Breakthrough Enables Prediction of Relapse in Common Childhood Cancer

New research has allowed experts to identify the time, nature, and outcome of pediatric medulloblastoma relapse, allowing physicians to tailor treatments for each individual patient and improve prognosis.

Published in The Lancet Child & Adolescent Health, the study shows that different biological and treatment groups within the disease relapse at different times and with different patterns of spread throughout the body. Medulloblastoma is the most common malignant brain tumor in children and relapse following initial treatment has a grave prognosis, according to the authors. Approximately 70 children are diagnosed with the cancer each year in the UK, of whom approximately 30% have a relapse within 5 years of diagnosis.

The new research identified which patients are most at risk of continuing problems with the disease. The findings can be applied immediately in medical clinics to help with disease monitoring, advance treatment decisions, and to improve quality of life after relapse, according to Steve Clifford, director of Newcastle University’s Centre for Cancer.

“Our study allowed us to undertake biology-directed disease surveillance after initial treatment, in other words to gather and analyze a large amount of data on patients’ tumors, looking out for particular types of relapse in particular groups of patients,” Clifford said in the press release. “This revealed that some patient biological groups relapse later and therefore need to be monitored longer as it is not a one-size-fits-all approach to tackling this kind of brain tumor.”

The press release outlined the case study of a 4-year-old boy, Evan Wharton, who was diagnosed with medulloblastoma at 15 months old after having severe balance problems. Within 24 hours of his diagnosis, Wharton underwent a 9-hour surgery to remove a brain tumor the size of a golf ball. He also had months of intense chemotherapy and was cleared in September 2018, but his cancer relapsed 10 months later.

Wharton underwent more surgeries and a course of proton therapy, and a scan in October 2020 found no sign of the cancer. He has hearing problems and still does not walk or speak, but his parents say more tailored treatment options can lessen the adverse effects for other children, according to the press release.

“Evan has a lot of long-term health issues due to the type of treatment he received which, yes, saved his life but has also altered his life,” said his mother, Lindsey Wharton, in the press release. “With more tailor-based options available, this will hopefully lessen the long-term side effects and harsh treatments that children have to endure.”

REFERENCE

Breakthrough in childhood brain cancer will save lives [news release]. EurekAlert; November 17, 2020. https://www.eurekalert.org/pub_releases/2020-11/nu-bi111720.php. Accessed December 2, 2020.