childhood cancer in Europe,” said Dr. Vassal. “Through setting specific and obtainable objectives, strengthening collaborations, and establishing funding partnerships, we believe that we will be able to make a real difference to the lives of pediatric cancer survivors. We would like to see our report form the basis of a European Cancer Plan for children and adolescents, and we urge all those involved to work together with us in order to see this come about.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
