The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). Methods: Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0–19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. Findings: Globally, in 2017, there were 11·5 million (95% uncertainty interval 10·6–12·3) DALYs due to childhood cancer, 97·3% (97·3–97·3) of which were attributable to YLLs and 2·7% (2·7–2·7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82·2% (82·1–82·2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50·3% (50·3–50·3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26·5% (26·5–26·5) of global childhood cancer DALYs. Interpretation: The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern. Funding: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities (ALSAC), and St. Baldrick's Foundation

Gibbon genome and the fast karyotype evolution of small apes

Gibbons are small arboreal apes that display an accelerated rate of evolutionary chromosomal rearrangement and occupy a key node in the primate phylogeny between Old World monkeys and great apes. Here we present the assembly and analysis of a northern white-cheeked gibbon (Nomascus leucogenys) genome. We describe the propensity for a gibbon-specific retrotransposon (LAVA) to insert into chromosome segregation genes and alter transcription by providing a premature termination site, suggesting a possible molecular mechanism for the genome plasticity of the gibbon lineage. We further show that the gibbon genera (Nomascus, Hylobates, Hoolock and Symphalangus) experienced a near-instantaneous radiation 5 million years ago, coincident with major geographical changes in southeast Asia that caused cycles of habitat compression and expansion. Finally, we identify signatures of positive selection in genes important for forelimb development (TBX5) and connective tissues (COL1A1) that may have been involved in the adaptation of gibbons to their arboreal habitat.The gibbon genome project was funded by the National Human Genome Research Institute (NHGRI) including grants U54 HG003273 (R.A.G.) and U54 HG003079 (R.K.W.) with further support from National Institutes of Health NIH/NIAAA P30 AA019355 and NIH/NCRR P51 RR000163 (L.C.), R01_HG005226 (J.D.W., M.F.H.), NIH P30CA006973 (S.J.W.), a fellowship from the National Library of Medicine Biomedical Informatics Research Training Program (N.H.L.), R01 GM59290 (M.A.B.) and U41 HG007497-01 (M.A.B, M.K.K.), R01 MH081203 (J.M.S.), HG002385 (E.E.E.), National Science Foundation (NSF) CNS-1126739 (B.U., M.A.B., M.K.K.) and DBI-0845494 (M.W.H.), PRIN 2012 (M.R.), Futuro in ricerca 2010 RBFR103CE3 (M.V.), ERC Starting Grant (260372) and MICINN (Spain) BFU2011-28549 (T.M.-B.), grant of the Ministry of National Education, CNCS – UEFISCDI, project number PN-II-ID-PCE-2012-4-0090 (A.D.), grant of the Deutsche Forschungsgemeinschaft SCHU1014/8-1 (G.G.S.), ERC Starting and Advanced Grant and EMBO Young Investigator Award (Z.I., N.V.F.), ERC Starting Grant and EMBO Young Investigator Award (D.T.O.), Commonwealth Scholarship Commission (M.C.W.). E.E.E. is an investigator of the Howard Hughes Medical Institute. We acknowledge the contributions of the staff of the HGSC, including the operations team: H. Dinh, S. Jhangiani V. Korchina, C. Kovar; the library team: K. Blankenburg, L. Pu, S. Vattathil; the assembly team: D. Rio-Deiros, H. Jiang; the submissions team: M. Batterton, D. Kalra, K. Wilczek-Boney, W. Hale, G. Fowler, J. Zhang; the quality control team: P. Aqrawi, S. Gross, V. Joshi, J. Santibanez; and the sequence production team: U. Anosike, C. Babu, D. Bandaranaike, B. Beltran, D. Berhane-Mersha, C. Bickham, T. Bolden, M. Dao, M. Davila, L. Davy-Carroll, S. Denson, P. Fernando, C. Francis, R. Garcia III, B. Hollins, B. Johnson, J. Jones, J. Kalu, N. Khan, B. Leal, F. Legall III, Y. Liu, J. Lopez, R. Mata, M. Obregon, C. Onwere, A. Parra, Y. Perez, A. Perez, C. Pham, J. Quiroz, S. Ruiz, M. Scheel, D. Simmons, I. Sisson, J. Tisius, G. Toledanes, R. Varghese, V. Vee, D. Walker, C. White, A. Williams, R. Wright, T. Attaway, T. Garrett, C. Mercado, N. Ngyen, H. Paul and Z. Trejos. We thank Z. Ivics for providing some of the reagents. We additionally acknowledge the Production Sequencing Group at The Genome Institute. Wellcome Trust (grant numbers WT095908 and WT098051), NHGRI (U41HG007234) and European Molecular Biology Laboratory. For the production of next-generation sequences, we acknowledge the Massively Parallel Sequencing Shared Resources (MPSSR) at OHSU, the National Center of Genomic Analyses (CNAG) (Barcelona, Spain), the University of Arizona Genetics Core (UAGC), and the UCSF sequencing core. We also acknowledge the Louisiana Optical Network Institute (LONI). We thank the Gibbon Conservation Center and the Fort Wayne Children’s Zoo for providing the gibbon samples. The MAKER annotation pipeline is supported by NSF IOS-1126998.We thank T. Brown for proofreading and editing the manuscript

Application of Quantitative Pharmacology in Development of Therapeutic Monoclonal Antibodies

The advancement of therapeutic monoclonal antibodies during various stages of the drug development process can be effectively streamlined when appropriate translational strategies are applied. Design of successful translational strategies for development of monoclonal antibodies should allow for understanding of the dose– and concentration–response relationships with respect to both beneficial and toxic effects from early phases of drug development. Evaluation of relevant biomarkers during early stages of drug development should facilitate the successful design of safe and effective dosing strategies. Moreover, application of quantitative pharmacology is critical for translation of exposure–response relationships early on

The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017

BACKGROUND: Accurate childhood cancer burden data are crucial for resource planning and health policy prioritisation. Model-based estimates are necessary because cancer surveillance data are scarce or non-existent in many countries. Although global incidence and mortality estimates are available, there are no previous analyses of the global burden of childhood cancer represented in disability-adjusted life-years (DALYs). METHODS: Using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 methodology, childhood (ages 0-19 years) cancer mortality was estimated by use of vital registration system data, verbal autopsy data, and population-based cancer registry incidence data, which were transformed to mortality estimates through modelled mortality-to-incidence ratios (MIRs). Childhood cancer incidence was estimated using the mortality estimates and corresponding MIRs. Prevalence estimates were calculated by using MIR to model survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated by multiplying age-specific cancer deaths by the difference between the age of death and a reference life expectancy. DALYs were calculated as the sum of YLLs and YLDs. Final point estimates are reported with 95% uncertainty intervals. FINDINGS: Globally, in 2017, there were 11·5 million (95% uncertainty interval 10·6-12·3) DALYs due to childhood cancer, 97·3% (97·3-97·3) of which were attributable to YLLs and 2·7% (2·7-2·7) of which were attributable to YLDs. Childhood cancer was the sixth leading cause of total cancer burden globally and the ninth leading cause of childhood disease burden globally. 82·2% (82·1-82·2) of global childhood cancer DALYs occurred in low, low-middle, or middle Socio-demographic Index locations, whereas 50·3% (50·3-50·3) of adult cancer DALYs occurred in these same locations. Cancers that are uncategorised in the current GBD framework comprised 26·5% (26·5-26·5) of global childhood cancer DALYs. INTERPRETATION: The GBD 2017 results call attention to the substantial burden of childhood cancer globally, which disproportionately affects populations in resource-limited settings. The use of DALY-based estimates is crucial in demonstrating that childhood cancer burden represents an important global cancer and child health concern. FUNDING: Bill & Melinda Gates Foundation, American Lebanese Syrian Associated Charities (ALSAC), and St. Baldrick's Foundation