Full Citation
Title: Enterovirus infection and childhood leukaemia: An association?
Citation Type: Book, Whole
Publication Year: 2015
ISBN:
ISSN: 14745488
DOI: 10.1016/S1470-2045(15)00194-1
NSFID:
PMCID:
PMID: 26321215
Abstract: Comment 1278 www.thelancet.com/oncology Vol 16 October 2015 challenge the existing regulatory infrastructure. Would 11 drugs in nine treatment groups, using various companion diagnostics, and for any histology, all be simultaneously approved for expanded indication if confi rmed in a phase 3 trial? What if some drugs are not already commercially available? What should be done about development and approval pathways for multiple incorporated companion diagnostics? Thus, to pre-emptively tackle these issues in preparation for potential future positive type II trials, next-generation regulation must accompany next-generation trials through the integration of next-generation companion diagnostics and the concept of personalised treatment strategies, to continue to advance clinical cancer care. 1 fi rst speculated that acute lymphoblastic leukaemia is indirectly caused by an absence of infection in early life and subsequent fl orid immune response when infections are inevitably encountered. Many lines of evidence address this hypothesis and not all agree. For instance, the rough correlation of acute lymphoblastic leukaemia incidence with national socioeconomic status is consistent with this hypothesis. However, evidence from studies of individuals is less clear about the role of early infection, partly because of the frequent reliance on case-control studies with data for infections collected by maternal interview. Other studies 2 examine proxies for infection, with the largest study of its kind indicating that acute lymphoblastic leukaemia risk is decreased in children with early exposure to day care, where increased transmission of microbes would be expected. Into this ambiguous scientifi c literature comes a study by Jiun-Nong Lin and colleagues in The Lancet Oncology, 3 who report fi ndings from a unique cohort study that uses data from Taiwan's nearly universal National Health Insurance programme to examine the association between enterovirus infection and childhood leukemia. They identifi ed that early enterovirus infections seemed to halve the risk of leukaemia. In view of the general absence of strong, modifi able risk factors for childhood leukaemia, 4 this study is exciting because it alludes to the possibility of inoculation against the most frequent forms of cancer in children. 5 Yet, a crisis of reproducibility exists in biomedical science,
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Authors: Spector, Logan G.
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Pages: 1278-1279
Volume: 16
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