Mikaela Gave Kids a Chance.

September is Childhood Cancer Awareness Month, and this year there is something real to celebrate. But the story of how we got here begins with a sixteen-year-old who tragically did not live to see it.

Mikaela Naylon was diagnosed with osteosarcoma on July 1, 2020, and spent more than five years crossing the country for treatment. She was a dancer and a high school tennis player who never wanted cancer to define her. But somewhere in those years, her focus shifted. She traveled to Washington for Climb the Hill and CureFest. She sat across from members of Congress and told them what it is like to be out of options because the drugs that might help you were never tested in someone your age.

Mikaela died on October 29, 2025. Her final act was donating her body to research so that other children might have what she did not.

Three months later, on February 3, 2026, the president signed the Mikaela Naylon Give Kids a Chance Act into law. It reauthorizes the Rare Pediatric Disease Priority Review Voucher program through 2029, which has helped bring more than fifty new treatments to market for dozens of rare childhood diseases. It lets the FDA require that adult cancer drugs be studied in combination in children, which is how modern cancer treatment actually works. And it puts real enforcement behind pediatric study requirements that companies have too often ignored.

That is worth celebrating this month. Then, we should ask why it took so long, and why the fight is not over.

The honest answer is that we have never treated childhood cancer as seriously as adult cancer. Cancer remains the leading cause of death by disease for American children. Nearly 16,000 kids are diagnosed every year. Roughly one in five will not survive, and most who do will live with serious long-term health problems, because the chemotherapy and radiation that saved them attack healthy cells alongside cancer cells.

Against that reality, the National Cancer Institute directs only about four percent of its research budget to childhood cancers. Since 1980, just a small handful of drugs have been developed specifically for children with cancer, compared with hundreds for adults. For some pediatric cancers, the standard treatment today is essentially unchanged from the 1970s.

Here is the hardest part to hear. Kids get so little not because no one cares, but because the numbers are small. Sixteen thousand diagnoses a year, spread across dozens of distinct cancers, means no single pediatric cancer is a market large enough for a company to recoup the cost of developing a drug for it. Osteosarcoma affects a few hundred American children a year. Commercially, there is no return.

So children get hand-me-downs: adult drugs, dosed down and tested late, if they are tested at all. Therapies designed for a 60-year-old’s biology. If those fail, they can turn to a clinical trial, if one exists and the family can afford to fly to it.

That is exactly what the Give Kids a Chance Act was written to fix. Incentives had to be manufactured where the market would not supply them. Companies were not going to volunteer to test their drugs in children. It employs carrots and sticks together, because neither alone had worked.

But a law is a floor, not a ceiling. The voucher program sunsets again in 2029. The FDA has new authorities; it needs the resources and the will to use them. And four percent is still four percent.

The small-numbers argument cuts both ways. Sixteen thousand children is a small market. It is also a solvable problem. A serious national commitment to pediatric cancer research would cost a fraction of what we spend on adult cancer, and it would reach every one of those children.

Mikaela spent the years she had making sure Congress could not look away. The law that carries her name is proof that advocacy works. It is also a reminder that the work belongs to the rest of us now.

This September, remember her name. Then ask your representatives what they plan to do next.