Research aims to take guesswork out of treating childhood cancer
The treatment of childhood cancers could be revolutionised thanks to a group of Australian researchers who have created a way of potentially minimising devastating side effects.
- Children's Cancer Institute conducted analysis of unique cancer cells of 59 children
- Researchers were able to successfully grow 50 per cent of the tumours in mice and 40 per cent in lab flasks
- This meant they could then test drugs on those cells, rather than on children
Cancer kills more kids than any other disease. Even when children survive, they are at risk of severe side effects for the rest of their lives from the drugs used to treat them.
A research initiative called Zero Childhood Cancer is hoping to change that.
Since 2015, scientists led by the Children's Cancer Institute have been conducting detailed laboratory analysis of the unique cancer cells of 59 children from New South Wales.
Many of the young patients involved had brain cancer.
All of them had less than a 30 per cent chance of surviving and more than half had relapsed after undergoing conventional treatment.
The researchers sequenced the genes of all the children's individual tumours and were able to successfully grow 50 per cent of them in mice, and 40 per cent of the tumours in laboratory flasks.
This meant they could then test about 200 drugs on those cells, rather than on the children.
"We're taking the guesswork out of which ones are the best drugs for children," research leader Michelle Haber said.
"If you have a drug that doesn't work you're basically poisoning the children with drugs that not only affect the cancer cells but actually have devastating side effects on all the normal cells in the child's body."
'We think we can prolong life … but we can't promise that'
At least two of the children in the pilot study received a new diagnosis.
"We've been able to say to them 'No, the gene analysis has actually shown this is a different cancer altogether'," clinical leader Professor Glenn Marshall from the Sydney Children's Hospital said.
"That's immensely helpful because often it redirects the oncologist's thinking to a different type of therapy."
He also said several of the children in the study were put onto different drugs.
"It's too early to say whether they've actually prolonged life," he said.
"We think we can prolong life and hopefully for considerable periods of time — years — but we certainly can't promise that and there'll be lots of failures before there'll be successes."
But Professor Marshall said the new approach gave doctors more options for treating seriously ill children.
"When all this is said and done the Zero Child Cancer project, national personalised cancer-care project, is really aimed at providing hope to families to children who don't have much in the way of hope now," he said.
And now that researchers have shown their program works, it has been opened up as a large clinical trial.
Professor Haber said labs in Sydney were ready to receive cancer cell samples from up to 400 more children with the most aggressive cancers.
"This is the single largest initiative for childhood cancer ever in Australia, we're very excited about it," Professor Haber said.
'The treatment saves you but it can lead to other things'
Nixon Ball was born with a cancerous tumour on his head and started chemotherapy when he was two-and-a-half weeks old.
"We were terrified of losing him, we just were panicked," his mother Brodie Donegan said.
"We didn't know what to do, we didn't know any other babies that had been born with cancer. We didn't know this even happened really."
For the first year of his life, Nixon spent more time in hospital than at home.
Now aged two, his tumour has not returned but it is too early to say if he is in remission.
Ms Donegan said Nixon would have a "lifelong connection" with hospitals because some of the drugs he was given could weaken his heart muscle, cause kidney problems, or lead to secondary cancers.
"If he bumps his leg and then he gets a giant bruise I start panicking, thinking he might have leukaemia, that goes through your mind, or if he gets a temperature you start panicking," she said.
"The treatment saves you but it can kind of lead to other things.
"When you're two weeks old and you're getting these drugs, you've got still a long time to live — there's a lot of things that can go wrong."
Ms Donegan said she was thrilled Australian children with cancer would be able to receive personalised treatment programs.
"There's a lot of kids that don't respond to the treatment, Nixon was really lucky but there's a lot of kids that don't, so they need that [personalised treatment]," she said.
"If anything happens [with Nixon] I will feel safe knowing that they have other new therapies out there, and they have this new way of identifying which therapies work."