RT Book, Section A1 Tanaka, Ryuma A1 Zweidler-McKay, Patrick A. A2 Kantarjian, Hagop M. A2 Wolff, Robert A. SR Print(0) ID 1126745685 T1 Pediatric Cancers T2 The MD Anderson Manual of Medical Oncology, 3e YR 2016 FD 2016 PB McGraw-Hill Medical PP New York, NY SN 9780071847940 LK hemonc.mhmedical.com/content.aspx?aid=1126745685 RD 2024/10/13 AB Fortunately, pediatric cancers are rare, with only 1 in 300 children being diagnosed before 18 years of age. And, with overall survival (OS) approaching 80%, there is hope for most of these children and for their families. However, just as in adults, if their cancer is metastatic at diagnosis, if the cancer does not respond to standard therapies, or if they suffer a relapse, the prognosis is universally grim. Despite intensified therapies, the survival for most children with relapsed cancer has not improved in decades. In large part, this is due to the toxicities of such regimens as we have likely reached the tolerable limit with most chemotherapeutic agents. Thus, as is the case for adults with cancer, there has been a focus on understanding the underlying biology of the disease to find targetable lesions and to develop novel agents and treatment regimens to improve survival in children with relapse. However, there are multiple challenges we face. First, the spectrum of pediatric cancers is distinctly different from adults (Fig. 46-1), with acute lymphoblastic leukemia (ALL), medulloblastoma and gliomas, neuroblastoma, Hodgkin and non-Hodgkin lymphomas, and sarcomas the most common cancers in children as opposed to the most common carcinomas of the prostate, breast, lung, colon, and so on in adults. Second, the relative rarity of these cancers results in less preclinical research to find and develop potential therapeutic targets and limited patient numbers to enroll and test novel therapeutic strategies.