Pediatric Cancer Genetics and Genomics

Molecular profiling of DNA and RNA from pediatric cancers by next-generation sequencing has been demonstrated to improve diagnosis and prognosis and to identify somatic alterations indicating vulnerability to targeted therapies. Hence, much like in the treatment of adult cancers, molecular profiling is now routinely utilized in clinical workflows for pediatric cancers as a companion to conventional pathology diagnosis. Many variants of unknown significance identified through DNA profiling are being characterized by saturation genome editing, enabled by CRISPR editing technology and clever functional assays. Newer technologies and analytics are revealing additional structural complexity around cancer drivers and gene fusions in pediatric cancer DNA. Similarly, computational methods such as rare variant association studies and polygenic risk scoring are being used to identify novel cancer susceptibility. Together, these advances are expanding our understanding of pediatric cancer's complexity and fueling the development of emerging methods such as liquid biopsy-based monitoring.