{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:57:10Z","timestamp":1791295030336,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Five-year survival rates for childhood cancer now exceed 85%, with recent improvements driven by advances in understanding of tumor biology allowing for molecular risk stratification. The introduction of novel therapies, including antibodies, antibody-drug conjugates, immune checkpoint inhibitors, cellular therapy, and targeted small molecule inhibitors into early-phase and pivotal trials has the potential to further improve survival. Although these agents have transformed outcomes for some children with cancer, their long-term toxicity profiles remain poorly defined. Large cohort studies have characterized the late effects of conventional cytotoxic chemotherapies and radiation, informing survivorship guidelines and risk-based surveillance strategies. In contrast, the distinct mechanisms of action of targeted and immune-based therapies introduce new and potentially persistent toxicities affecting cardiovascular, neurologic, endocrine, gastrointestinal, and immune systems. This review synthesizes current evidence on acute toxicities of novel therapies and summarizes available data about persistent long-term toxicities and new onset late effects outcomes, including growth impairment, persistent immune dysfunction, and subsequent malignancies in children treated with these agents. We focus on therapies with U.S. Food and Drug Administration approval for pediatric indications. Current evidence from acute toxicity profiles, limited pediatric long-term follow-up, and emerging data from adult populations highlights the urgent need for systematic evaluation of long-term outcomes in children treated with these therapies. As the use of novel agents continues to expand, extending established survivorship cohorts to include children exposed to novel therapies, while developing complementary approaches to detect previously unrecognized toxicities, will be essential for defining late effects and informing evidence-based surveillance and intervention strategies.<\/jats:p>","DOI":"10.1093\/jnci\/djag371","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:42:17Z","timestamp":1790941337000},"source":"Crossref","is-referenced-by-count":0,"title":["Late effects after novel therapies for childhood cancer: Anticipating the future landscape of health outcomes for survivors"],"prefix":"10.1093","author":[{"given":"Amy M","family":"Berkman","sequence":"first","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Epidemiology and Cancer Control, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T","family":"Teachey","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Perelman School of Medicine, , Philadelphia PA,","place":["USA"]},{"name":"Children\u2019s Hospital of Philadelphia Division of Oncology and Center for Childhood Cancer Research, , Philadelphia PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Ehrhardt","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Epidemiology and Cancer Control, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Hon","family":"Pui","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Department of Global Pediatric Medicine, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Department of Pathology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Inaba","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth E","family":"Karol","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M","family":"Castellino","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine Department of Pediatrics, , Atlanta GA,","place":["USA"]},{"name":"Children\u2019s Healthcare of Atlanta Aflac Cancer & Blood Disorders Center, , Atlanta GA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie B","family":"Dixon","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Epidemiology and Cancer Control, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun J","family":"Yang","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Department of Pharmacy and Pharmaceutical Sciences, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G","family":"Gross","sequence":"additional","affiliation":[{"name":"Phoenix Children\u2019s Hospital Center for Cancer & Blood Disorders, , Phoenix, AZ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara M","family":"Federico","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger J","family":"Packer","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital Brain Tumor Institute and Gilbert Family Neurofibromatosis Institute, , Washington, DC,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto S","family":"Pappo","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Qaddoumi","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Global Pediatric Medicine, , Memphis TN,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital Division of Neuro-Oncology, Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Salloum","sequence":"additional","affiliation":[{"name":"Boston Children's Hospital; Harvard Medical School Department of Pediatric Oncology, Dana-Farber Cancer Institute; Division of Hematology\/Oncology, , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie M","family":"Smith","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine Department of Pediatrics, Division of Hematology, Oncology, Stem Cell Transplantation & Regenerative Medicine, , Palo Alto CA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd","family":"Cooper","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle Children\u2019s Hospital Cancer and Blood Disorders Center, Department of Pediatrics, , Seattle WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara O","family":"Henderson","sequence":"additional","affiliation":[{"name":"Yale School of Medicine Department of Pediatrics, , New Haven CT,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S","family":"Hawkins","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle Children\u2019s Hospital Cancer and Blood Disorders Center, Department of Pediatrics, , Seattle WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C","family":"Nathan","sequence":"additional","affiliation":[{"name":"University of Toronto Department of Pediatrics, The Hospital for Sick Children, , Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Chow","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle Children\u2019s Hospital Cancer and Blood Disorders Center, Department of Pediatrics, , Seattle WA,","place":["USA"]},{"name":"Fred Hutchinson Cancer Center Clinical Research and Public Health Sciences Divisions, , Seattle WA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Fox","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Oncology, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory T","family":"Armstrong","sequence":"additional","affiliation":[{"name":"St. Jude Children\u2019s Research Hospital Department of Epidemiology and Cancer Control, , Memphis TN,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,6]]},"container-title":["JNCI: Journal of the National Cancer 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