By Dr Gareth Veal, Senior Lecturer at the Northern Institute for Cancer Research, Newcastle University
Over the past several decades we have seen significant improvements in the treatment of childhood cancer, with overall five-year survival rates exceeding 80 per cent now being reported. Advances have largely been made through the development of new drugs and improvements in the use of established chemotherapy treatment.
In the pharmacology group at the NICR, we are investigating how children’s bodies process cancer drugs, and how the actions of drugs are influenced by variation in a person’s genes. By investigating differences in the way that individual patients process drugs and respond to them we can endeavour to improve the beneficial effects of the drugs for every patient.
In the study that Joe Johnson took part in, which was published in the scientific journal Clinical Cancer Research, we found that in three quarters of cases the patients were achieving drug exposures which may not be beneficial.
The study showed that, when given a standard dose, some patients were achieving levels of drug in the bloodstream that could be too low to be effective, and that this could be overcome by individually tailoring the dose of the drug to children taking part in the study.
A major challenge in administering 13-cis-retinoic acid is that it only comes in capsule form. As most children with neuroblastoma are too young to swallow the capsules, they have to be opened up and the contents either put down the child’s feeding tube or mixed with food.
This means it’s very hard to control exact doses, as some medicine can be left in the capsule or not transferred efficiently. This under-dosing could have a significant impact on a child’s recovery. The findings from the trial, which recruited patients being treated at hospitals across the UK, have resulted in patients being prescribed more appropriate doses Europe-wide.
It is essential that drugs like 13-cis-retinoic acid are used as effectively as possible to further improve the treatment of childhood cancer. In this respect, clinical pharmacology studies are central to determining the most appropriate selection of drugs and dosing regimes to further improve survival rates and minimise side effects in children with cancer.
The Newcastle University Centre for Childhood Cancer will enable us to continue to run clinical trials which directly impact on patient treatment, helping us to make more discoveries that save the lives of children like Joe.
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