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All ranked pediatric cancer papers
In this multicentre, single-arm phase 2 cohort, single-agent inotuzumab ozogamicin produced responses in 22 of the first 31 evaluable children (71%) with CD22-positive, very high-risk first B-cell acute lymphoblastic leukaemia relapse, with substantial haematologic toxicity and sinusoidal obstructive syndrome in four of 23 transplanted patients.
The trial provides preliminary evidence that inotuzumab ozogamicin can serve as active reinduction therapy in CD22-positive very high-risk first paediatric B-ALL relapse; it is reasonable to hypothesize that this could facilitate subsequent curative treatment, but comparative benefit, durability of response, and effects on survival are not established by this single-arm report.
In a 17-patient phase II study of pediatric refractory acute leukemias after allogeneic HSCT, WT1 peptide vaccination was associated with a 70.6% 3-year overall survival rate, expansion of WT1-specific cytotoxic T cells among clinical responders, and manageable reported adverse events.
The study provides evidence that post-transplant WT1 peptide vaccination can induce WT1-specific cytotoxic T-cell responses associated with sustained remission and survival; it remains an inference, not established causality, that vaccine-driven immune expansion prevents relapse and improves survival.
In a 150-patient, single-arm phase 2 trial of adults aged 18–60 years with untreated advanced-stage classic Hodgkin lymphoma, PET after one A-AVD cycle guided continuation of A-AVD or intensification to BrECADD, with an estimated 2-year modified progression-free survival of 89.5% and no deaths reported.
The trial supports that metabolic response after one A-AVD cycle can feasibly select patients for early treatment intensification while allowing the 60% with PET1-negative disease to avoid BrECADD; whether this strategy improves efficacy, toxicity, or survival over standard PET-guided care—and whether it applies to patients younger than 18 years—remains inferential and requires comparative testing.
In the 233-patient randomized phase 2 BIOMEDE trial, adding erlotinib, dasatinib, or everolimus to radiotherapy did not improve overall survival relative to a historical temozolomide-treated cohort, although everolimus had lower toxicity and mTOR-pathway alterations or activation were associated with better response to everolimus.
The trial does not support broad use of these targeted agents in DIPG; however, the reported association between mTOR-pathway status and everolimus response suggests—without establishing—that molecular selection could identify a subgroup more likely to benefit from mTOR inhibition plus radiotherapy in future trials.
In this Spanish multicentre, single-arm phase 2 trial, 27 of 32 adults treated with fractionated, adaptively escalated CD19-directed varnimcabtagene autoleucel achieved complete response with undetectable measurable residual disease by day 28, with severe cytopenias, grade 3 or higher cytokine release syndrome in four patients, and one treatment-associated syndrome resulting in death after a protocol violation.
The trial provides evidence that fractionated var-cel can induce early, deep remissions in selected adults with relapsed or refractory CD19-positive B-cell precursor acute lymphoblastic leukaemia; it remains an inference that adaptive fractionation preserves efficacy while reducing acute toxicity or expanding access, because there was no comparator and no pediatric population was studied.
This single-arm clinical trial reports complete, partial, and minor responses in children with relapsed/refractory neuroblastoma treated with haploidentical NK cells, dinutuximab beta, cytokines, spironolactone, and chemotherapy, alongside prolonged severe cytopenias but mild cytokine release syndrome and no neurotoxicity.
The record provides preliminary evidence that adding haploidentical NK-cell infusion and spironolactone to anti-GD2–based multimodal therapy may enhance antitumor activity in recurrent neuroblastoma; the inferred hypothesis is that spironolactone-enhanced NK cytotoxicity and antibody-dependent killing could improve responses, but comparative efficacy and the contribution of each component remain unproven.
In 870 transplant-eligible adults aged 18–65 years with untreated mantle cell lymphoma, this three-arm phase 3 trial found that adding ASCT to first-line ibrutinib-containing immunochemotherapy did not improve 4-year failure-free survival, while ASCT increased toxicity and both ibrutinib-containing regimens improved survival outcomes versus the ASCT-based control.
The trial directly supports the clinical hypothesis that an ibrutinib-containing induction and maintenance regimen can omit ASCT without loss of failure-free survival in transplant-eligible adults with mantle cell lymphoma; extension to adolescents or other pediatric populations is an inference not tested by this record.
This retrospective clinical-trial subanalysis reports high early remission rates and encouraging four-year survival after co-administered CD19/CD22 CAR-T cells in pediatric relapsed/refractory Ph+ ALL, including sustained remission in six patients without consolidative allo-HSCT.
The reported remissions and long-term survival support the hypothesis that co-targeting CD19 and CD22 could provide durable disease control in pediatric relapsed/refractory Ph+ ALL and potentially reduce reliance on consolidative allo-HSCT; however, superiority over single-target CAR-T therapy, TKIs, or transplant-based strategies is not established by this uncontrolled retrospective subanalysis.
In a single-center retrospective comparison of 55 patients with TP53-altered relapsed/refractory B-ALL, CD19/22 CAR-T was associated with higher MRD-negative remission and better 3-year overall and leukemia-free survival than CD19 CAR-T, particularly among patients receiving subsequent allogeneic HSCT.
The reported clinical associations support the hypothesis that dual CD19/22 targeting, potentially followed by allogeneic HSCT, may improve disease control in TP53-altered relapsed/refractory B-ALL; however, superiority and causality remain unproven because the comparison was small, retrospective, single-center, and apparently nonrandomized.
This phase 0/1 study reports target-selection and in-vitro evidence for trastuzumab-mediated cytotoxicity and found intrathecal trastuzumab plus subcutaneous GM-CSF safe at the two tested dose levels in children with recurrent posterior fossa ependymoma, with exploratory progression and immune-correlate findings.
The record provides evidence that HER2/ErbB2 is a candidate ependymoma target, that trastuzumab can promote antibody-dependent cytotoxicity in PFA ependymoma co-cultures with GM-CSF-stimulated immune cells, and that the intrathecal combination was feasible and reported safe at tested doses; it remains an inference, requiring a larger controlled study, that this immune strategy improves disease control or survival.
A 687-compound screen followed by validation in DMG cell lines, 3D spheroids, and an in ovo CAM assay found that the ATR inhibitor berzosertib enhanced the antiproliferative and tumor-suppressive effects of radiotherapy in H3K27-altered diffuse midline glioma models.
The supplied preclinical evidence supports berzosertib as a radiosensitizer in DMG models; it is reasonable—but not yet clinically demonstrated—to hypothesize that ATR inhibition could improve radiotherapy efficacy in patients with H3K27-altered DMG.
In a multicenter, nonrandomized phase 1/2 trial, first-line avelumab plus methotrexate produced serum hCG normalization in 96.2% of 26 assessable patients with low-risk gestational trophoblastic tumors, with manageable reported toxicity, no relapses at a median 41-month follow-up, and pregnancies in 13 of 14 patients who intended pregnancy.
The trial provides preliminary human evidence that adding PD-L1 blockade to methotrexate can achieve durable hCG normalization while preserving fertility in low-risk GTT; it is an inference, not yet comparative evidence, that this combination improves cure rates or is especially beneficial for patients at higher risk of methotrexate resistance.