Abstract

In Japan, 2000-2500 pediatric patients are newly diagnosed as malignancies per year. About half of them are hematological malignancies and the other half are solid tumors. Chemotherapy for pediatric solid tumors is variedaccording to the type of malignancies. High-risk neuroblastoma is the most challenging pediatric malignancy, whose over-all survival remains around 40% despite of the progress of multidisciplinary therapies, including high-dose chemotherapy and radiotherapy. Induction chemotherapy for high-risk neuroblastomaconsist of five to six chemotherapeutic agents. Compared with neuroblastoma, chemotherapy for hepatoblastoma is concentrated to platinum-containing anti-cancer drugsand anthracycline. In SIOPEL 4 study, weekly CDDP plus DOX has the excellent outcome for high-risk hepatoblastoma. At the end of therapy, 79% of high-risk hepatoblastoma patients were in complete remission. For rhabdomyosarcoma, VAC (VCR+ActD+CY) regimen is still the most powerful chemotherapeutic combination. Treatment using VAC regimen for stage II/III, group II/III alveolar rhabdomyosarcoma revealed superior to VAC/VTC arm (EFS 68% vs. 52%, respectively) in IRS IV trial. Molecularly targeted therapy would be one of the promising modality of the therapy for pediatric solid tumors. For example, Bevacizumab, a humanized monoclonal antibody for VEGF, is approved for colorectal cancer, breast cancer and glioblastoma. Cetuximab is a chimeric antibody that inhibit epidermal growth factor receptor (EGFR) and might be a therapeutic reagent for rhabdomyosarcoma.