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A scientific breakthrough has allowed experts to predict a relapse of a common childhood cancer and means doctors can tailor treatment for each child and improve prognosis.
Research from Newcastle University, UK, has found that experts can determine the time, nature and outcome of a medulloblastoma relapse based on the biology of the disease at diagnosis and initial therapy received.
The study, published today in The Lancet Child & Adolescent Health, shows that different biological groups and treatment groups within the disease relapse at different times and with different patterns of spread throughout the body.
High relapse rate
Medulloblastoma is the most common malignant brain tumor in children, and relapse after initial treatment – surgery, radiation therapy, and chemotherapy – has a severe prognosis.
Around 70 children develop cancer in the UK every year. Relapse occurs in about 30% of children, usually within five years of diagnosis.
The Newcastle Study will identify which patients are at greatest risk for persistent problems with the disease and provide an opportunity to optimize treatment and monitoring to improve the child’s prognosis.
Professor Steve Clifford, director of Newcastle University’s Center for Cancer who led the research, said the results can be used immediately in medical clinics to aid disease surveillance, advance treatment decisions, and improve quality of life after a relapse.
He said, “Our research is a very exciting development for the treatment of medulloblastoma patients and will help improve clinical outcomes.
“Our study enabled us to conduct biologically guided disease surveillance after initial treatment, which is to collect and analyze a large amount of data on tumors from patients, looking for specific types of relapses in specific patient populations.
“This found that some biological groups of patients relapse later and therefore need to be monitored longer, as this is not a single approach to combating this type of brain tumor.
“Our results also mean we can now predict disease progression after relapse and tailor treatments to improve these patients’ care through more personalized approaches based on an understanding of their individual disease.”
Hundreds of patients
For the study, 247 young patients with relapsed medullary blastoma were monitored worldwide.
Professor Clifford stated, “For a while we thought these differences might exist in medulloblastoma relapse. To test this, we have collected the world’s largest data on these relapsed patients to investigate possible associations and the type of cancer for them clinical time to be precisely defined application.
“We now need to understand the biological mechanisms underlying these findings and whether these offer opportunities to develop new, more effective therapies for the disease.”
The study’s lead author, Dr. Rebecca Hill, has received an MRC Clinician Scientist Fellowship to work in the field for the next five years.
Patient case study
Little Evan Wharton is a bundle of joy and lives life to the fullest, the best he can.
It was a difficult start for the four-year-old, however, as he was shocked with medulloblastoma at the age of only 15 months after severe balance disorders.
Within 24 hours of the discovery, Evan spent nine hours in surgery at the Great North Children’s Hospital in Newcastle removing a brain tumor the size of a golf ball.
Months of intensive chemotherapy followed and in September 2018 he was given the all-clear. Unfortunately, his cancer returned just 10 months later – further surgery and proton therapy were required.
His parents, Lindsey Sparrow, 38, and Scott Wharton, 43, a construction manager from Morpeth, Northumberland, turned their lives upside down when they saw their lucky son battle the brutal disease.
Lindsey said, “Just a month after Evan became one, we found that he had stopped pulling himself up on furniture, was unsure of himself when crawling, and was frequently falling over.
“At first the doctors thought it was an ear infection, but when he didn’t get better and went back to normal with his development, he was taken to the hospital for tests.
“We were shocked when we were told it was medulloblastoma because it was a cancer we had never heard of before. Evan was still eating, was a happy boy and not sick, so was it is a bolt from the blue.
“There is always a gray cloud hanging over your head and when we were told that his cancer relapsed it was annoying again because we knew he would have to go through more surgeries and intensive treatments.”
In October of that year, Evan had a brain scan done to monitor his health and there were no signs of cancer.
He has hearing problems, doesn’t walk or doesn’t speak yet, but is back in kindergarten and enjoys spending time with friends, which helps him develop.
Lindsey said: “It is amazing and encouraging to hear about this breakthrough from Newcastle University scientists.
“Evan has many long-term health problems due to the type of treatment he received that saved his life but also changed his life.
“With more tailored options, hopefully this will reduce the long-term side effects and harsh treatments that children have to endure.
“It’s a big step forward and it’s fantastic that Newcastle has this breakthrough.”
Scientists show how brain tumors fall back in childhood
Time, pattern, and outcome of medulloblastoma relapse and their association with tumor biology in diagnosis and therapy: a multicenter cohort study. Rebecca M. Hill et al. The Health of the Lancet & Adolescent. DOI: 10.1016 / S2352-4642 (20) 30246-7
Provided by Newcastle University
Quote: Breakthrough in Childhood Brain Cancer Will Save Lives (2020, November 17), accessed November 18, 2020 from https://medicalxpress.com/news/2020-11-breakthrough-childhood-brain-cancer.html
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