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Sidney Kimmel Cancer Center / Centers & Clinics

Pediatric Oncology

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Thoughts From Our Childhood Cancer Expert

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Nicolas J. Llosa, M.D., Instructor of Oncology and Pediatrics

His research expertise in pediatric cancer immunology represents a new and exciting frontier in the oncology field. While cancer immunology, which examines the interplay between a patient’s immune system and cancer cells, is one of the most promising areas of cancer research today, it has been explored primarily only in adults. Dr. Llosa, an instructor of Oncology and Pediatrics at Johns Hopkins, would like to see immunology eventually applied to tough-to-treat pediatric cancers, such as refractory or reoccurring sarcomas.

As a scientist-clinician experienced in treating children with sarcoma, Dr. Llosa expresses frustration at the disease’s current treatment limitations. Management options are limited primarily to chemotherapy. For those who relapse, says Dr. Llosa, there is very little that can be done. But he sees promise in immunotherapy.

“We are seeing remarkable success in many adult patients, and I see a lot potential for trying these therapies in pediatric sarcomas,” says Dr. Llosa.

Dr. Llosa has direct experience witnessing the success of immunotherapy applied to adult patients. Over the span of four years in a joint hemotology/oncology fellowship program through Johns Hopkins and the National Cancer Institute (NCI), he devoted his efforts to the study of the immune microenvironment of colorectal cancer.

Dr. Llosa’s findings were the first to demonstrate a link between a genetically defined subtype of cancer and its corresponding expression of immune checkpoints in the tumor microenvironment. His work, published in a January 2015 publication in the journal Cancer Discovery, provides a framework for additional high impact studies seeking to understand the diversity of the tumor microenvironment in patients affected by the disease.

Dr. Llosa hopes to conduct clinical trials studying the immunology of pediatric solid tumors. He notes that, already, the Children’s Oncology Group has begun a multi-site study examining this form of treatment in pediatric patients with relapsed sarcoma. Dr. Llosa strongly believes that Hopkins has the proper infrastructure required to continue research in this area providing an unparalleled opportunity for running immunotherapy clinical trials in children.

Acknowledging that existing treatment modalities for these patients have been ‘maxed out’, Dr. Llosa envisions a time in the future when immunotherapy will be combined with existing modalities to improve outcomes.

“I think we’re close,” he says. “I see a lot of potential.”