Established in 2002 by Childhood Cancer International (CCI), international childhood cancer day takes place on the 15th February each year. On this day members of CCI stand united to raise awareness of childhood cancer, to support survivors and their families and to campaign for the rights of every child and adolescent suffering with cancer. The core belief of the CCI is that “every child and adolescents with cancer deserves the best possible medical and psychosocial care, regardless of country of origin, race, financial status or social class”.
Approximately 300,000 children (0-19 years of age) are diagnosed with cancer each year. It is the leading cause of death in children and adolescents, despite cures being available, in most cases as generic and inexpensive medications. Although this is reflected in high-income countries where more than 80% of children with cancer are cured, this is in stark contrast to the situation in low- and middle-income countries in which only around 20% of children are cured. This striking contrast is most likely due to the inability to obtain accurate diagnoses, lack of access to essential medicines and technology, abandonment of treatment and higher rates of relapse. Thus, the message for International Cancer Day in 2020 is that there should be no more borders for children with cancer regardless of where in the world they live, #nomoreborders, to eliminate avoidable deaths.
For the 20% of children currently living with an “incurable” cancer due to relapse or resistance to treatment, Advanced Therapies represent a new hope for a curative treatment. Not least of those is chimeric antigen receptor (CAR) T cell immunotherapies (What is CAR T cell therapy? Click here to find out). Leukaemia accounts for about 28% of all cancers in children, with acute lymphoblastic leukaemia making up the majority of childhood leukaemia cases. Although the 5-year survival rates for ALL range from 78% to 91%, approximately 2-3% of patients will have therapy resistance disease, whilst 10-15% will relapse1. The 5-year survival after relapse decreases, and diminishes further with each subsequent relapse1. Thus, recurrent ALL persists as the leading cause of cancer related death in children. The autologous anti-CD19 CAR T cell therapy, tisagenlecleucel, was one of the first cellular cancer immunotherapies to receive FDA and EMA approval for the use in patients with refractory (resistant to standard treatment) leukaemia or relapsed patients. Treatment with Tisagenlecleucel in a phase 2 clinical study has resulted in an impressive remission rate of 81% in paediatric and adolescent patients with relapsed or refractory B cell ALL1. CAR T cell therapy may therefore represent an important new treatment option for children, adolescents and young adult patients with ALL. The article “The journey to CAR T cell therapy: the pediatric and young adult experience with relapsed or refractory B-ALL” outlines the case studies for four patients with differing ALL experiences, all of whom have benefitted from CAR T cell therapy.
However, despite the early promise of CAR T cell therapy, there are still many hurdles standing in the way of this therapy becoming a mainstay of cancer treatments. Ranging from problems in manufacturing (often lengthy and complex isolation and modification process) to CAR toxicity, evasion by tumour cells (resistance to therapy) and ineffectiveness against solid tumours. RESTORE is a large-scale research initiative dedicated to making Advanced Therapies a reality for all patients in need (https://www.restore-horizon.eu/). A key tenet of this promise is making these therapies accessible, meaning that they are both affordable and readily available. RESTORE recognises the significant barriers that face such innovative new therapies and will continue to lobby at policy level, promote information exchange and involve and connect patients, researchers, physicians and industry players to bring accessible and affordable Advanced Therapies to all those in need regardless of their geographical, social or economic situation.
It is important to acknowledge the necessity of affordable and accessible medicines across the whole range or treatment options in order to successfully combat chronic diseases such as childhood cancer. Therefore, join the CCI global network today in campaigning for an end to avoidable childhood cancer deaths by promoting fair and accessible options for therapies for all children, no matter their economic, global or social status.
If you want to find out more about the CCI and patient organisations in your country, more information can be found here: https://internationalchildhoodcancerday.org/
If you are interested in the research and the strategic plan to combat childhood cancer in Europe, then check out SIOPE, the European Society for Paediatric Oncology. They are active in many areas to highlight the issues and needs related to treating childhood cancer: https://www.siope.eu/