Department of Pediatric Oncology

Ako Hosono, Hiroshi Kawamoto, Naoko Yasui

Introduction

The Department of Pediatric Oncology was established in December 2011 to provide treatment of pediatric cancers including a wide variety of diseases such as hematologic malignancies comprising leukemia and lymphoma, embryonal tumors comprising neuroblastomas, nephroblastomas and hepatoblastomas, and mesenchymal tumors comprising Ewing sarcomas, rhabdomyosarcomas, and osteosarcomas. Although they usually occur in children under the age of 15, they occasionally occur in adolescents and young adults (AYA). Most of the pediatric cancers are highly chemosensitive as well as radiosensitive. They are possibly curable in a certain situation where the intensity of multidisciplinary treatment and disease characteristics are balanced well. However, there are absolute refractory cases who need new treatments other than standard chemotherapy. Moreover, long-term survivors of pediatric cancers often suffer from complications secondary to chemotherapy and radiotherapy.

Our team and what we do

The pediatric outpatient service is open three days a week, Monday, Wednesday, and Friday to treat newly diagnosed patients, patients who received chemotherapy in the outpatient setting, and to provide follow-up treatment for patients who have completed an intensive treatment course. Also, the care for children receiving palliative treatment is carried out with the Palliative Care and Psycho-Oncology group. Daily rounds and a conference are held every morning. We also attend conferences with the Departments of Breast and Medical Oncology, Musculoskeletal Oncology and Rehabilitation, Thoracic Surgery, and Urology at any time.

Research activities

Our projects include treatment development using relatively new off-label drugs as well as experimental agents such as peptide vaccines. One of the objectives of the following trials is gathering data on, and assessing the safety and efficacy date of, such off-label drugs and eventually getting them approved by the Ministry of Health, Labour and Welfare.

Two clinical trials described below are currently active.

1)Randomized phase II study of two cross-over sequences, Gemcitabine/ docetaxel (A) and temozolomide/etoposide (B), for relapsed or refractory Osteosarcoma

2)Phase I/II Study of Irinotecan and Gemcitabine in Pediatric, Adolescent and Young Adult Patients with Relapsed or Refractory Solid Tumors

Future prospects

There are three major missions in the Department of Pediatric Oncology of the National Cancer Center Hospital East (NCCHE) as follows.

1)To provide a state-of-the-art treatment for AYA patients in collaboration with the Medical Oncology group.

2)To develop new treatments for pediatric cancer by sharing agents and knowledge with the Department of Experimental Therapeutics.

3)To provide less toxic proton-beam radiation therapy as one of the three proton centers for children in Japan.

All three activities are currently in process and several projects have already started.