Rare cancers, a survival rate of over 801 per 100,000 in France and great therapeutic progress but still some failures: five things to know about pediatric cancers, at the center of the "Golden September" mobilization month, which is celebrating its tenth anniversary.
Rare cancers, with very poorly understood causes
Rare but often aggressive, pediatric cancer accounts for 1 to 21 per 1,000,000 cancers in developed countries. In France, some 2,300 cases are diagnosed each year, representing approximately 0.61 per 1,000,000 cancers across all age groups., reports the National Cancer Institute (INCa).
Those under 17 are primarily affected by leukemias (26%), central nervous system tumors (25%) and lymphomas (15%), which have different characteristics, symptoms, treatments and chances of recovery from adult cancers.
While "the vast majority of these cancers are not of genetic origin,"« That's always the first question parents ask us: could mom or dad have passed it on?«,« Dr. Anne-Sophie Defachelles, a pediatric oncologist and head of department at the Oscar Lambret Center in Lille, told AFP. “Evidence is still lacking,” she said, “regarding the potential impact of environmental exposure (pesticides, etc.),” which« raises a great many studies and questions“.
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80% survival rate… in rich countries
Over the period 2000-2016, the five-year survival rate of sick children up to age 15 increased from 81% to 85% in France, a positive trend observed in wealthy countries for most cancers, particularly leukemias and brain tumors.
But some pediatric cancers still have a poor prognosis – central nervous system tumors in infants under one year old, gliomas in older children. And cancer remains the leading cause of death from disease in children over one year old.
In low- and middle-income countries, the survival rate often remains below 30%, indicates the World Health Organization, which launched a program in 2025 for free deliveries of medicines.
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Significant progress in treatments
The considerable progress of recent decades now makes it possible to cure 4 out of 5 children in France, depending on the type and extent of cancer at diagnosis: increasingly effective chemotherapies, care involving different specialists, treatments harmonized at the national and international level.
Dr. Defachelles coordinates the Interregional Pediatric Oncology Network, which covers the Northwest region, including the university hospitals of Lille, Rouen, Amiens, etc., and is part of the European consortium ITCC (Innovative Therapies for Children with Cancer), along with colleagues from all over France, which allows access to "« therapeutic approaches that offer the best chance of recovery based on the most recent international knowledge«" she specifies.
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September in gold
Launched in 2012 in the United States and in 2016 in France, "September in Gold" mobilizes the general public, helping to finance research, access to innovative therapies, and long-term follow-up of cured children.
Among them are studies from the Gustave Roussy Institute on pediatric gliomas: a gene mutation that influences patient survival time, a protein that allows tumor cells to survive, an innovative therapy using AI…
Two therapeutic approaches are promising: immunotherapy – less effective than in adults – which the Curie Institute is working on in particular, in the face of Ewing sarcoma, a rare form of bone cancer that affects 80 to 100 children per year.
And cell therapies such as CAR cells, genetically modified to attack tumor cells in certain blood cancers: the challenge is to use them to fight solid tumors.
Another challenge: adapting many anticancer drugs developed for adults (difficulty swallowing, dosages, etc.).
Long-term monitoring
Thanks to advances, the population of adults cured of childhood cancer is increasing. These individuals require long-term clinical follow-up: Gustave Roussy has therefore developed the personalized prevention program "Interception".
“ We know that these adults, 30 years later, have psychological and physical after-effects that require specialized care, which general practitioners are not used to.«", summarizes Dr. Defachelles.
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