In the few past months important new discoveries from clinical trials in pediatric hemato-oncology were published. We list some of the most outstanding:
1. Mitoxantrone for relapsed ALL - UK Children's Cancer Group reported in Lancet last December that children with relapsed ALL (a disease with poor prognosis, in contrast with primary ALL which is highly curable) benefited from treatment with the drug mitoxantrone, when compared with the standard therapy with idarubicin. Survival in children with relapsed ALL was 69% (overall) and 65% (progression-free), whereas the standard treatment yielded 36-45% survival. Link here.
2. Second-look surgery for RMS - Children's Oncology Group reported last November in the Journal of Pediatric Surgery that children with rhabdomyosarcoma may benefit from second-look surgical procedures in order to check local control rates. Image-proven complete remissions were reliable in this study, but 41% of patients with residual disease by image had no viable tumor in second-look procedure. Patients with no viable disease had a better failure-free survival in this study. Link here.
3. Beta-2 adrenergic receptor and ALL - French researchers reported this December that genetic polymorphisms in the promoter region of the gene encoding the beta-2 adrenergic receptor reliably correlate with relapse and response rate to methotrexate. The beta-2 adrenoceptor, mostly known by its involvement in smooth muscle contraction, is part of a proapoptotic signaling pathway, and thus its expression by cancer can possibly influence drug resistance. Link here.
1. Mitoxantrone for relapsed ALL - UK Children's Cancer Group reported in Lancet last December that children with relapsed ALL (a disease with poor prognosis, in contrast with primary ALL which is highly curable) benefited from treatment with the drug mitoxantrone, when compared with the standard therapy with idarubicin. Survival in children with relapsed ALL was 69% (overall) and 65% (progression-free), whereas the standard treatment yielded 36-45% survival. Link here.
2. Second-look surgery for RMS - Children's Oncology Group reported last November in the Journal of Pediatric Surgery that children with rhabdomyosarcoma may benefit from second-look surgical procedures in order to check local control rates. Image-proven complete remissions were reliable in this study, but 41% of patients with residual disease by image had no viable tumor in second-look procedure. Patients with no viable disease had a better failure-free survival in this study. Link here.
3. Beta-2 adrenergic receptor and ALL - French researchers reported this December that genetic polymorphisms in the promoter region of the gene encoding the beta-2 adrenergic receptor reliably correlate with relapse and response rate to methotrexate. The beta-2 adrenoceptor, mostly known by its involvement in smooth muscle contraction, is part of a proapoptotic signaling pathway, and thus its expression by cancer can possibly influence drug resistance. Link here.
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