Pediatric Oncology, Solid tumors of childhood and adolescence and lymphomas

Programme description

For over 50 years this Pediatrics Unit has dealt with children, adolescents and young adults suffering from solid tumors of the pediatric age. The Pediatric Oncology unit of INT conducts clinical and research projects on typical solid cancers of pediatric and adolescence age, and represents a referral center for all the country. Most members belong to a vast network of scientific societies in an international background that is at the origin of the majority of academic trials here driven. Many of those are here nationally and/or internationally coordinated. Over 75% patients are treated within clinical controlled trials also including phase 1 and 2 with new drugs. Patient management is based on a true multidisciplinary approach that includes diagnosis (with specific dedicated histological and imaging expertise), treatment (including interdisciplinary activity with the pediatric surgical unit and the pediatric radiotherapy unit, a Bone Marrow Transplantation Jacie approved program and a team dedicated to phase 1-2 therapy in patients with relapsing/refractory solid tumors). Psychosocial support both for kids and parents is provided since diagnosis and during all treatment and follow-up as well as long term survivors program (for the follow-up of iatrogenic sequelae and social re-entry). Counseling and genetic testing are ad hoc provided and will be implemented. Scholastic career is daily followed with dedicated teachers of public school of any grade from nursery to secondary school end with tailored programs both in and out of the hospital.  During 2018, over 250 new patients/year were diagnosed and treated. The Structure, also in the next few years, will continue to promote research aimed at integrating increased survival and quality of life improvement through multi-center, national and European cooperative studies, with the collection of fresh tissue to better outline the treatment and prognosis and for the construction of academic tissue banks. The main objectives of these studies are to increase knowledge about the natural history of pathologies and their biological characteristics; the identification of new therapeutic targets; the development of new drugs for patients with resistant or progressive disease. The Structure will also continue to promote translational research in order to study the heterogeneity of pediatric tumors, define its carcinogenic and progression mechanisms and identify prognostic and predictive factors through the most innovative genomic techniques and the definition of adequate and representative animal models of the tumor of origin on which to evaluate the efficacy of new drugs. Pediatrics is part of the Pediatric Rare Tumours Network (pediatric network on rare pediatric tumors: incidence <2 / 1,000,000) and will work to define models for the management and study of extra rare pediatric tumors. Moreover, the peculiar location of this Unit within the Fondazione IRCCS Istituto Nazionale dei Tumori, an oncology reference center, has favored the development of a special attention to adolescent and young adult patients with the creation of a project dedicated to patients in this age range, the Youth Project. The structure will continue to work, through this project, expanding collaboration also to population cancer registries, with the aim of:

1. optimize patient access to clinical protocols and special services,
2. provide models to create spaces and initiatives dedicated exclusively to patients in this age group,
3. assess the impact of the treatment and quality center of treatment on the prognosis of adolescents and young adults with cancer.

Finally, children, adolescents and young adults who recover from cancer have a greater risk than peers to report health problems even years after recovery. There is no complete information on how much they are at risk, why and how to avoid these health problems thus we are involved in the PanCare project, Childhood and Adolescent Cancer Survivor Care and Follow-up Studies.