Annual Report 2023
Department of Pediatric Oncology
Toru Mukohara, Ako Hosono
Introduction
Since its establishment in December 2011, the Department of Pediatric Oncology has been dedicated to the comprehensive management and medical treatment of solid tumors commonly diagnosed in children and adolescents, known as pediatric and AYA (adolescent and young adult) cancers. We collaborate closely with related departments, including medical oncology, orthopedic oncology, urology, radiation oncology, the AYA support team, and the neuro-oncology and ocular oncology units at the central hospital, to provide multidisciplinary treatment.
A distinctive feature of our department is our strong partnership with medical oncology, which allows us to treat a wide age range, from older children in late elementary school to adolescents and young adults. In addition to treatment, we emphasize holistic care for pediatric and AYA patients, including educational support, family support (for parents, siblings, and children of patients), and long-term follow-up for late complications.
Since April 2016, pediatric cancer patients have been eligible for insurance-covered proton therapy in Japan. This has led to an increasing number of patients from both Japan and abroad, including many from China, seeking this treatment. In collaboration with the Department of Radiation Oncology, we have established a safe treatment environment for children requiring sedation. Our main areas of focus include brain tumors and sarcomas such as rhabdomyosarcoma and Ewing sarcoma, which develop in the head, neck, and torso. For sarcomas, radiation therapy is commonly combined with chemotherapy, facilitated by our outpatient treatment center.
Additionally, through our pediatric and AYA cancer helpline, we provide guidance and support to patients and families nationwide regarding treatment options and daily life during treatment.
The Team and What We Do
The pediatric outpatient department treats newly diagnosed patients and patients undergoing outpatient chemotherapy every Wednesday and provides follow-up treatment for patients who have completed an intensive course of treatment. Flexible arrangements are made for outpatient treatment of patients on days other than Wednesdays. Cancer patients of the AYA generation are treated jointly with the Department of Oncology every Monday, Wednesday and Friday. Ward rounds and conferences are held each morning jointly with the Medical Oncology group. Sarcoma conferences are held every other Tuesday. For patients undergoing proton beam therapy, a conference is always held with the participation of the radiation therapy department, nurses, and technicians.
Research Activities
In addition to providing standard treatment for newly diagnosed patients, we have also established a system that allows us to provide clinical trial treatment for patients with relapsed or refractory disease, including the use of drugs outside of the approved indications, and we accept patients from other medical institutions.
Clinical Trials
The two clinical trials described below are currently active.
1) Phase II study of vincristine, actinomycin-D, cyclophosphamide and irinotecan for patients with newly diagnosed low-risk subset B rhabdomyosarcoma. (JRS-II LRB)
2) 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.)
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 and AYA support team
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 in progress and several projects have already started.
List of papers published in 2023
Journal
1. Funasaka C, Hanai A, Zenda S, Mori K, Fukui M, Hirano N, Shinohara R, Fuse N, Wakabayashi M, Itagaki M, Tomioka Y, Nishina M, Arai Y, Kogawa T, Ozaki Y, Nishimura M, Kobayashi T, Hara F, Takano T, Mukohara T. Mitigation of paclitaxel-induced peripheral neuropathy in breast cancer patients using limb-cooling apparatus: a study protocol for a randomized controlled trial. Frontiers in oncology, 13:1216813, 2023
2. Krop IE, Masuda N, Mukohara T, Takahashi S, Nakayama T, Inoue K, Iwata H, Yamamoto Y, Alvarez RH, Toyama T, Takahashi M, Osaki A, Saji S, Sagara Y, O'Shaughnessy J, Ohwada S, Koyama K, Inoue T, Li L, Patel P, Mostillo J, Tanaka Y, Sternberg DW, Sellami D, Yonemori K. Patritumab Deruxtecan (HER3-DXd), a Human Epidermal Growth Factor Receptor 3-Directed Antibody-Drug Conjugate, in Patients With Previously Treated Human Epidermal Growth Factor Receptor 3-Expressing Metastatic Breast Cancer: A Multicenter, Phase I/II Trial. Journal of clinical oncology, 41:5550-5560, 2023
3. Baba K, Kawamoto M, Mamishin K, Uematsu M, Kiyohara H, Hirota A, Takahashi N, Fukuda M, Kusuhara S, Nakajima H, Funasaka C, Nakao T, Kondoh C, Harano K, Matsubara N, Naito Y, Hosono A, Kawasaki T, Mukohara T. The impact of the COVID-19 pandemic on perioperative chemotherapy for breast cancer. Cancer medicine, 12:12095-12105, 2023
4. Uematsu M, Nakajima H, Hosono A, Kiyohara H, Hirota A, Takahashi N, Fukuda M, Kusuhara S, Nakao T, Funasaka C, Kondoh C, Harano K, Matsubara N, Naito Y, Akimoto T, Mukohara T. Safety of immune checkpoint inhibitors after proton beam therapy in head and neck mucosal melanoma: a case series. Melanoma research, 33:547-552, 2023
5. Masuda J, Sakai H, Tsurutani J, Tanabe Y, Masuda N, Iwasa T, Takahashi M, Futamura M, Matsumoto K, Aogi K, Iwata H, Hosonaga M, Mukohara T, Yoshimura K, Imamura CK, Miura S, Yamochi T, Kawabata H, Yasojima H, Tomioka N, Yoshimura K, Takano T. Efficacy, safety, and biomarker analysis of nivolumab in combination with abemaciclib plus endocrine therapy in patients with HR-positive HER2-negative metastatic breast cancer: a phase II study (WJOG11418B NEWFLAME trial). Journal for immunotherapy of cancer, 11:e007126, 2023