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    Some Childhood Cancers Are Still Killers

    Better funding is vital to improve treatments, experts say

    continued...

    Overall, the five-year survival rate from all childhood cancers combined has risen from around 60 percent in the mid-1970s to more than 80 percent in more recent years, according to the cancer institute.

    Downing said, however, that cancer still kills more kids under age 15 than any other disease. And certain types remain stubbornly resistant to everything doctors have thrown at them.

    "There's a subset of cancers where we just have not made progress," Maris said.

    One example is a tumor of the brain stem called pontine glioma -- a "terrible disease," Downing said, that usually kills within a year.

    Another example is neuroblastoma, a cancer of the nerve tissue in various parts of the body that usually arises before age 5. Many more kids survive the disease than in years past, but the chances depend in part on the child's age.

    Infants have a high cure rate, with about 90 percent alive five years later; that dips to 68 percent among children diagnosed between the ages of 1 and 4, according to the cancer institute.

    The biology of a child's neuroblastoma is also key. "We used to think all neuroblastomas were the same," Maris said. "They're not."

    Maris and his colleagues found that mutations in a gene called ALK are behind a rare form of neuroblastoma that runs in families.

    An oral cancer drug -- already tested and approved for certain cases of lung cancer in adults -- targets ALK. In early trials, the drug, called crizotinib, led to remission in kids with the rare form of neuroblastoma and children with an uncommon, aggressive type of lymphoma.

    At St. Jude, Downing and his colleagues have been working on a project to "decode" the genomes of more than 600 children with cancer in an attempt to gain a better understanding of the genetic origins of various tumors. They've found specific gene mutations in certain gliomas, neuroblastomas and rare subtypes of leukemia that they hope will someday lead to better treatments.

    But even with highly curable cancers, such as ALL, safer treatments are needed. The chemotherapy, radiation and other therapies used to battle kids' cancer can have unfortunate side effects years later -- including other cancers and heart and lung damage.

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