Annual Report 2020
Department of Pediatric Oncology
Toru Mukohara, Ako Hosono
Introduction
The Department of Pediatric Oncology was established in December 2011 to treat a wide variety of childhood cancers, including embryonal tumors such as neuroblastoma, nephroblastoma, hepatoblastoma, and mesenchymal tumors such as Ewing's sarcoma, rhabdomyosarcoma and osteosarcoma. It usually occurs in children under the age of 15, but occasionally in adolescents and young adults (AYAs). Most childhood cancers are highly sensitive to chemotherapy and radiotherapy. If the intensity of multidisciplinary treatment is well balanced with the characteristics of the disease, there is a chance of cure. However, some cases are refractory and require new treatments other than standard chemotherapy. In addition, long-term survivors of childhood cancer often suffer from complications secondary to chemotherapy and radiotherapy.
The Team and What We Do
The pediatric outpatient clinic is open every Wednesday and provides treatment for newly diagnosed patients and patients who have received outpatient chemotherapy, as well as follow-up treatment for patients who have completed an intensive care course. AYA generation cancer patients are treated jointly with the oncology outpatient clinic every Monday and Friday. The care of children undergoing palliative treatment is also provided together with the Palliative Care and Psycho-Oncology Group. Daily ward rounds and conferences are held every morning jointly with the oncology department. Sarcoma conferences are held every other Tuesday. The cases of all patients undergoing proton radiotherapy are always discussed in a conference involving the radiotherapy department, nurses and technicians.
Research activities
Our projects include treatment development using relatively new off-label drugs as well as experimental agents. One of the objectives of the following trials is gathering data on and assessing the safety and efficacy date of such off-label drugs and eventually getting them approved by the Ministry of Health, Labour and Welfare.
Clinical trials
Three clinical trials described below are currently active.
1) Phase II study of vincristine, actinomycin-D, cyclophosphamide and irinotecan for patients with newly diagnosed intermediate rhabdomyosarcoma. (Phase II study of VAC2.2/VI therapy for patients with newly diagnosed intermediate rhabdomyosarcoma.)
2) JCOG0905: A Phase III Study Comparing Methotrexate, Adriamycin and Cisplatin (MAP) with MAP + Ifosfamide (MAP + IF) for the Treatment of Osteosarcoma (OS-MAP + IF-P3)
3) A Phase 2 Trial of Multimodal Treatment based on VDC-IE with Interval Compressed Schedule by using G-CSF for Patients with Non-metastatic Ewing Sarcoma Family Tumor (JESS14)
Future Prospects
There are three major missions in the Department of Pediatric Oncology of the National Cancer Center Hospital East (NCCHE) as follows.
1) To provide a state-of-the-art treatment for AYA patients in collaboration with the Medical Oncology group
2) To develop new treatments for pediatric cancer by sharing agents and knowledge with the Clinical Development Center
3) To provide less toxic proton-beam radiation therapy as one of the three proton centers for children in Japan
All three activities are currently in process and several projects have already started.
List of papers published in 2020
Journal
1. Hasegawa Y, Matsubara N, Kogawa T, Naito Y, Harano K, Hosono A, Onishi T, Hojo T, Shimokawa M, Mukohara T. Neo-Bioscore in Guiding Post-surgical Therapy in Patients With Triple-negative Breast Cancer Who Received Neoadjuvant Chemotherapy. In Vivo, 35:1041-1049, 2021
2. Umeda K, Miyamura T, Yamada K, Sano H, Hosono A, Sumi M, Okita H, Kamio T, Maeda N, Fujisaki H, Jyoko R, Watanabe A, Hosoya Y, Hasegawa D, Takenaka S, Nakagawa S, Chin M, Ozaki T. Prognostic and therapeutic factors influencing the clinical outcome of metastatic Ewing sarcoma family of tumors: A retrospective report from the Japan Ewing Sarcoma Study Group. Pediatr Blood Cancer, 68:e28844, 2021
3. Mukohara T, Hosono A, Mimaki S, Nakayama A, Kusuhara S, Funasaka C, Nakao T, Fukasawa Y, Kondoh C, Harano K, Naito Y, Matsubara N, Tsuchihara K, Kuwata T. Effects of Ado-Trastuzumab Emtansine and Fam-Trastuzumab Deruxtecan on Metastatic Breast Cancer Harboring HER2 Amplification and the L755S Mutation. Oncologist, 2021
4. Umeda K, Miyamura T, Yamada K, Sano H, Hosono A, Sumi M, Okita H, Kumamoto T, Kawai A, Hirayama J, Jyoko R, Sawada A, Nakayama H, Hosoya Y, Maeda N, Yamamoto N, Imai C, Hasegawa D, Chin M, Ozaki T. Clinical outcome of patients with recurrent or refractory localized Ewing's sarcoma family of tumors: A retrospective report from the Japan Ewing Sarcoma Study Group. Cancer Rep (Hoboken), e1329, 2021
5. Chin M, Yokoyama R, Sumi M, Okita H, Kawai A, Hosono A, Koga Y, Sano H, Watanabe H, Ozaki T, Mugishima H. Multimodal treatment including standard chemotherapy with vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide for the Ewing sarcoma family of tumors in Japan: Results of the Japan Ewing Sarcoma Study 04. Pediatr Blood Cancer, 67:e28194, 2020
6. Fujimoto Y, Morita TY, Ohashi A, Haeno H, Hakozaki Y, Fujii M, Kashima Y, Kobayashi SS, Mukohara T. Combination treatment with a PI3K/Akt/mTOR pathway inhibitor overcomes resistance to anti-HER2 therapy in PIK3CA-mutant HER2-positive breast cancer cells. Sci Rep, 10:21762, 2020
7. Saito T, Makiura D, Inoue J, Doi H, Yakushijin K, Okamura A, Matsuoka H, Mukohara T, Saura R, Sakai Y, Ono R. Comparison between quantitative and subjective assessments of chemotherapy-induced peripheral neuropathy in cancer patients: A prospective cohort study. Phys Ther Res, 23:166-171, 2020
8. Sasaki A, Harano K, Kogawa T, Matsubara N, Naito Y, Hosono A, Mukai H, Yoshino T, Mukohara T. Intestinal Perforation due to Neutropenic Enterocolitis in a Patient Treated with Bevacizumab for Ovarian Cancer. Case Rep Oncol Med, 2020:7231358, 2020
9. Shingaki S, Kogawa T, Shimokawa M, Harano K, Naito Y, Kusuhara S, Fujimoto Y, Matsubara N, Hosono A, Mukai H, Onishi T, Hojo T, Mukohara T. Use of eribulin as an earlier-line chemotherapy for patients with HER2-negative metastatic breast cancer. J Cancer, 11:4099-4105, 2020