India emerging as key centre for clinical trials for paediatric cancer drugs

India is fast emerging as a hub for paediatric oncology drug trials. Currently, major hospitals like All India Institute of Medical Science (AIIMS), Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Gujarat Cancer and Research Institute, Ahmedabad are carrying out studies on paediatric cancer cases. Childhood cancers are malignant diseases that affect children under the age of 18 years. Two-thirds of children with cancer are cured. Despite enormous progress in the treatment of childhood cancer, it is the second-most common fatality in children older than one year, with accidents being the first. But the big consolation for paediatric oncologists is that parents are agreeable for the clinical trials as it would provide the much-needed access to drugs and relief, Dr JB Sharma, Hon. senior consultant, department of medical oncology, Action Cancer Hospital, New Delhi told Pharmabiz. It is the Monoclonal antibodies(MABs) like Rituximab, oral targeted therapy like Imatinib and other newer drugs which are being used in clinical trials to improve the survival and quality of life. Both multinational and Indian pharma majors are engaged in the clinical trials for paediatric cancers. Childhood cancer is often more aggressive than adult cancers. It grows faster and is frequently metastatic when diagnosed. Thus, surgery alone is less likely to cure a child. Nevertheless, the cancers children develop tend to be more responsive to chemotherapy and radiation than those of adults. The treatment of paediatric cancer patients is highly specialized. In India, the children diagnosed of the dreaded disease are treated mostly by panel of medical oncologists and at specialized tertiary centre by paediatric oncologist. Although the current incidence of paediatric cancers is less than five percent, oncologists are faced with the challenge of late diagnosis as the child comes only after several references and treatments. Although a typical presentation is persistent fever, lymphadenopathy, abdominal distention, vomiting and headache, eye reflex and weakness, there is usually lack of suspicion for a general paediatrician to diagnose cancer. Therefore, the child comes in to a cancer centre in an advanced stage of the disease. The reason for this is the financial burden of the families and the manifestation of late side effects after treatment, stated Dr Sharma. The treatment of childhood cancer depends on the specific disease, tissues are affected, and the extent of its spread at the time of diagnosis. Acute lymphocytic leukaemia (ALL) is the most common form of cancer in children, occurring about three times as often as acute myelocytic leukaemia (AML). Leukaemia of either type causes symptoms such as fevers, pallor, fatigue, bleeding or bruising, swollen glands, and bone pain—which can manifest itself as a limp or refusal to walk. The diagnosis is made based on blood tests and bone marrow studies.