Children, sadly, are among the 14,000 West Australians who are diagnosed with cancer each year. Our vibrant research community includes researchers who are working tirelessly on cancers that affect our youngest population.
One of these childhood cancers is high-risk neuroblastoma, which affects a child's nerve cells. Sadly, 50 per cent of children with this cancer pass away within five years. One of the biggest challenges facing our cancer researchers is understanding why some children respond well to current treatments, while others do not.
To better understand this, Dr Alison McDonell and her team at The Kids Research Institute Australia (formerly Telethon Kids Institute) are looking to identify a marker that will tell us whether children will respond to treatment, and to develop new treatments for those who don't.
We spoke with Dr Alison McDonnell to learn more about her team's research.
What are the current survival rates for kids with neuroblastoma?
"For kids with neuroblastoma, there's different risk groups based on the likelihood of their treatment working. The kids that have low and intermediate risk generally have a 95 to 96 per cent survival rate. But the kids with high risk only have a 50 per cent survival rate."
What is the standard treatment they receive?
"Kids with high-risk neuroblastoma undergo a very intense treatment schedule consisting of chemotherapy, surgery, more high dose chemotherapy, followed by a stem cell transplant, radiotherapy and maintenance immunotherapy.
"Unfortunately, they can suffer several side effects from this intense treatment, such as nausea and vomiting, fevers, hearing loss and increased risk of infection. They also have prolonged hospital admissions, often for months at a time while they are undergoing treatment.
"Currently, there is no way to tell whether a child will respond to these treatments, so they may have to go through this process, only to find out that it won't work."
How will your research help these children?
"We are hoping to develop an 'immune fingerprint', which would essentially predict whether a child will respond to treatment.
"We are doing this by looking at the tumour tissue of kids with high-risk neuroblastoma collected before and after treatment.
"If we can find out how they will respond to treatment, either before they start or at best after the first few cycles of chemotherapy, then it will save those kids who won't respond to this standard treatment from going through all of the remaining procedures. Instead, we could send them straight to clinical trial or try a different treatment."
"So this research is really about finding a marker that will tell us that the current treatment schedule is not going to work. It has the potential to save these children and their families a lot of time and unnecessary treatment and side-effects."
How could this lead to new treatments for kids that don't respond?
"As well as looking for a marker that says the child won't respond, we are also looking for new therapies that these kids will respond to.
"We are looking at how their immune cells communicate with their cancer cells and hoping to link that with the response to treatment.
"If we can find something that removes the need for the chemotherapy or radiotherapy, or allows us to bring these treatments down to less toxic levels, that that would really help these children."
What results have you found so far?
"In our initial analysis, we found groups of genes that appeared to be linked with poorer survival. We have also seen an inflamed immune microenvironment in these kids after chemotherapy. In adults, this inflamed immune microenvironment is generally good and means that they will respond the treatment. But in these kids, we are seeing the opposite and that it appears to correspond with a worse response to treatments.
"This is an important finding, because no one has really shown this result before. Our next step is to see if we can recreate this with another larger sample."
Do you have any personal connection to cancer that has made your work more significant?
"A friend of mine, her son died of osteosarcoma when he was 14. It's different seeing cancer in a young person as opposed to where we normally see it in older adults.
"Talking to her about it, she said that it was very isolating, because childhood cancer is so rare. In her case they didn't know anything about osteosarcoma, the prognosis, the outcomes, or anyone who had been through this and it seemed like there wasn't a lot of research being done to help. This was one of the things that really drove me to do this research. I think it can help people to know that someone is working towards a cure."
What would you say to the donors who contributed to this research?
"It doesn't matter how large or small the donation is, any form of help in the lab is amazing. These donations enable us to do experiments that in two or three years from now, may be the missing link that someone has been looking for.
I can't thank the donors enough – we really wouldn't exist without them."
As a community-funded organisation, we rely on donations to help fund local cancer research, such as Dr Alison McDonnell's. If you'd like to make a difference, please donate today.
