Immune checkpoint inhibitors for refractory childhood cancers

• Published in: The lancet oncology 2020-01, Vol.21 (1), p.14-15
• Main Author: Widemann, Brigitte C
• Format: Article
• Language: English
• Subjects: Children; Clinical trials; Drug dosages; FDA approval; Hodgkin's lymphoma; Immune checkpoint inhibitors; Immunotherapy; Lymphoma; Medical research; Microsatellite instability; Monoclonal antibodies; Oncology; Patients; PD-L1 protein; Pembrolizumab; Regulatory approval; Solid tumors; Targeted cancer therapy; Tumors; Young adults
• ISSN: 1470-2045; 1474-5488
• DOI: 10.1016/S1470-2045(19)30777-6

[...]the clinical development of immune checkpoint inhibitors in children with refractory tumours has lagged behind that in adults, in contrast to adult tumours, few paediatric tumour types have shown objective responses to date.1 In The Lancet Oncology, Birgit Geoerger and colleagues2 report on the first early phase trial of the PD-L1 inhibitor atezolizumab for children and young adults with refractory solid tumours. Early inclusion of paediatric patients in future clinical trials of immune checkpoint inhibitors should be a priority given the overwhelmingly similar adverse profiles in adults and children and the support by the US Food and Drug Administration (FDA) to include adolescents (aged ≥12 years) in early adult trials.7 The approval by the FDA of pembrolizumab for use in children and adults with Hodgkin lymphoma or with microsatellite instability-high solid tumours8 shows the FDA's innovation and support of paediatric indications when scientifically justified and safe. Notably, Geoerger and colleagues report that two patients with Hodgkin lymphoma discontinued atezolizumab treatment and subsequently developed multi-organ failure after allogeneic stem cell transplant.