A moonshot: Pediatric cancer chief tells how effort could help young patients

Melanie Comito, MD, Upstate's chief of pediatric hematology and oncology. (PHOTO BY SUSAN KAHN)

Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology. (PHOTO BY SUSAN KAHN)

BY JIM HOWE

Overall, one could say the U.S. is doing well in battling childhood cancers.

Since the 1960s, pediatric cancer deaths have fallen steadily. Today’s average five-year survival rate is 84 percent, compared to about 50 percent in 1975.

But challenges remain, says Melanie Comito, MD, Upstate’s chief of pediatric hematology and oncology.

She points out that progress has been slow, or nonexistent, in treating some childhood cancers in the last two decades, resulting in lost lives and devastated families.

In addition, of the roughly 80 percent of childhood cancer patients who are alive after five years, about half end up with chronic medical conditions. About a fifth die prematurely.

Most of the money for cancer research goes to adult cancers, Comito says, because adults make up about 99 percent of all cancer cases. Of the 1.6 million Americans diagnosed with cancer each year, about 16,000 are younger than 20.

While far more adults get cancer, children pay a bigger cost in death or chronic medical conditions, Comito told an audience at an Upstate cancer symposium in September. The average loss of life from cancer is 71 years for children, vs. 15 years for adults, since adults tend to be diagnosed at age 67, and children at age 6.

Put another way, 11 U.S. children die of cancer every day, or about 4,000 a year, making it the biggest cause of childhood death from disease.

Comito expresses hope as she describes how the  “Cancer Moonshot” – the ambitious national effort underway to defeat the disease – could help young cancer patients:

  • repurposing drugs now used only for adults.
  • developing drugs targeted to children’s cancers and aiming to lessen later effects.
  • adapting immunotherapy – using the patient’s immune system — for children’s cancers.
  • studying the microenvironment, or healthy tissue around tumors, to better target the disease.
  • increasing research funding.
  • continuing and improving the multidisciplinary approach to treatment, to pool the knowledge of researchers and health care providers.

What if a cure meant not only getting rid of cancer but that no one could ever tell you had been treated for it? Comito muses. Or if children could be screened for cancer, then given a biologic agent of some sort, so  no one ever needed treatment?

“We not only want to cure more children, but we want a cure that will last into adulthood and make them productive adults,” she says.

This article appears in the fall 2016 issue of Cancer Care magazine. Hear a radio interview/podcast with Comito about pediatric brain and spine cancers.

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