Melanoma Survivors Should Take Extra Measures to Protect Their Children from Sun

“A new study has found that children whose parents are melanoma survivors are not receiving the best possible protection from the sun and ultraviolet radiation.

“This lack of protection can lead to sunburn, increasing the risk of melanoma for the children, who already face a substantially higher risk of developing the skin cancer due to their family history.

“Melanoma is the most serious form of skin cancer as well as one of the most common. In the US, in 2014, it was estimated that 76,100 new melanomas would be diagnosed with around 9,710 people dying from the disease. According to the American Cancer Society, melanoma rates have been rising for the past 30 years.

“The authors of the study, published in Cancer Epidemiology, Biomarkers & Prevention, state that childhood is estimated to be one of the most critical exposure periods for conferring risk.”


MRD May Guide Augmented Post-Remission Treatment in Pediatric ALL

Editor’s note: In a recent study, scientists compared two different post-remission treatments for children and adolescents with acute lymphoblastic leukemia (ALL) who had only a small number of cancerous cells left in the body (minimal residual disease, MRD) after initial treatment (remission induction therapy). The scientists found that patients who received an augmented post-remission treatment, compared to the standard one, experienced better outcomes. However, these patients also had worse side effects. Ongoing clinical trials will reveal more about improved post-remission treatment and reduction of side effects.

Excerpt:

“Children and adolescents with acute lymphoblastic leukemia who had minimal residual disease at the end of remission induction therapy demonstrated improved outcomes with augmented post-remission therapy compared with standard treatment, according to study results.

“However, patients who received augmented therapy experienced higher rates of adverse events, results showed.”


Pediatric ALL Protocols Have Low Risk of Late Effects

Bone marrow from a 3-year-old ALL patient

“Long-term outcomes of patients treated for pediatric acute lymphoblastic leukemia (ALL) with modern treatment protocols are good, with an overall low risk for serious long-term side effects, according to the results of report from the Childhood Cancer Survivor Study cohort.

“ ‘This data will be useful for oncologists counseling newly diagnosed patients, and provides reassurance that the ‘devastating’ diagnosis of ALL can often have good short- and long-term outcomes,’ study author Paul C. Nathan, MD, of the Hospital for Sick Children, University of Toronto, told Cancer Network.

“With survival rates of childhood ALL at about 90%, researchers and clinicians have to focus not only on curing the disease, but on the quality of that cure and its long-term adverse effects.”

Image: “Bone marrow from a 3-year-old ALL patient”


FDA Grants Breakthrough Designation to Personalized Immunotherapy for ALL

“The FDA today granted breakthrough therapy designation for CTL019, an investigational personalized immunotherapy, for the treatment of relapsed and refractory adult and pediatric acute lymphoblastic leukemia, according to a press release issued by Penn Medicine.

“CTL019 (Novartis), developed by the University of Pennsylvania, is the first personalized cellular therapy for the treatment of cancer to receive this classification.

“In early-stage clinical trials conducted at the Hospital of the University of Pennsylvania and Children’s Hospital of Philadelphia, 89% of patients with ALL who were not responding to conventional therapies achieved complete remission after treatment with CTL019.

“ ‘Our early findings reveal tremendous promise for a desperate group of patients, many of whom have been able to return to their normal lives at school and work after receiving this new, personalized immunotherapy,’ Carl H. June, MD, director of translational research in the Abramson Cancer Center of the University of Pennsylvania. ‘Receiving the FDA’s Breakthrough Designation is an essential step in our work with Novartis to expand this therapy to patients across the world who desperately need new options to help them fight this disease.’ ”

Editor’s note: This story describes a new leukemia treatment called CTL019, which boosts a patient’s own immune system to fight cancer. CTL019 treatment is personalized for each patient, since it involves altering a patient’s immune system cells to attack tumor cells. It has been tested in volunteer patients in clinical trials, and has shown promising results for adults and children with relapsed or refractory acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has now granted breakthrough therapy designation for CTL019, meaning that review and approval will be accelerated so that the drug can more quickly reach patients outside of clinical trials.


Preventive Counseling Program Helps Children of Cancer Patients

“A cancer diagnosis affects the whole family, and a significant number of children of cancer patients may be at risk for emotional and behavioral problems. A new analysis published early online in CANCER, a peer-reviewed journal of the American Cancer Society, suggests that family dysfunction may increase a child’s risk of experiencing such problems after learning of a parent’s illness.

“Approximately 21% of all newly diagnosed cancer patients are between the ages of 25 and 54 years, and many may have dependent children living with them at home. While most children and adolescents cope well with a parent’s illness, some can become highly distressed or develop psychosocial issues. Therefore, it is important to know which factors may affect a children’s adjustment to a parent’s cancer diagnosis and to develop specific screening tools and healthcare programs for children who may go on to experience problems.”


Study Offers Evidence that Sunscreen Use in Childhood Prevents Melanoma in Adults

“Research conducted at the Texas Biomedical Research Institute, published in the latest issue of the scientific journal Pigment Cell and Melanoma, has established unequivocally in a natural animal model that the incidence of malignant melanoma in adulthood can be dramatically reduced by the consistent use of sunscreen in infancy and childhood.

“According to senior author John L. VandeBerg, Ph.D., the research was driven by the fact that, despite the increasing use of sunscreen in recent decades, the incidence of malignant melanoma, the most aggressive form of skin cancer, continues to increase dramatically. The American Cancer Society estimates that more than 75,000 new cases of melanoma will be diagnosed in the U.S. this year.”


Youth Linked to Melanoma Survival

Melanoma is rare in children and is usually treated as it is in adults. However, this skin cancer behaves differently in young people. To pinpoint the differences and their significance for survival in these patients, researchers created an international registry of children with melanoma. The registry includes 365 children between ages 1 and 21 years who were diagnosed with melanoma between 1953 and 2008. While the numbers are too small to be sure, a new analysis of this registry suggests that 10-year survival is higher in younger children: 100% for up to age 10 years versus 70% to 80% for between ages 10 and 20 years. That said, the analysis failed to identify differences in childhood and adult melanoma, prompting the researchers to call for expanding this registry as well as for more rigorous collecting of information on the melanomas.


ABCDE Method Often Misses Melanomas in Children

A common rule of thumb for diagnosing melanomas is not reliable in children. A new study evaluated the ABCDE method—asymmetry, border irregularity, color variation, diameter greater than 6 mm, evolution—in 70 children up to age 19 years who had been diagnosed with melanoma or treated for suspected melanoma. The ABCDE criteria did not apply to about 45% of them. Rather, these ‘nonstandard’ melanomas were often new, bled, bumpy, varied in diameter, and were one color or lacked pigment altogether (amelanotic). Of the 10 children who died, 7 had melanomas that lacked pigment. To diagnose melanoma in children more accurately, the researchers call for using new ABCD criteria—amelanotic; bleeding; bump; color uniformity; de novo, any diameter—in conjunction with the conventional ABCDE criteria.


Melanoma in Children is Rare—But Rising

Melanoma, which currently accounts for 3% of cancers in children, is increasing by about 2% a year amongst newborns to 19-year-olds, according to a new study in Pediatrics. The researchers studied 1,230 white children and found that the biggest jump in melanoma rates was in those aged 15 to 19 years. Girls were particularly at-risk,and were more likely to have melanomas on their lower legs and hips. Boys were more likely to have melanomas on their faces and trunks. Melanoma is also on the rise in adults and the increase in this cancer among both children and adults may be driven by exposure to ultraviolet (UV) radiation from the sun or tanning beds. Doctors recommend frequent application of sunscreen that blocks both UV A and UV B rays and urge parents to watch for new or changing moles on their children.