Peer-reviewed – Clinical guidelines - People
New clinical guidelines enabling a better understanding of childhood bone cancer will revolutionise treatment for these young patients across Europe, according to a leading researcher from the University of East Anglia.
The new guidance, which will be implemented across every hospital and research institute in Europe that works with patients with bone cancer, are ultimately aimed at moving treatment away from untargeted chemotherapy and more towards precision medicine.
The new framework includes specifications for biological samples from patients.
The hope is that these samples can then be used for additional testing to better understand each child's cancer and lead to personalisation of effective treatments with reduced side effects.
Gathering high-quality samples from across Europe, along with the patient's medical information, will help researchers and clinicians to pinpoint different subtypes of disease and understand the genetic, biological, and other factors involved.
This can guide the development of tailored treatments for each patient's cancer type.
Dr Darrell Green, of UEA's Norwich Medical School, was one of three joint lead researchers on the project, which brought together more than 60 universities, hospitals and research institutions.
He said: "Bone cancer treatment is brutal, involving a combination of untargeted chemotherapy and surgery, which sometimes involves limb amputation.
"Most patients with bone cancer have a limited number of biological samples collected when they are diagnosed; enough to diagnose the cancer but not enough for scientists to perform experiments to better understand the disease, which leads to the development of better treatments with fewer side effects.
"Chemotherapy has of course saved many lives but is now horribly outdated by today's expectations - developed in the 60s, 70s and 80s - extremely toxic and long-term survival is poor at 40-50pc."
Jointly led by authors at UEA, The Princess Máxima Center for Pediatric Oncology in The Netherlands, and Regina Margherita Children's Hospital in Italy, the new clinical guidelines include step-by-step procedures and protocols for collecting biological samples that will lead to a better understanding and the development of more effective treatments with fewer side effects.
Dr Zoe Davison, Head of Research, Information & Support at the Bone Cancer Research Trust, which funded the work, said: "Our patients have overwhelmingly expressed their support for sample donation, which is why we are committed to improving this process and supporting the use of patient samples in research.
"Because some childhood bone cancers are rare and tissue collection and handling is complex, scientists often do not have enough of the right samples for both treating patients and doing research. We are delighted to see our scientific and clinical community uniting to produce these guidelines for patient sample collection.
"The new Europe-wide framework is intended to underpin translational research with the hope of identifying more effective and kinder treatments."
Two international panels of scientists, clinicians and patient and parent advocates have formed the Fight Osteosarcoma Through European Research (FOSTER) consortium and the Euro Ewing Consortium (EEC). The consortia shared their expertise and institutional practices to formulate the new guidelines.
The Bone Cancer Research Trust funds FOSTER and EEC structure and activities and provides the five surgical centres in England with funding to support sample collection.
'Biological sample collection to advance research and treatment: a Fight Osteosarcoma Through European Research (FOSTER) and Euro Ewing Consortium (EEC) statement' is published in Clinical Cancer Research.
