September 2016 Today is the first day of Childhood Cancer Awareness Month and it is timely that Childhood Cancer 2016 takes place next week, representing an important opportunity for us to talk about childhood cancer.
Childhood Cancer 2016 has a very different flavour to our previous conferences, which have focused on the aetiology of childhood cancer. This year we are looking at how new developments in translational science are being harnessed to improve survival and quality of survival for children with cancer. Read more
We will start the conference by considering, on day one, the potential of precision medicine to improve the outlook for children with cancer in the UK, discussing the promise and pitfalls of making DNA sequencing available for all young cancer patients. Children with Cancer UK has recently committed funding to support the preliminary stages of rolling out sequencing across the UK and as part of his day one talk Dr Darren Hargrave will discuss plans for the implementation of this work.
On day two, attention will turn to immunotherapy as we hear from world-leading experts about the remarkable success that is being achieved in the US and here in the UK.
On day three we will revisit the question of causation, what is known about influenceable causes of cancer and what steps can realistically be taken to reduce the incidence of cancer in children and young people.
With an exciting combination of invited speakers, free communications and panel debates – our aim is for Childhood Cancer 2016 to support a two-way dialogue – or indeed a multi-way dialogue. With a broad mixture of scientists and clinicians joining us from the UK and overseas (and we are pleased to welcome speakers and delegates from the US, France, Germany, Italy, Greece, Brazil and Pakistan), the conference will facilitate the sharing of information and knowledge and provide a forum for networking and discussion. Importantly, we see the conference as a key opportunity to engage with the childhood cancer research community and garner your views on how we work and what we should be funding. We will be actively seeking input into the development of our new research strategy.
We are delighted that many of our grant-holders are joining us to showcase some of the work that we are funding.
For those who are unable to join us next week, we will be videoing the sessions and much of the content will be available here in the next few weeks. We are also pleased to be joined by ecancer, who will be producing a conference report as well as filming interviews with some of our speakers. Conference abstracts will also be available here shortly.
Research Development Manager, Children with Cancer UK
1st September 2016
Mark Miller replaces Chris Portier on day three
July 2016 Mark Miller will be discussing perspectives on what constitutes adequate evidence for action and benefits versus risks of potential preventative actions.
Chris Portier has unfortunately had to withdraw from Childhood Cancer 2016, where he had been poised to deliver a talk on day three, on effecting policy change to protect the health of children.
We’re disappointed that Chris is no longer able to join us, but delighted to report that Dr Mark Miller will be joining the day three line-up in his place. Read more
Mark is an Assistant Clinical Professor in the Departments of Pediatrics and Internal Medicine at the University of California, San Francisco (UCSF). He is also the Co-Director of the UCSF Pediatric Environmental Health Specialty Unit (PEHSU) and the Director of the Children’s Environmental Health Program at California Environmental Protection Agency.
Mark is a co-investigator at the UC Berkeley, Center for Integrative Research on Childhood Leukemia and the Environment (CIRCLE) where a diverse team of scientists is investigating possible environmental causes of childhood leukaemia.
Mark will discuss whether we can reduce exposure to risk factors associated with childhood leukaemia and other cancers:
“A growing body of literature has implicated the role of several environmental hazards in the etiology of childhood leukemia….. Despite the strength of these findings, the dissemination of current research to clinicians has been limited. Currently there is an absence of programs directed at reducing exposures to these identified risk factors. The incidence of childhood leukemia is high and increasing in Hispanic children in California, demonstrating a particular vulnerability in certain populations not entirely explained by genetics. It would be prudent to establish programs to alter exposure to those factors with well-established associations with cancer risk rather than to suspend judgment until no uncertainty remains. I will discuss perspectives on what constitutes adequate evidence for action and benefits vs risks of potential preventative actions.”
Research Development Manager, Children with Cancer UK
19th July 2016
A tale of two meetings
We began last week in Liverpool for the biennial meeting of the International Symposium on Pediatric Neuro-Oncology (ISPNO) and ended the week in London at the Childhood Cancer Conference 2016, organised by the Childhood Cancer and Leukaemia Group (CCLG) and Bethany’s Wish, the Wilms Tumour Charity. Read more
ISPNO 2016: 17th International Symposium on Pediatric Neuro-Oncology
ISPNO is the major global meeting of the multi-disciplinary international community of professionals involved in the scientific research, diagnosis, treatment and rehabilitation of infants, children and young people with tumours of the central nervous system (CNS).
We were pleased to be a Silver Sponsor of the Liverpool meeting. It was a great beast of a meeting, with more than 1,100 delegates. The main meeting took place over three days, preceded by two days of pre-conference meetings. The three days themselves were packed full of content, with breakfast meetings, lunchtime symposiums and sessions running in parallel throughout the day. There were around 150 oral presentations and 600 poster presentations. All providing updates on progress in the research and treatment of childhood brain tumours.
The range of topics was diverse, with sessions devoted to all of the major brain tumour types, and from clinical, molecular and surgical viewpoints. And the conference was truly international - Europe, the US and Canada were well-represented as would be expected, but research was presented from countries including Nepal, Mexico, India, China, Poland and Taiwan.
UK Childhood Cancer Conference 2016
The Childhood Cancer Conference had a very different flavour to ISPNO. The aim of this annual conference is to provide a platform for parents and professionals to come together to find out about the latest research into childhood cancer, share experiences and collaborate.
It was a much smaller, more intimate meeting, with around 100 delegates comprised of parents, survivors, researchers, health professionals and charities.
We heard from some of the UK’s leading childhood cancer experts on developments in treatment and research, and from parents, who provided thought-provoking and moving perspectives on childhood cancer. These put a very different spin on the presentations, discussion and debate taking place at ISPNO. With so many participants presenting so much research, you would be forgiven for thinking that we are on top of this, great progress is being made and survival must be increasing, right?
What progress are we making?
Four out of five children diagnosed with cancer can now be cured. This survival rate is double what it was 50 years ago so there is much to celebrate. But survival has now plateaued. And still one child in five is dying - either because there is no effective treatment for their cancer or because their body can’t withstand the toxic treatment.
In the main, the gains in survival have been achieved not through the introduction of new drugs but rather through improvements in the way we use existing drugs. We’ve improved diagnostics and learned how to stratify children into different treatment groups so that they can be treated under the regime that has been shown to be most effective for their particular situation, using the best combinations of therapy. Improvements in surgical techniques, radiotherapy and supportive care have played an important role.
But we have reached the limits of what existing treatments can achieve. New treatments are desperately needed to save the thousands of children worldwide that are let down by current treatments.
‘Let down by science’
Oscar Knox was diagnosed with high-risk neuroblastoma when he was three years old. After a long, bravely fought battle, he died in 2014.In a poignant presentation at the Childhood Cancer Conference, Oscar’s mum, Leona, explained how she feels that Oscar was let down by science; that he didn’t die because he got neuroblastoma but because he ran out of treatment options.
This may seem harsh, given the sheer volume of research that is in progress as evidenced at ISPNO. Whilst ISPNO focused on childhood brain tumours, the Advances in Neuroblastoma Research (ANR) meeting taking place this week in Australia is on a scale not dissimilar to ISPNO, with hundreds of researchers from around the world joining together to share research findings and discuss progress in the research and treatment of neuroblastoma.
So in the face of all this research, why are children still dying of cancer? Why haven’t we found new treatments? It’s no comfort to parents to be told that research is slow, that it doesn’t happen overnight. Their children need the treatments now. Or yesterday.
In his rather sobering closing remarks at ISPNO, Professor Richard Gilbertson (Cambridge University) reminded delegates that – despite the significant developments in biological knowledge and advances in technology, little has been translated to wide scale patient benefit. He called for a paradigm shift in how prospective drugs are developed and emphasised the need to utilise new technologies to enable precision medicine and early screening.
Making a difference
Ultimately there are two measures of success in childhood cancer research and treatment: the numbers of children being cured and the quality of life enjoyed by survivors. Much attention is being devoted to the latter in light of the numbers of children now surviving cancer.
Immunotherapy and precision medicine are two areas of research that hold great promise for progress against both of these measures.
The relatively recent ability to (rapidly and affordably) map out the genetic code of any individual person and any cancer they develop holds great promise for the design of targeted treatments with the aim not only to improve cure rates but to also reduce toxicity. This type of precision medicine has proven benefit in some of the common adult cancers. Precision medicine technology is now being systematically applied in the US and Europe to children with cancer, with real success. Ad hoc efforts in the UK have also shown success and we hope that the approach will shortly be rolled out systematically so that all children diagnosed with cancer can have their tumour DNA sequenced. This is the culmination of a vast research effort, but is still only the first part of the story as its success ultimately depends on the availability of effective treatments.
Cancer immunotherapy refers to the use of treatments that harness and enhance the natural powers of the immune system to fight cancer. The last few years have seen a surge of new immune-based therapies that are changing the landscape of how children with some of the more deadly cancers are treated. Such therapies have already been used successfully in the UK in children with leukaemia and neuroblastoma. At the Childhood Cancer Conference, Professor Paul Veys from Great Ormond Street Hospital outlined a new ‘off the shelf’ approach currently being pioneered at GOSH, using engineered donated immune cells to treat relapsed leukaemia. A new trial has opened at GOSH just this month, with the first patient currently undergoing treatment. Its early days but if the treatment proves successful, it will be a turning point in the treatment of relapsed leukaemia, with implications for other childhood cancers as well.
What are the greatest barriers to progress in the successful treatment of children with cancer? Funding is obviously important but undoubtedly it is about HOW we fund as well as HOW MUCH we fund.
As funders, entrusted with publicly-donated funds, we have a responsibility to choose the research that we fund with the utmost of care. There are many criteria against which submitted research applications are scrutinised but ultimately selection is based upon the NEED for the research (is it addressing an important question that needs to be answered?), the potential IMPACT of the research (will it make a difference and how quickly?) and the quality of the SCIENCE (can they actually do what they say they are going to do and will it mean what they say it will mean?).
Richard Gilbertson is speaking at our September conference, Childhood Cancer 2016, on ‘the opportunities for precision medicine for children with brain tumours’. The conference, chaired by Dr Nick Goulden, will bring together clinicians and scientists from different disciplines within the childhood cancer field to exchange knowledge and ideas. Precision medicine is one of three themes to be featured over three days, alongside Immunotherapy and Causation.
Discussions taking place at the conference will feed into a review of our research strategy, which we hope to complete by the end of the year - to consider how best we can apply a limited amount of funds to greatest effect for the benefit of children like Oscar.
Research Development Manager, Children with Cancer UK
21st June 2016
What do we know about influenceable causes of childhood cancer?
April 2016 Professor Denis Henshaw has been Scientific Director of Children with Cancer UK since retiring from the University of Bristol in 2011.
Denis is co-chairing the third day of Childhood Cancer 2016, focusing on the influenceable causes of childhood cancer. He sets the scene for the day:
“I spent the major part of my research career at Bristol studying a number of environmental exposures linked to the incidence of childhood leukaemia, especially ionising radiation, electric and magnetic fields and air pollution. I have since become interested in all aspects of environmental exposures and lifestyle factors that may affect childhood cancer risk. Read more
Historic wisdom argues that the causes of childhood cancer remain largely unknown and that incidence is probably down to bad luck, meaning it is merely a random event over which we have no control. Recent years, however, have seen the growth of large-scale epidemiological studies, including pooled analysis of national studies, providing a level of statistical resolving power that is starting to detect statistically significant links with disease incidence and exposure to a number environmental agents and lifestyle factors.
Most studies have investigated childhood leukaemia, although some have addressed brain tumours and neuroblastoma. Studies range from pre-conceptual parental exposure to in utero exposure to exposure in childhood per se.
Natural background ionising radiation, from cosmic rays and trace radioactive elements in the ground constitute a largely unavoidable exposure that in the UK appears responsible for up to 20 per cent of childhood leukaemia incidence. Magnetic fields associated with the electricity supply may be responsible for 5 per cent of incidence. There is strong evidence that carcinogenic components of motor vehicle air pollution could be a significant factor and a firm link has been established with parental exposure to pesticides. Recent research has demonstrated that carcinogens present in maternal diet can cross the placenta and induce DNA damage in the fetus.
Studies of actual, or surrogates, of exposure indicate that infections have a mixed role in childhood leukaemia risk, which appears to be related to the time window where exposure occurred.
Our four eminent keynote speakers - Kurt Straif, Tariq Enver and Soterios Kyrtopoulos – will help us consider whether any of these exposures can be avoided, either in principle or in practice, and whether the strength of evidence is sufficient to justify avoidance measures.
I feel certain we can look forward to a lively debate.”
Dr Nick Goulden on CC2016
Dr Nick Goulden has recently taken up the role of Medical Research Director at Children with Cancer UK. He is chairing the organising committee for Childhood Cancer 2016.
He explains what we are hoping to achieve through this meeting:
“Until my retirement in 2015 I worked as a consultant paediatric haematologist initially in Bristol and subsequently at Great Ormond Street Hospital. My experience as a clinician and chief investigator of national clinical trials led me to champion translational research that has a positive impact on prognosis and mitigation of toxicity for all patients. I was fortunate to have personal experience of this, having been part of teams that played a leading role in the improvement of risk directed therapy for acute lymphoblastic leukaemia in the UK and the development of alternative donor stem cell transplant and immunotherapy. Read more
Much of my research was supported by Children with Cancer UK and I have a long and strong link with the charity as a member and chair of the Scientific Advisory Panel and more recently as Medical Research Director.
Children with Cancer UK annually grants over £4 million for research. As Research Director I am keen to maximise the positive impact of that money on children suffering from cancer. This aim is shared by the members of the Scientific Advisory Panel.
What's different about Childhood Cancer 2016?
Previous Children with Cancer UK conferences have focused on causation. By contrast Childhood Cancer 2016 has a broader remit.
The organising committee believes that the conference represents an exciting opportunity to broaden knowledge, exchange views and enthuse new researchers. Our aim is to bring together scientists and clinicians working in different areas of childhood cancer research and care to facilitate the sharing of information and knowledge, to discuss important issues and to network and develop new collaborations.
We will provide a state of the art update as to how new developments in translational science - including the revolution in molecular genetics, advances in functional imaging technologies and wider use of humoral and cellular immunotherapy - are being harnessed to further improve survival and quality of survival for children suffering from cancer.
On the third day, we will turn our attention to causation as we discuss the implications of recent well-designed epidemiological studies and consider how they may impact on strategies for prevention.
We have an exciting line-up of speakers joining us in London to share their very specific expertise and experience across the three conference themes: precision medicine, immunotherapy and influenceable causes. Their plenary talks will be combined with free communication and we are hoping for some lively panel debates at the end of each day!