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Medical Matters

Family Matters - Winter 2008

Children's Cancer Hospital Presents New Research at SIOP Meeting

Pediatric oncologists from the Children’s Cancer Hospital at M. D. Anderson Cancer Center unveiled new research in October at the 40th annual International Society of Pediatric Oncology (SIOP) Meeting in Berlin, Germany.

Alternatives for radiation of low-grade brain tumors 

Joann Ater, M.D., professor of pediatrics at the Children’s Cancer Hospital at M. D. Anderson, presented findings from a study she led for the Children’s Oncology Group (COG) on progressive brain tumors.

Ater’s study found that using chemotherapy alone and delaying or avoiding radiation to the brain can be effective in treating pediatric patients with low-grade glioma whose tumors are in locations that prevent surgical removal or are progressive after surgery.

For these hard-to-treat brain tumors, a majority of pediatric oncologists use cranial (brain) radiation. Although radiation is often effective, the long-term effects such as mental impairment, hormonal deficiencies and increased rate of stroke late in life can be detrimental to young patients — causing some physicians and families to decide against treatment.

“This is the first large, multi-institutional study to investigate using chemotherapy as an alternative to cranial radiation,” says Ater. “The results have confirmed the ability of chemotherapy to control the disease and gives parents more information and alternative options when making decisions about their child’s treatment.”

A new way to “starve” neuroblastoma cells

Last summer, researchers from the Children’s Cancer Hospital discovered that the drug, Glycolysin (3-BrOP) was able to kill a wide range of leukemia cells, the most common type of cancer in children. The same team, led by Patrick Zweidler-McKay, M.D., Ph.D., has now shown that this treatment also kills another type of childhood cancer, neuroblastoma, in a preclinical mouse study. The study was presented at SIOP by Alejandro Levy, M.D.

The M. D. Anderson-developed drug works by blocking glycolysis, which is a process that turns glucose (sugar) into energy for cells. Cancer cells are highly dependent on glycolysis to give them energy to grow. Using 3-BrOP, researchers blocked glycolysis, thus starving the neuroblastoma cells from their energy source while avoiding damage to healthy cells.

New therapy found to kill leukemia cells through blocking nerve growth factor

Researchers in the Children’s Cancer Hospital labs have also discovered that a family of neural receptors called tropomyosin receptor kinases (TRK) are unexpectedly found in acute myelogenous leukemia (AML) cells. As a result, they tested a drug that blocks TRK, called AZ23, on human leukemia cells in the lab and found that the drug caused leukemia cell death within 48 hours of being injected. They also found that mice with AML had significantly less leukemia after receiving the AZ23 treatment and lived longer. Senior investigator of the study is Zweidler-McKay. Based on these results, a form of this drug is scheduled to enter clinical trials in 2009.

A comparison between limb salvage and amputation

In addition to the many drug therapy studies reported at SIOP from the Children’s Cancer Hospital, other specialists presented research focused on the psychological well-being of its patients. Investigators Rhonda Robert, Ph.D., Winston Huh, M.D., and Norman Jaffe, M.D., found surprising evidence regarding the psychological outcomes of osteosarcoma survivors who received a limb salvage or an amputation.

The clinical team found that regardless of whether a patient receives a limb salvage or amputation, his/her psychological well-being is directly associated with their functional ability. This finding may help doctors and patients make decisions on what type of surgery would allow for the patient’s best functionality and thus better quality of life.

A retrospective analysis of jaw osteosarcoma

Each year, the Children’s Cancer Hospital treats many cases of osteosarcoma, a type of bone cancer. Doctors from the hospital presented a poster at SIOP about a rare form of the bone cancer known as jaw osteosarcoma. This study reviewed past patients’ medical charts, and researchers found that the majority of jaw osteosarcoma cases do not develop lung metastases, a difference from osteosarcoma in other locations.

Senior investigator on the study, Peter Anderson, M.D., from the Children’s Cancer Hospital, said the results emphasized the need for a multidisciplinary approach to cure jaw osteosarcoma. Surgery is the best option for curing the disease, but chemotherapy and radiation help control the risk of recurrence. Anderson noted that an experienced surgical team will ensure the best function of the jaw area after surgery.

Obesity in survivors of childhood sarcomas

With obesity on the rise in America, clinical researchers Winston Huh, M.D., and Joanne Ater, M.D., at the Children’s Cancer Hospital conducted a study to detect whether there was an obesity trend in childhood sarcoma survivors and what factors may contribute to it during treatment. Researchers found that 43 percent of the survivors were overweight or obese.

There was a trend towards obesity for patients treated with radiation, chemotherapy without doxorubicin, and those whose primary disease site was in the head, abdomen, pelvis or lower extremity. Previous studies have also shown childhood leukemia survivors at an increased risk for having an abnormal body mass index.

Huh and Ater plan more studies to evaluate the potential relationship of radiation therapy to abnormal body mass index (BMI) in head/neck cancer patients. Additional follow-up is needed to see if abnormal BMI leads to other health problems such as metabolic syndrome.

Moving forward in research

Although the SIOP meeting is over, researchers at the Children's Cancer Hospital have continued to build on their initial findings by conducting additional research in the lab and initiating clinical trials in order to improve cancer care for children.

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