Why Some Childhood Cancers Lack a Standard Treatment Path

Childhood cancer treatment is complex, particularly when it comes to rare childhood cancers. Common cancers such as Acute Lymphoblastic Leukemia (ALL) follow well-established and standardized treatment protocols, but many rare childhood cancers do not yet have a clear or uniform treatment pathway. In India, limited resources combined with a large patient population further challenge the delivery of personalized cancer care, making it harder to tailor treatment to each child’s specific needs.

What make standard treatment difficult

The major limitation to establishing a standard treatment is the rarity of the disease. Rare childhood cancers are a small fraction of all pediatric cancer cases. The number of diagnostics makes it difficult to conduct large-scale and definitive studies. This results in less data for an evidence-based treatment path. Oncologists must rely on standard treatments that are for common adult cancers or less specific pediatric treatments. This makes the treatment journey complicated.

Differences in tumor biology

Rare cancers show wide differences in their tumor biology. While many adult cancers share common genetic mutations, rare childhood cancers often have distinct molecular features and unique genetic drivers. Because of this biological diversity, a treatment that works well for one child may not be effective for another child with the same diagnosis. This is why personalized cancer care is essential—it allows treatment to be tailored to each child’s individual molecular profile, improving the chances of better outcomes.

Fewer clinical trials and evidence-based treatment

As the incidence rate is low, the feasibility of dedicated clinical trials is also low. Pharmacological companies and research institutions hesitate to invest in these trials due to the small patient population. So many rare childhood cancers have a major lack of clinical trials and a lack of high-quality data required for standard treatment paths. Regulatory frameworks are complex, which obstructs cancer research in India. This slows down the initiation and adoption of these rare cancer subtype trials.

Constraint of resources and infrastructure

These childhood cancers need sophisticated diagnostic tools and highly trained professionals. But access to specialized pediatric cancer treatment is only available in metropolitan areas. Many other regions have constraints on resources and infrastructure, which limit the ability to provide diagnostics and treatments. 

Treating the child, not just the cancer

Considering these difficulties, treatment should be aimed at the individualised treatment of cancer. This includes intricate genetic profiling of the tumor, meticulous evaluation of the child's general health, and efficient decision-making by a multidisciplinary medical team. Although this method may be aggressive, it has a much higher potential of enhancing outcomes compared to using a blanket treatment plan.

Despite the many complexities, there is real reason for hope. Advances in genomics, precision medicine, and global research collaborations are opening doors to more targeted therapies. Increased investment in cancer research and stronger clinical trial networks are essential to building solid evidence and developing clearer, more effective treatment pathways for every child.