Annual Report 2019
Department of Pediatric Oncology
Toru Mukohara, Ako Hosono
Introduction
The Department of Pediatric Oncology was established in December 2011 to provide treatment for pediatric cancers including a wide variety of diseases such as 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 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 absolutely refractory cases that need new treatments other than standard chemotherapy. Moreover, long-term survivors of pediatric cancers often suffer from complications secondary to chemotherapy and radiotherapy.
The Team and What We Do
The pediatric outpatient service is open three days a week, namely Monday, Wednesday, and Friday to treat newly diagnosed patients and patients who received chemotherapy in the outpatient setting, and to provide follow-up treatment for patients who have completed an intensive treatment course. The care for children receiving palliative treatment is also carried out with the Palliative Care and Psycho-Oncology group. A daily ward round 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 as and when.
Research activities
Our projects include treatment development using relatively new off-label drugs as well as experimental agents. One of the objectives of the following trials is gathering data on, and assessing the safety and efficacy of, such off-label drugs and eventually getting them approved by the Ministry of Health, Labour and Welfare.
Clinical trials
Three clinical trials described below are currently active.
1) Phase II study of vincristine, actinomycin-D, cyclophosphamide and irinotecan for patients with newly diagnosed intermediate rhabdomyosarcoma. (Phase II study of VAC2.2/VI therapy for patients with newly diagnosed intermediate rhabdomyosarcoma.)
2) JCOG0905: A Phase III Study Comparing Methotrexate, Adrimycin and Cisplatin (MAP) with MAP + Ifosfamide (MAP + IF) for the Treatment of Osteosarcoma (OS-MAP + IF-P3)
3) A Phase 2 Trial of Multimodal Treatment based on VDC-IE with Interval Compressed Schedule by using G-CSF for Patients with Non-metastatic Ewing Sarcoma Family Tumor (JESS14)
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 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 Clinical Development Center
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.
List of papers published in 2019
Journal
1. Modi S, Saura C, Yamashita T, Park YH, Kim SB, Tamura K, Andre F, Iwata H, Ito Y, Tsurutani J, Sohn J, Denduluri N, Perrin C, Aogi K, Tokunaga E, Im SA, Lee KS, Hurvitz SA, Cortes J, Lee C, Chen S, Zhang L, Shahidi J, Yver A, Krop I. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer. N Engl J Med, 382:610-621, 2020
2. Goto K, Fujiwara Y, Isobe T, Chayahara N, Kiyota N, Mukohara T, Tsubata Y, Hotta T, Tamura K, Yamamoto N, Minami H. Pharmacokinetic study of the oral fluorouracil antitumor agent S-1 in patients with impaired renal function. Cancer Sci, 110:1987-1994, 2019
3. Akazawa Y, Hosono A, Yoshikawa T, Kaneda H, Nitani C, Hara J, Kinoshita Y, Kohashi K, Manabe A, Fukutani M, Wakabayashi M, Sato A, Shoda K, Shimomura M, Mizuno S, Nakamoto Y, Nakatsura T. Efficacy of the NCCV Cocktail-1 vaccine for refractory pediatric solid tumors: A phase I clinical trial. Cancer Sci, 110:3650-3662, 2019
4. Miyachi M, Tsuchiya K, Hosono A, Ogawa A, Koh K, Kikuta A, Hara J, Teramukai S, Hosoi H. Phase II study of vincristine, actinomycin-D, cyclophosphamide and irinotecan for patients with newly diagnosed low-risk subset B rhabdomyosarcoma: A study protocol. Medicine (Baltimore), 98:e18344, 2019
5. Chayahara N, Mukohara T, Tachihara M, Fujishima Y, Fukunaga A, Washio K, Yamamoto M, Nakata K, Kobayashi K, Takenaka K, Toyoda M, Kiyota N, Tobimatsu K, Doi H, Mizuta N, Marugami N, Kawaguchi A, Nishigori C, Nishimura Y, Minami H. Adapalene Gel 0.1% Versus Placebo as Prophylaxis for Anti-Epidermal Growth Factor Receptor-Induced Acne-Like Rash: A Randomized Left-Right Comparative Evaluation (APPEARANCE). Oncologist, 24:885-e413, 2019