Children’s cancer is different. The methods and medicines used to treat adults are not directly transferrable and there are no obvious behavioural preventions like giving up smoking or staying out of the sun. By definition, all childhood cancers are rare cancers, making up less than one per cent of the total number of new cancer diagnoses in Australia each year.
This difference also extends to research. Paediatric oncology is one of the very few areas in which clinical research is seamlessly integrated with clinical care and no other field has a higher level of patient enrolment in clinical trials. This has led to huge improvements in treatment, but to make further advances there are some hurdles to overcome – outside the lab.
The first is the rarity of childhood cancer, which means international collaborations are absolutely essential. This has its own knock-on effect, though, in that it is difficult to secure competitive grant funding when the principal investigators are based overseas. Clinical trials are expensive, and that cost isn’t included in hospital operating budgets. The money doesn’t generally come from pharmaceutical industry sponsors either, because the rarity of children’s cancer means there isn’t much economic incentive for them to do so.
The second major issue is also related to this situation. It can be difficult for clinicians to gain access to targeted drugs and other therapeutic agents. In some cases this is because of complex distribution rights, and in others it is a question of regulatory bureaucracy that makes it less attractive for biopharmaceutical companies to take part in a paediatric trial.
ANZCHOG continues to support government initiatives and legislative change to improve this situation, for the benefit of children and adolescents with cancer in Australia, New Zealand and across the world.