A parent ’s guide to clinical trials

Children with life-threatening conditions, such as cancer, are often candidates for clinical trials. What are they? Which factors should parents weigh in determining whether enrolling in one is a good option for their child? Dr. Steven DuBois, director of the Advancing Childhood Cancer Therapies Clinic at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, answers questions about clinical trials. What are clinical trials? Why are they important? Clinical trials are systematic, scientific investigations of new drugs or therapies for a specific disease. Through clinical trials, we have taken many fatal pediatric cancers and turned them into diseases that now have cure rates of over 90 percent. Although we still want to improve those cure rates, research is now increasingly focused on making treatments more tolerable and reducing late effects of therapy. In other pediatric cancers, we are not doing as well, so our goal is to improve cure rates for patients with a poor prognosis. After decades of focusing on various chemotherapy agents and combinations to improve outcomes, much of today’s  focus is on precision medicine, immunotherapies and other novel approaches that we hope will deliver less toxic and more effective treatment than chemotherapy. What is a Phase 1 trial? Phase 2? Phase 3? When we hear about a new drug or combination that has not yet been tested in children but shows promise in laboratory research or adult trials, we must first determ...
Source: Thrive, Children's Hospital Boston - Category: Pediatrics Authors: Tags: Ask the Expert Research and Innovation clinical trial Dana-Farber/Boston Children's Cancer and Blood Disorders Center Dr. Steven DuBois Source Type: news

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Correspondence: Osteonecrosis in childhood acute lymphoblastic leukemia: a retrospective cohort study of the Italian Association of Pediatric Haemato-Oncology (AIEOP), Published online: 15 November 2018; doi:10.1038/s41408-018-0150-zCorrespondence: Osteonecrosis in childhood acute lymphoblastic leukemia: a retrospective cohort study of the Italian Association of Pediatric Haemato-Oncology (AIEOP)
Source: Blood Cancer Journal - Category: Hematology Authors: Source Type: research
Authors: Jeremias I, Schewe DM Abstract Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Early response to therapy, especially the measurement of minimal residual disease (MRD), remains the most reliable and strongest independent prognostic parameter. Intriguingly, little is known on the mechanisms sustaining MRD in that disease. Here, we summarize existing evidence on the influences of molecular genetics and clonal architecture of childhood ALL on disease persistence. Also, the impact of the leukemic niche on residual leukemia cells in the bone marrow and extramedullary compartments is revie...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Something as simple as a change in diet can potentially help to increase the cancer survival rate of obese children with acute lymphoblastic leukemia, the most common childhood cancer, according to a new study by UCLA scientists.The research team, led by Dr. Steven Mittelman, chief of pediatric endocrinology at  UCLA Mattel Children ’s Hospital and member of the  UCLA Jonsson Comprehensive Cancer Center, administered the chemotherapy drug vincristine to obese and non-obese mice with leukemia. Researchers discovered that if they switched the obese mice from a high-fat to a low-fat diet immediately befor...
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Genes, Chromosomes and Cancer,Volume 0, Issue ja, -Not available-.
Source: Genes, Chromosomes and Cancer - Category: Cancer & Oncology Authors: Source Type: research
(University of California - Los Angeles Health Sciences) Something as simple as a change in diet can potentially help to increase the cancer survival rate of obese children with acute lymphoblastic leukemia, the most common childhood cancer, according to a new study by UCLA scientists.
Source: EurekAlert! - Cancer - Category: Cancer & Oncology Source Type: news
We present the P-glycoprotein (P-gp) activity in 2 patients with different outcomes. Both patients had B-cell acute lymphoblastic leukemia; they were responding properly to the treatment, but one of them had an increment in the P-gp activity that correlates with an increment in the disease manifestation, the patient had to be hospitalized and developed sepsis and subsequently died. P-gp levels were correlated with disease progression. P-gp activity needs to be evaluated during treatment to assess and prevent disease relapse or the patient´s death.
Source: Journal of Pediatric Hematology Oncology - Category: Hematology Tags: Online Articles: Original Articles Source Type: research
AbstractPurposeMethotrexate polyglutamates (MTXpg) facilitate incorporation of thioguanine nucleotides into DNA (DNA-TG, the primary cytotoxic thiopurine metabolite and outcome determinant in MTX/6-mercaptopurine treatment of childhood ALL). We hypothesized that mapping erythrocyte levels of MTXpg with 1 –6 glutamates and their associations with DNA-TG formation would facilitate future guidelines for maintenance therapy dosing.Methods and resultsSummed MTX with 1 –6 glutamates resolved by LCMS [median (interquartile): 5.47 (3.58–7.69) nmol/mmol hemoglobin] was in agreement with total MTX by radio ligand a...
Source: Cancer Chemotherapy and Pharmacology - Category: Cancer & Oncology Source Type: research
Cancer, EarlyView.
Source: Cancer - Category: Cancer & Oncology Authors: Source Type: research
CONCLUSION: Subpopulations with nonclonal chromosomal aberrations were present in peripheral blood leukocytes of our cohort of childhood leukemia long-term survivors. PMID: 30273079 [PubMed - as supplied by publisher]
Source: Fetal and Pediatric Pathology - Category: Pathology Tags: Fetal Pediatr Pathol Source Type: research
Conclusion: From our preliminary data, the CT genotype of C3435T is associated with a poor ALL outcome while the CC genotype of C1236T is related with an increased incidence of relapse. Although our results provide assistance for oncologist choice of individual therapeutic strategy taking the patient genetic repertoire into consideration, further investigations with larger sample size should be conducted to validate our results. PMID: 30256048 [PubMed - in process]
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
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