No Child Left Behind

Childhood cancer garners sympathy from all, but drug development from few.

Roche, the maker of one experimental IGF-1 inhibitor, says it plans to include children early in the testing process. Catherine Wheeler, MD, the company’s medical director for science, says in her industry career, “it’s gone from a situation in which it was considered not ethical to be doing investigations in children to more ethical to do investigations first.”

If industry is treading cautiously, it is because pediatrics has a slate of considerations beyond market forces, she says. Babies to teenagers fall under the heading of children, which affects dose and formulations. Also, since the treatment comes at the beginning of a hopefully lengthy life, the distant side effects, including infertility, cardiac problems, and second cancers, are of particular concern.

Nonetheless, Dr. Wheeler says, “there’s clearly an interest on the part of regulators in getting more [drug] development in children.”

Since the effectiveness of IGF-1 inhibitors is still unclear, and the experimental trial is closed for now, Callie’s family decided to try an alternate chemotherapy. Yet before the second round of chemo began, Callie asked her doctors to postpone treatment long enough for her to play in a weekend tennis tournament. The cancer would have to wait. At 17, she simply has too much life to live first.

Talk about this article with other patients, caregivers, and advocates in the Childhood Cancers CURE discussion group.
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