Two years ago, Lianna Munir started spiking fevers and having fainting spells. At first doctors thought Munir, then 6, may have strep or a viral infection. But even after multiple trips to the emergency department, Munir wasn't getting better.
At the Children's Hospital of Philadelphia, Munir was diagnosed with a rare form of leukemia that defied intensive chemotherapy treatment.
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"Your world just ends," Munir's mother, Adrian Horn, said about receiving her daughter's cancer diagnosis. "I mean, nothing else exists besides living in the hospital and trying to find answers."
Fortunately, Munir, of Bellmawr, New Jersey, was a candidate for CAR T-cell therapy, a type of immunotherapy that used healthy immune cells harvested from her body to fight her leukemia.
To help Munir, now 8, understand the therapy, doctors told her that they took cells from kindergarten and sent them off to college, where they learned to become "secret agents," Horn said. "So they go through the body like little missiles, and they just target the leukemia cells."
As a result of CAR T-cell therapy, Munir's leukemia is no longer detectable.
"You don't know what every day is going to bring, but we lived through it, and we're in a great place," Horn said.
A need for more cancer research funding
Munir's case is an example of how advanced pediatric cancer therapies are saving and transforming children's lives – and also calls attention to the need for more research into these technologies, according to a new report from the American Association for Cancer Research, an advocacy organization based in Philadelphia and comprised of health care providers dedicated to curing cancer.
"We really felt it would be important to have a specific progress report that celebrated the wins, but also really brought a lot of the unknown and often undiscussed aspects about why pediatric cancers are difficult to treat, why there aren't many good drugs and sort of trying to get people to recognize that this was an ongoing problem," said Elaine Mardis, one of the report's authors and a pediatric cancer researcher at Ohio State University.
Funding for pediatric cancer research historically falls well below that for adult cancer research. About 4% of federal cancer research dollars went to childhood cancer before 2021, according to The Children's Cancer Foundation. The nearly $800 million of federal health research funding cut by the Trump administration this year included money for cancer research — a move critics say will erode advances in pediatric cancers.
The AACR Pediatric Cancer Progress Report 2025 – its first on childhood cancer – advocates for additional funding from the National Institutes of Health and other sources, in part by highlighting significant strides over the past decade.
Since 2015, the U.S. Food and Drug Administration has approved more than 20 molecularly-targeted therapies and more than 10 immunotherapies for pediatric cancers, such as the CAR T-cell therapy Munir received. These advances have enabled clinicians to tailor treatment for certain types of pediatric cancers based on the molecular profile of a child or adolescent. Gene editing, liquid biopsy and artificial intelligence also are leading to new therapies for childhood cancers.
"We've had really great gains in acute lymphoblastic leukemias and lymphomas, which are more frequently diagnosed," Mardis said. "But the downside is that pediatric brain cancers, which are much more difficult and have some of these challenging drivers, are now the leading cause of death by disease in children."
In 2025, an estimated 15,000 children and adolescents in the United States will be diagnosed with cancer – and nearly 1,700 will die of cancer. The five-year survival rates for some pediatric cancers, including Hodgkin lymphoma, thyroid carcinoma and retinoblastoma, are now above 90%. But for other childhood cancers, such as gliomas and sarcomas, the five-year survival rates remain below 25%, the AACR says.
Additionally, 60% to 90% of children who survive cancer will have at least one chronic health condition by the time they are adults due to their disease or its treatment, the AACR reports.
"We just want to continue to advocate for access and improved drugs and hopefully the ability to execute the clinical trials that we need to have to qualify those drugs for patient care," Mardis said.
'We need to keep being ready'
Munir was fortunate to get treatment for her cancer with re-engineered T-cells and to live near CHOP, a hospital on the cutting-edge of pediatric cancer technologies, Horn said.
Munir is back in school and has just been cleared to start playing sports again.
The hope is that the T-cells remain in Munir's body, fighting any leukemia cells that may pop up, but ongoing research is vital, Horn said.
"If we hit a plateau, we don't have a next step to go to," Horn said. "We need to keep being ready for it when it doesn't work anymore. We need to have another option."