Researchers are very interested in the diagnosis and treatment of neuroblastoma. There are a number of clinical trials for people to join in the UK. And many children and young people with neuroblastoma have their treatment as part of a clinical trial.
Individual trials close when enough people have joined. There might then be a period of time before the results are available. New trials then open based on the lessons learned.
Amy: My daughter Poppy is a fun loving, adventurous, excitable eight year old child and she’s just lovely.
Poppy was diagnosed age three with a rare type of cancer called neuroblastoma, and we were completely devastated.
The prognosis for Poppy at that stage was a 20% chance of survival.
We were approached by Poppy’s cancer specialist to take part in a new trial. This potentially could prolong Poppy’s life.
The only thing that did sort of trouble us as a family when they did tell us was that it was possibly quite painful.
We were told at that time that they would manage the pain, that we would have somebody with us 24 hours a day.
Poppy’s treatment was an infusion into her bloodstream. With regards to pain and any symptoms that arose with Poppy, somebody was always there to make sure that she wasn’t in any pain or any suffering.
The trial for Poppy has enabled her to be a normal healthy child and without that who knows what position we would have been in now.
The doctors and the nurses and the specialists are all there to help ease any worries and concerns that you have.
If I could give anybody any advice it would be if you have any queries or concerns or worries then speak to your cancer specialist. That is their job. That is their role. That is what they do.
Researchers are looking into different types of scans to see which is better at showing where neuroblastoma has spread in the body.
Scientists are also studying blood samples and samples of neuroblastoma tissue. This is to look at changes inside the cancer cells. Researchers would like to know if doctors can choose the best treatments based on these changes.
Doctors are looking into improving the treatment for high risk neuroblastoma.
This video shows one way that Cancer Research UK is supporting research into neuroblastoma.
Before we are born, stem cells divide and make new cells such as nerves, which can spread out from the spinal cord into the rest of the body.
In children with neuroblastoma however, they continue to divide when they shouldn’t, producing way too many cells and forming a tumour.
So what are they up to?
Meet MYCN and ALK. These two proteins have specific functions in our body and usually behave themselves.
In some cases of neuroblastoma though, these two proteins are thought to turn rogue, working together somehow to push the stem cells into making cells that can form tumours.
Professor Chesler at the Institute of Cancer Research in London, hopes that by using a model that recreates neuroblastoma in the lab, they can test new treatments which only target the excess cells created.
Across the country, Cancer Research UK is funding work like this, to better understand cancers affecting children and young people and to develop new, better and kinder treatments.
Targeted cancer drugs
Cancer cells have changes in their genes that make them different from normal cells. These changes mean that the cell might grow faster and work differently from normal cells. Targeted cancer drugs take advantage of this and target the specific gene changes the cancer cells have.
Several trials of new targeted cancer drugs and different ways of giving them have recently closed. New trials into targeted cancer drugs are being developed.
Researchers also want to find out if having a drug called bevacizumab can help children with neuroblastoma. Bevacizumab is a type of targeted cancer drug called a monoclonal antibody that targets the tumour’s blood supply.
This trial is also comparing different combinations of chemotherapy to see which works best. The trial is for children whose chemotherapy is no longer working and for those who have finished treatment but their neuroblastoma has come back.
A trial is looking at a new treatment using anti-GD2 T-cells. T cells are part of the immune system and help fight infection. The researchers are taking immune cells from the blood and changing them so they can attack the cancer cells. They change them by putting a gene into them. Genes are coded messages that tell cells how to behave. Doctors hope the new gene will help the T cells to recognise and attack the cancer cells.
Radiotherapy is a common treatment for neuroblastoma. It uses high energy x-rays to kill cancer cells. Doctors plan radiotherapy treatment so that cancer cells get a high dose of radiation and healthy cells receive a lower dose. But this can be hard to do using conventional radiotherapy.
Researchers have developed a new type of radiotherapy called Intensity Modulated Arc Therapy (IMAT). This allows radiotherapy to be directed more accurately at the cancer. Doctors think that using IMAT means a higher dose of radiotherapy can be given so the treatment might be better at killing the cancer cells.
Researchers are testing drugs called somatostatin analogues. These drugs can target a protein called somatostatin on the surface of neuroblastoma cells. It is similar to the mIBG treatment that some children with neuroblastoma have.
LuDO is a somatostatin analogue that has a radioactive molecule attached to it. LuDO finds the neuroblastoma cells and then the radioactivity kills them.
Blood and bone marrow tests
A recent study looked at particular protein markers found in the blood at diagnosis. The study team concluded that these markers can help show which children with stage 4 neuroblastoma have high risk disease. And so they might not respond as well to standard treatment. Knowing this early on could help doctors decide to give newer treatments straight away. We need more research to see how helpful these blood tests are.
Researchers are looking at collecting tumour cells that have broken away from neuroblastoma. These are circulating tumour cells. They want to find out if it is possible to collect these cells from the blood and bone marrow. And if so, use these cells to help develop new drugs to treat neuroblastoma.
Research into side effects
Researchers are also looking into the long term effects of treatment for all types of childhood cancer. The Centre for Childhood Survivor Studies is carrying out the British Childhood Cancer Survivor study.
This research is looking at children who were diagnosed with cancer between 1940 and 1991 and lived for at least 5 years after diagnosis.
This type of research takes many years to produce results because the children need to be followed throughout their lives. So it will be some time before we know the results.