From the Editor

Progress in Pediatric Cancer

The articles in thisCCRFocus section create a sense thatweare at the threshold of important therapeutic discoveries inthe treatment of childhood cancer. Pediatric oncologists canbe proud of their track record in treating children withcancer. As shown in Fig. 1, there has been steady, stepwiseprogress in the treatment of almost every tumor type overthe last 35 years (1). Given the rarity of childhood cancer,this progress is in no small part due to the willingness ofpediatric oncologists to work in cooperative groups. Inves-tigators have worked out the treatment of acute lympho-blastic leukemia iteratively, adding and subtracting agentsfor induction therapy, and altering treatment durations andconsolidation therapies. The result is a 90% 5-year survivalrate. However, the field has had its challenges. New agentsare classically developed in adults before children, withsafety in mind, but this has had the effect of placing moreemphasis on discoveries in adults than in children. Therarity of the diseases has made themmore difficult to studyand investigators more reliant on model systems. In addi-tion, success has generated long-term survivorswith chronicmedical problems due to long-term toxicity.

Our understanding of the basis of these cancers hasdramatically increased with the sequencing of the cancergenome and allowed the identification of new potentialtherapeutic targets. Further, our increased understanding ofthe molecular basis of immune response and of pharma-cology offers new directions going forward. Guest EditorsCarol Thiele and Susan Cohn have assembled a team toexamine pediatric cancer in the era of molecular oncology.Matthay and colleagues take us beyond MYCN to theidentification of 3 new targets in neuroblastoma, Loh andMullighan identify new targets for therapy in acute lymph-oblastic leukemia, and Lawlor and Thiele show that epige-netic dysregulation may underlie most childhood cancers.Lee and colleagues discuss new approaches for targeting theimmune system against tumor cells, and Pinto and collea-gues address the potential use of pharmacogenomics toavert toxicity from therapy. Together, these articles representhighlights and hope in our effort to protect our smallestpatients from these rare but mortal diseases.

As with every edition of CCR Focus, it is our hope that thearticles will inform and intrigue both the expert in the fieldand the interested but nonexpert observer.

Susan E. BatesDeputy Editor, CCR FocusNational Cancer Institute

Reference

1. National Cancer Institute [homepage on the Internet]. SEER CancerStatistics Review, 1975–2008, Table 28.8 [updated 2011 Nov 20; cited2012 Apr 24]. Available from: http://seer.cancer.gov/csr/1975_2008/results_merged/sect_28_childhood_cancer.pdf.

© 2012 American Association for Cancer Research

0

10

20

30

40

50

60

70

80

90

100

Bone & Joint

Soft tissue

Brain & CNS

Hodgkin lymphoma

Non-Hodgkinlymphoma

Leukemia

Acute lymphocyticleukemia

5-ye

ar s

urvi

val i

n ch

ildre

n ag

es 0

–14

(%)

Year of diagnosis

Acute myeloidleukemia

Neuroblastoma

Wilms' tumor

’75–

’77

’78–

’80

’81–

’83

’84–

’86

’87–

’89

’90–

’92

’93–

’95

’96–

’00

’01–

’07

Figure 1. SEER Cancer Statistics, 1975–2008 (1).

Published online May 16, 2012.doi: 10.1158/1078-0432.CCR-12-1014�2012 American Association for Cancer Research.

CCRFOCUS

Clin Cancer Res; 18(10) May 15, 20122734

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