CLINICAL NEWS
On Location
IOM/ACS
PEDIATRIC ONCOLOGY WORKSHOP
Washington, DC
IOM/ACS Pediatric Oncology Workshop
Highlights Survivorship Issues
n March 9-10, the Institute of
Medicine’s (IOM’s) National Cancer Policy Forum (NCPF) and the
American Cancer Society (ACS)
sponsored a workshop on Comprehensive Cancer Care for Children and their
Families to discuss recent trends in comprehensive cancer care for pediatric patients –
and their families.
During the two-day event, pediatric oncologists and palliative care clinicians shared
research from the pediatric oncology landscape, while patients, survivors, and families
offered their unique perspectives on the
experiences of living with a cancer diagnosis.
“There was a strong focus on survivorship,” said Richard A. Larson, MD, professor of medicine at the Pritzker School of
Medicine in Chicago, an NCPF member who
attended on behalf of ASH. “While there has
been considerable success treating many
childhood cancers – especially leukemia,
lymphoma, and neuroblastoma – there are
still issues with minimizing the toxicity of
the drugs used and their effects on children’s growth and development, both physical and psychosocial.”
ASH Clinical News spoke with Dr. Larson
and other presenters and attendees about
the findings from the two-day workshop,
including the need for education, improvements in palliative and psychosocial care,
and potential policy actions to improve care
and outcomes.
ASHClinicalNews.org
Underscoring the Differences Between
Adult and Pediatric Cancer Care
One of the core issues differentiating pediatric cancer care from adult cancer care is drug
side effects, Dr. Larson noted. For example, as
Smita Bhatia, MD, from City of Hope in Duarte,
California, discussed in a presentation, certain
cancer drugs carry cardiotoxic effects. Pediatric
cancer patients may be particularly susceptible
to these effects, and the effects be much longerlasting in children than in adults. While researchers have identified a genotype polymorphism
that indicates which patients are more likely to
experience anthracycline-induced cardiotoxicity
with doxorubicin and which subsets are likely to
be cured with less intensive dosing, there is still a
great knowledge gap about how patients experience these adverse effects.
“As oncology investigators, we tend to look at
the bottom line, asking how many patients survive their cancers,” Dr. Larson said. “We’re willing
to accept a fair bit of toxicity to get someone
to that bottom line. But we have relatively little
information from patients, themselves, as they
are going through these sometimes complicated –
and certainly uncomfortable – treatments.”
“The knowledge gap extends to many consequential questions that may ultimately affect
outcomes,” Dr. Larson continued. “Is the patient
able to continue attending school? Is he or she being ostracized? Has he or she lost friends? Often,
these types of patient-reported outcomes are not
included in the design of pediatric oncology clinical trials,” Dr. Larson said.
Integrating Palliative Care Throughout
the Disease Course
One issue common across cancer care – whether
adult or pediatric – i