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Precision oncology: A primer for pediatric surgeons from the APSA cancer committee
Courtney J Harris1, Alicia M Waters2, Elisabeth T Tracy3
1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Abstract:
Although most children with cancer can be cured of their disease, a subset of patients with adverse tumor types or biological features, and those with relapsed or refractory disease have significantly worse prognosis. Furthermore, current cytotoxic therapy is associated with significant late effects. Precision oncology, using molecular therapeutics targeted against unique genetic features of the patient's tumor, offers the potential to transform the multimodal therapy for these patients. Potentiated by advances in sequencing technology and molecular therapeutic development, and accelerated by large-scale multi-institutional basket trials, the field of pediatric precision oncology has entered the mainstream. These novel therapeutics have important implications for surgical decision making, as well as pre- and postoperative care. This review summarizes the current state of precision medicine in pediatric oncology including the active North American and European precision oncology clinical trials. LEVEL OF EVIDENCE: Treatment study Level V.
Insights
Precision oncology offers new hope for children with difficult-to-treat cancers, improving outcomes and reducing side effects. This approach uses targeted molecular therapies based on a child's unique tumor genetics.
Area of Science:
- Pediatric Oncology
- Molecular Therapeutics
- Cancer Genomics
Background:
- Most childhood cancers are curable, but some patients have poor prognoses due to tumor type, biology, or relapse.
- Current cytotoxic therapies cause significant long-term side effects in pediatric cancer survivors.
- Precision oncology aims to improve outcomes for these challenging cases.
Purpose of the Study:
- To review the current landscape of precision oncology in pediatric cancer.
- To summarize active precision oncology clinical trials in North America and Europe.
- To discuss the implications of precision therapeutics for surgical and perioperative care.
Main Methods:
- Review of current literature and clinical trial data.
- Analysis of advances in sequencing technology and molecular therapeutic development.
- Synthesis of information from large-scale, multi-institutional basket trials.
Main Results:
- Pediatric precision oncology has become a mainstream approach.
- Novel molecular therapeutics show promise for targeted treatment.
- Precision medicine influences surgical decisions and patient care.
Conclusions:
- Precision oncology represents a significant advancement in treating pediatric cancers.
- Targeted therapies offer improved prognoses and reduced late effects.
- Ongoing clinical trials are expanding the reach of precision medicine in pediatric oncology.
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