Innovations in Cancer Treatment of Children

Humanin alone and in combination with GnRHa therapy attenuates ovarian dysfunction induced by prepubertal cyclophosphamide chemotherapy in female mice

Prepubertal chemotherapy induced ovarian damage poses a significant threat to female fertility, particularly following cyclophosphamide (CP) treatment. Humanin (HNG), a small molecule polypeptide encoded by mitochondrial DNA, has a variety of effects, this study aimed to investigate the protective effects of HNG and its combination with conventional Gonadotropin Releasing Hormone Agonist (GnRHa) on ovarian function in a CP-induced damage model. The 21-day-old C57BL/6 J female mice were randomly assigned to six groups: Control, CP model, HNG, HNG+CP, GnRHa+CP, and HNG+GnRHa+CP. Reproductive related parameters were assessed through histopathological examination, follicle counts, serum sex hormone levels, estrous cycle monitoring, and oxidative stress evaluation. Results indicated that CP treatment led to significant reproductive dysfunction especially ovarian dysfunction, evidenced by reduced follicles, hormonal imbalances, prolonged estrous cycles, reduced body weight, and diminished ovarian and uterine weights, alongside pathological alterations. Notably, HNG treatment, both alone and in conjunction with GnRHa, significantly mitigated these adverse effects, however the combination did not provide additional benefits over HNG alone regarding follicles preservation and antioxidant capacity. Transcriptomic analysis revealed significant enrichment in inflammation and immune response pathways following HNG treatment. In conclusion, HNG demonstrates potential as a therapeutic agent to protect against CP-induced ovarian damage, offering insights for future strategies aimed at preserving female fertility during chemotherapy.

The childhood cancer data initiative: enabling data sharing to drive research advances and transform pediatric cancer diagnosis and treatment

PURPOSE OF REVIEW

With growing emphasis on data-driven research in pediatric oncology, particularly in the context of advances in molecular characterization and precision medicine, there is an urgent need for comprehensive data-sharing initiatives. This review explores how the Childhood Cancer Data Initiative (CCDI) addresses this critical need.

RECENT FINDINGS

CCDI plays a key role in enhancing pediatric cancer research by improving data integration, sharing, and collaboration. Its Molecular Characterization Initiative advances the field by leveraging detailed molecular data to inform clinical trials and therapeutic strategies. For small patient populations, such as those with rhabdomyosarcoma, CCDI's efforts in integrating data across institutions are vital for advancing risk-based treatment strategies to achieve meaningful clinical outcomes.

SUMMARY

CCDI's advancements in data sharing have profound implications for both clinical practice and research. By enabling precise diagnoses, tailoring treatments based on individual genetic profiles, and addressing the challenges associated with small patient populations, CCDI is driving transformative changes in pediatric oncology. Continued support and expansion of such initiatives are crucial to fully realizing their potential in improving outcomes for children with cancer.

The Prevalence of Cancer Predisposition Syndromes (CPSs) in Children with a Neoplasm: A Cohort Study in a Central and Eastern European Population

IMPORTANCE

The etiology of pediatric cancers is often unclear; however, advancements in genetics have identified significant roles for genetic disorders in their development. Over time, the number of cancer predisposition syndromes (CPSs) and awareness of them have increased, providing the possibility of cancer prevention and early detection.

PURPOSE

In this study, we present data concerning the number and type of oncological cases and their correlation with CPS occurrence in a cohort of Central and Eastern European pediatric patients.

MATERIALS

The data were collected between 2000 and 2019 at the Karol Jonscher Clinical Hospital of Poznan University of Medical Sciences, resulting in a cohort of 2190 cases in total, of which 193 children (8.81%) were confirmed to have a CPS.

RESULTS

CPSs occurred most frequently in infancy (22.90% of all children suffering from any diagnosed cancer during the first year of life; p < 0.0001), accounting for more than one-quarter of all CPS cases in our cohort. CPSs were least likely to be observed in patients aged 14 and 15 years (2.17% and 2.44% of children diagnosed with any of the listed cancers at the exact age, respectively; p < 0.05). Among CPSs, the most common were neurofibromatosis type I (NF1), Li-Fraumeni syndrome (LFS), and Down syndrome (DS).

CONCLUSIONS

To conclude, it is important to emphasize the need for personalized treatment for each patient affected by both CPSs and subsequent cancer in order to reduce the toxicity of therapy and improve quality of life by reducing the risk of side effects.

Expression of Growth Hormone-Releasing Hormone and Its Receptor Splice Variants in a Cohort of Hungarian Pediatric Patients with Hematological and Oncological Disorders: A Pilot Study

Hematological and oncological diseases are still among the leading causes of childhood mortality. Expression of growth hormone-releasing hormone (GHRH) and its receptors (GHRH-R) has been previously demonstrated in various human tumors, but very limited findings are available about the presence and potential function of GHRH-Rs in oncological and hematological disorders of children. In this study, we aimed to investigate the expression of mRNA for GHRH and splice variant 1 (SV) of GHRH-R in 15 pediatric hematological/oncological specimens by RT-PCR. The presence and binding characteristics of GHRH-R protein were also studied by Western blot and ligand competition assays. Of the fifteen specimens studied, eleven pediatric samples (73%) showed the expression of mRNA for GHRH. These eleven samples also expressed mRNA for GHRH receptor SV1. GHRH-R protein was found to be expressed in two benign tumor samples and five malignant tumors examined by Western blot. The presence of specific, high affinity binding sites on GHRH-R was demonstrated in all of the seven human pediatric solid tumor samples investigated. Our results show that the expression of GHRH and SV1 of GHRH-R in hemato-oncological diseases in children can pave the way for further investigation of GHRH-Rs as potential molecular targets for diagnosis and therapy.

Efficiency of the Technology-Based "HomeCARE-Family EmPow" for Children with Cancer and Their Parents: A Study Protocol for a Randomized Controlled Trial

OBJECTIVES

Home-based pediatric cancer care requires addressing both physical and psychosocial care needs for children and their parents Currently, there is a notable gap in intervention programs that evaluate technology-based psychosocial empowerment for children and parents in home-based pediatric cancer care. The study protocol was to assess the efficiency of a technology-based psychosocial empowerment intervention for home-based care for children with cancer and their parents.

METHODS

This study was planned as a single-blinded parallel-group randomized controlled experimental design. The study was intended to include 64 children and parents in the research sample. The HomeCare-Family EmPow is a technology-based intervention based on the Psychological Empowerment Theory. This 4-week program, delivered via the website, consists of four modules for parents and two for children. The descriptive form, Self-Efficacy Scale- for children and adolescents with cancer, State-Trait Anxiety Inventory, and Pediatric Cancer Coping Scale will be used in the data collection for children. The descriptive form, Self-Efficacy Scale, Problem-Solving Inventory, and Psychological Resilience Scale will be used for parents. Repeated measures analysis of variance and linear mixed-effects models will be applied for intragroup and intergroup comparisons. Outcome measures will be assessed before randomization, 1 week after the intervention, and 1 month after.

RESULTS

The possible differences between the intervention and control groups will be evaluated after the implementation of the intervention. Our proposed hypotheses will report the findings.

CONCLUSIONS

This research may provide a more comprehensive and evidence-based approach to pediatric cancer management at home-based pediatric cancer management by improving children's and parents' self-efficacy and coping by providing feasible, accessible, and innovative support.

IMPLICATIONS FOR NURSING PRACTICE

The study outcomes are expected to enrich the understanding and management of the psychosocial well-being of children and their parents and empower them to cope with the treatment process more effectively during home-based care.