The Royal Marsden

Paediatric and adolescent cancers

The Royal Marsden’s paediatric and adolescent drug development programme has the largest portfolio of early-phase paediatric cancer trials in the UK and one of the largest in Europe.
Dr Louise Soanes (left) and Emma Potter (right) support young cancer patients following their treatment

Dr Louise Soanes (left) and Emma Potter (right) support young cancer patients following their treatment


children aged 14 or under are diagnosed with cancer each year in the UK


of children survive for five years or more


Recognised as a world leader in the field, the team has the objective of improving survival rates for children and young people with cancer. Key to this is our bench-to-bedside approach with our academic partner The Institute of Cancer Research (ICR), which aims to quickly bring novel targeted therapies from the laboratory into the clinic, with the goal of developing personalised treatment strategies for children and young people.

We work closely with other academic partners, pharmaceutical companies and international regulatory bodies to drive forward drug development for our patients. 

“We have a highly committed team who go to great lengths to provide the best possible clinical care while offering the most promising new treatment options for our young patients,” says Dr Lynley Marshall, Oak Foundation Consultant in Paediatric and Adolescent Oncology Drug Development at The Royal Marsden. “Our centre has contributed to the development of new drugs in increasingly sophisticated studies, with real impacts on the lives of our patients and their families.” 

Two paediatric trials of new immunotherapy drugs have recently opened at the hospital. Both use drugs that have been trialled in adult patients to discover if they can also successfully treat a range of paediatric and adolescent cancers. Known as immune checkpoint inhibitors, these drugs help the patient’s own immune system to kill cancer cells by recognising them as ‘foreign’.

The first is testing pembrolizumab for young patients with advanced melanoma or certain other types of solid tumour (including brain tumours), or lymphoma. The Royal Marsden is the only UK centre running the trial, together with pharmaceutical company Merck and other international paediatric investigators. 

The second is assessing atezolizumab for patients with advanced solid tumours or lymphoma. The Royal Marsden is one of five centres running the study, in partnership with Roche-Genentech, and other international investigators. 

“This is an exciting and optimistic time for paediatric and adolescent drug development,” says Dr Marshall. “As the science is advancing, there are new opportunities arising – especially in the field of tumour profiling and personalised medicine, where The Royal Marsden is taking a lead role.”


of all paediatric cancer cases are soft-tissue sarcomas


As well as providing the latest in paediatric drug development, we also support our young patients once their treatment has finished. Sometimes, the treatment that children and teenagers may undergo can cause problems that only become
evident years later. 

When treatment finishes, young patients initially return to the hospital regularly to see their consultant, who monitors their health and growth. After five years, they transfer to the long-term follow-up team who will help patients and their families manage the long-term consequences of treatment. At 16, this is in the teenage and young adult late-effects clinic. 

As young adults, most patients will be discharged to self-management supported by their GP, although they can still contact the late-effects team if they have any concerns. Others are transferred to the late-effects clinic at University College London Hospitals NHS Foundation Trust (UCLH). The aim of the service is to help patients cope with side effects, live independent lives and make good choices about their health and wellbeing. 

The long-term follow-up service was developed by Emma Potter, Clinical Nurse Specialist in the Oak Centre for Children and Young People, who also ensures that all patients receive an end-of-treatment summary and long-term care plan. She has introduced nurse-led clinics that ensure patients receive information and further support in an age-appropriate manner and was key in establishing the adult late-effects clinic at UCLH for patients who continue to need intervention. Emma and her colleagues run a bi-monthly clinic to ensure a successful transition from The Royal Marsden to UCLH. 

Dr Louise Soanes, Teenage Cancer Trust Nurse Consultant for Adolescents and Young Adults, works with Emma. She says: “It is important that young people are able to manage their own physical and psychological care. Emma’s work has been essential in giving young patients the tools to make good wellbeing choices.” 

Emma adds: “We’re empowering our young patients to move beyond cancer and take responsibility to manage their own health and wellbeing. It’s about setting achievable goals and supporting our young patients to make good decisions about their health and their future, and ultimately help them to live their lives to their full potential.”

Case study: Chloe Parsons, 24

“I was diagnosed with Ewing sarcoma, a form of bone cancer, in my leg in 2005, when I was 13. I had to have chemotherapy, radiotherapy and surgery for a year at The Royal Marsden, which was really difficult. But my cancer has now been in remission for 10 years, and I recently transferred to the long-term follow-up clinic under Emma Potter and her team. 

“The care my family and I have received from The Royal Marsden has been fantastic. I’ve always felt supported, and now that I’m in follow-up, I feel treated like a VIP. It’s so reassuring that Emma and the team are always on hand if you have any questions or worries. 

“Now, as well as volunteering for charities, I spend time speaking publicly about my experiences of cancer and survivorship. I recently spoke to professionals at a survivorship conference in Brussels.”