5 March 2009
Some infants diagnosed with a form of childhood cancer do not require intensive treatment and in some cases need no treatment at all in order to survive their cancer, according to a paper published in the March edition of Journal of Clinical Oncology (1 March 2009).
In its aggressive form, neuroblastoma is a major cause of death from cancer in the US for children. These findings may influence the treatment of infants diagnosed as having the low-risk form of the disease, sparing them from unnecessary chemotherapy.
Professor Andy Pearson at The Institute of Cancer Research (ICR) has led the two European trials, which were funded by Cancer Research UK. Professor Pearson also acts as Cancer Research UK's Professor of Paediatric Oncology.
“The number of MYCN genes are known to be increased in about 25 per cent of neuroblastoma cases and tumours with an increased numbers of genes behave much more aggressively. We can now test for this gene in the tumour and where it is not increased, patients with no symptoms may receive reduced treatment or no treatment at all,” he says.
“By limiting treatment we are significantly reducing the risks and side-effects for these very young patients while maintaining their likelihood of survival. In some cases, chemotherapy can cause children to feel tired, sick and the treatment makes it more likely they’ll pick up infections, so it’s important to avoid this where possible. Our current goal is to individualise or personalise treatment for children with neuroblastoma.”
Current practice in the USA for infants with this less aggressive form of neuroblastoma recommends that they are given multiple courses of chemotherapy. In this study, infants received a maximum of 4 rounds. These studies showed that survival rates remained around 96 per cent over five years, regardless of treatment.
The majority of the children with Neuroblastoma are diagnosed before the age of 12 months. In its aggressive form, neuroblastoma is responsible for 15 per cent of all cancer deaths.
“Neuroblastoma is very unique, as it has the potential to spontaneously regress or “disappear” without treatment. Unfortunately, where an infant does carry a MYCN gene, known as having the MYCN-amplified version of the disease, this can have the opposite effect and makes an infant more resistant to treatment. It is also associated with a poorer chance of recovery,” Professor Pearson says.
Researchers from the International Society of Paediatric Oncology Europe Neuroblastoma Group (SIOPEN) conducted these trials involving 150 children who were diagnosed between June 1999 and June 2004.
Kate Law, Cancer Research UK’s Director of Clinical Trials, said: “Overall, survival rates for children’s cancers have been rapidly improving over the past three decades. But it’s crucial we support trials like this to refine treatments and reduce the long-term side effects that curative therapies can sometimes cause.
“This study confirms the importance of understanding the personal biology of individual patients in creating successful, tailored treatment regimes.”
Media contact: Cathy Beveridge ([email protected]) 0207 153 5359
Notes for editors
This study was conducted in nine European counties: UK, Italy, France, Spain, Portugal, Norway, Austria, Belgium and Switzerland.
Treatment for advanced neuroblastoma in older children, over one year of age and babies with the amplified MYCN gene typically occurs in five phases. The first phase, an initial round of chemotherapy, followed by surgery, high dose chemotherapy, radiotherapy and, finally, treatment with more drugs.
About Professor Pearson
Professor Pearson is a consultant paediatric oncologist at The Institute of Cancer Research and also works as a clinician at The Royal Marsden Hospital, Sutton. He works in collaboration with the Children's Cancer and Leukaemia Group. His work is supported by Cancer Research UK and he hold's the Cancer Research UK Chair of Paediatric Oncology.
About The Institute of Cancer Research
The Institute of Cancer Research is Europe’s leading cancer research centre with expert scientists working on cutting edge research. In 2009, The ICR marks its 100 years of world leading research into cancer prevention, diagnosis and treatment. The ICR is a charity that relies on voluntary income. It is one of the world’s most cost-effective major cancer research organisations with over 95p in every £ directly supporting research. For more information visit www.icr.ac.uk
The ICR works in a unique partnership with The Royal Marsden NHS Foundation Trust, forming the largest Comprehensive Cancer Centre in Europe.
About Cancer Research UK
- Together with its partners and supporters, Cancer Research UK's vision is to beat cancer.
- Cancer Research UK carries out world-class research to improve understanding of the disease and find out how to prevent, diagnose and treat different kinds of cancer
- Cancer Research UK ensures that its findings are used to improve the lives of all cancer patients.
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