Pediatric Sarcoma Improved Management, New Targeted Therapies Elevate Outlook for Pediatric Sarcomas Pediatric sarcomas are among the most challenging of childhood cancers, with five-year survival-rate estimates ranging from 59.2 percent to 68.5 percent. However, oncologists are optimistic that survival can be improved through a growing understanding of the biology of the disease and the use of targeted therapies. Already, significant gains have been made to enhance the care and quality of life of pediatric sarcoma patients through specialized services aimed at addressing all of a child’s needs. STORY HIGHLIGHTS Oncologists are optimistic that survival for patients with sarcomas can be improved through a growing understanding of the biology of the disease and the use of targeted therapies. Patients with sarcomas typically require multimodal therapy, including aggressive chemotherapy, high-dose radiation and surgery. “We see a group of much more aggressive types of sarcoma — metastatic disease, recurrent disease or refractory disease,” says Noah Federman, MD, associate clinical professor of pediatrics and director of UCLA’s Pediatric Bone & Soft Tissue Sarcoma Center. “We have a large population of those patients because we are a referral center.” Pediatric soft-tissue sarcomas are a heterogenous group of malignant tumors that originate from primitive mesenchymal tissue. Sarcomas are diagnosed in about 1,600 U.S. children each year. At UCLA, the pediatric sarcoma center, which is part of UCLA’s Jonsson Comprehensive Cancer Center, was established within the long-standing adult program to focus on the particular issues related to children. Patients with sarcomas typically require multimodal therapy, including aggressive chemotherapy, high-dose radiation and surgery. To coordinate a multi-pronged and individualized treatment approach, each case is reviewed by a team, including physicians from pediatric oncology, medical oncology, orthopaedic oncology, surgical oncology, pediatric surgery, musculoskeletal radiology, radiation oncology and musculoskeletal pathology, as well as specialists in nursing, social work, psychology, physical therapy and nutrition. “At UCLA we understand the need for a devoted pediatric sarcoma program,” explains Dr. Federman, UCLAHEALTH.ORG 1-800-UCLA-888 (1-800-825-2888) A deeper understanding of pediatric sarcoma has ushered in a new era of targeted medications aimed at addressing the underpinnings of the disease, Dr. Federman says. who has joint appointments to the departments of pediatrics and orthopaedics. “Most of the sarcomas tend to predominate in the adolescent or young-adult years. These cases are very different from small children and very different from older adults. That’s what this program is about. It’s about state-of-the-art multidisciplinary care and, at the same time, state-of-the-art psychosocial care of these patients.” An overarching philosophy of the pediatric oncology-hematology division at UCLA is to provide treatment while lessening the burden of illness, pain and disability on children and adolescents. The UCLA Daltrey/Townshend Teen & Young Adult Cancer Program — an extension of Teenage Cancer Trust, a charity dedicated to improving the lives of young people with cancer — is designed to meet the special needs of patients ages 13 to 25. UCLA’s Children’s Pain and Comfort Care Program aims to alleviate pain and other causes of distress for children and adolescents with complex illnesses and to offer support to family members. Moreover, the Pediatric Long-term Follow-up Clinic at Mattel Children’s Hospital UCLA was created to address the medical and quality-of-life issues of childhood-cancer survivors through a comprehensive health evaluation, psychosocial assessment and targeted specialty referrals.