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In 2022, more than 275,000 children and adolescents worldwide were diagnosed with cancer, while more than 105,000 children died from the disease. In Europe, 35,000 children are diagnosed with cancer each year, and in Germany, according to the Children's Cancer Registry (DKR), 2,400 children are diagnosed each year. In comparison, around 500,000 new cases of cancer are registered in adults in Germany each year.
The most common form of cancer in children is leukemia (blood cancer), while adolescents most often suffer from lymphoma (cancer of the lymph nodes). According to the Frankfurt Foundation for Children with Cancer, 80 percent of patients are cured. However, the chances of a cure for many types of cancer have not improved in the last 30 years – on average, one in five children with cancer dies.
If a child who has been cured later has cancer, the prognosis is poor. The average survival time in such cases is eight months. In addition, there is no standardized treatment for relapses.

One of the biggest problems in treating cancer in children is the lack of specialized medications. For children, there is only a fraction of what is available for adult patients. Many new drugs that come to market are approved exclusively for adults.
Therefore, researchers at the Hopp Center for Children's Tumors (KiTZ) in Heidelberg are relying on an individualized treatment approach using "mini-tumors." Since 2019, doctors have been able to send there tissue samples from children with cancer who are classified as high-risk patients or who have already had a relapse.
Based on these samples, researchers grow hundreds of mini-tumors, explains Ina Oehme, head of the Department of Drug Testing. These small tumors, also known as organoids, allow for the testing of 80 different drugs in different doses and combinations. The drugs tested are mainly adult oncology drugs, including those that have already been approved, as well as those that are still in the clinical trial phase.

According to Oehme, more than 500 tissue samples have been taken so far, two-thirds of which were suitable for testing. In about 80 percent of these samples, a suitable drug was found, which led to tumor regression in laboratory conditions. About three weeks after taking the sample, researchers can know whether a particular drug works or not.
In addition to drug testing, researchers at KiTZ are sequencing the entire tumor genome to better understand the biological processes behind childhood cancer and serious blood diseases. KiTZ is a joint institution of the German Cancer Research Center (DKFZ), Heidelberg University Hospital and Heidelberg University. The institute collaborates with many national and international research centers.
According to its own statements, KiTZ is leading the first pan-European genome sequencing program for children with cancer. So far, more than 1,700 patients have been involved in the program and more than 100 centers from 12 European countries and Israel have sent tumor samples to Heidelberg.
Although other research centers also use the mini-tumor cultivation approach to test drugs, the uniqueness of the KiTZ project lies in its systematic methodology. By collecting a large number of tumors, this center has an extensive database, which enables more accurate and reliable results, explains Uta Dirksen, pediatric oncologist at the University Hospital in Essen./ DW
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