1
|
Xie J, Kumar A, Dolman MEM, Mayoh C, Khuong-Quang DA, Cadiz R, Wong-Erasmus M, Mould EVA, Grebert-Wade D, Barahona P, Kamili A, Tsoli M, Failes TW, Chow SO, Arndt GM, Bhatia K, Marshall GM, Ziegler DS, Haber M, Lock RB, Tyrrell V, Lau L, Athanasatos P, Gifford AJ. The important role of routine cytopathology in pediatric precision oncology. Cancer Cytopathol 2021; 129:805-818. [PMID: 34043284 DOI: 10.1002/cncy.22448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The development of high-throughput drug screening (HTS) using primary cultures provides a promising, clinically translatable approach to tailoring treatment strategies for patients with cancer. However, this has been challenging for solid tumors because of often limited amounts of tissue available. In most cases, in vitro expansion is required before HTS, which may lead to overgrowth and contamination by non-neoplastic cells. METHODS In this study, hematoxylin and eosin staining and immunohistochemical staining were performed on 129 cytopathology cases from 95 patients. These cytopathology cases comprised cell block preparations derived from primary tumor specimens or patient-derived xenografts as part of a pediatric precision oncology trial. Cytopathology cases were compared with the morphology and immunohistochemical staining profile of the original tumor. Cases were reported as tumor cells present, equivocal, or tumor cells absent. The HTS results from cytopathologically validated cultures were incorporated into a multidisciplinary tumor board report issued to the treating clinician to guide clinical decision making. RESULTS On cytopathologic examination, tumor cells were present in 77 of 129 cases (60%) and were absent in 38 of 129 cases (29%), whereas 14 of 129 cases (11%) were equivocal. Cultures that contained tumor cells resembled the tumors from which they were derived. CONCLUSIONS Cytopathologic examination of tumor cell block preparations is feasible and provides detailed morphologic characterization. Cytopathologic examination is essential for ensuring that samples submitted for HTS contain representative tumor cells and that in vitro drug sensitivity data are clinically translatable.
Collapse
Affiliation(s)
- Jinhan Xie
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Amit Kumar
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - M Emmy M Dolman
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Chelsea Mayoh
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Dong-Anh Khuong-Quang
- Children's Cancer Center, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Roxanne Cadiz
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Marie Wong-Erasmus
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Emily V A Mould
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Dylan Grebert-Wade
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Paulette Barahona
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Alvin Kamili
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Maria Tsoli
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Timothy W Failes
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Australian Cancer Research Foundation Drug Discovery Center, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick, New South Wales, Australia
| | - Shu-Oi Chow
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Australian Cancer Research Foundation Drug Discovery Center, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick, New South Wales, Australia
| | - Greg M Arndt
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Australian Cancer Research Foundation Drug Discovery Center, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick, New South Wales, Australia
| | - Kanika Bhatia
- Children's Cancer Center, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Glenn M Marshall
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Kids Cancer Center, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - David S Ziegler
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia.,Kids Cancer Center, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Michelle Haber
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Richard B Lock
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia
| | - Vanessa Tyrrell
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia
| | - Loretta Lau
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,Children's Cancer Center, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Penny Athanasatos
- Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Andrew J Gifford
- Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia.,Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| |
Collapse
|
2
|
Wong M, Mayoh C, Lau LMS, Khuong-Quang DA, Pinese M, Kumar A, Barahona P, Wilkie EE, Sullivan P, Bowen-James R, Syed M, Martincorena I, Abascal F, Sherstyuk A, Bolanos NA, Baber J, Priestley P, Dolman MEM, Fleuren EDG, Gauthier ME, Mould EVA, Gayevskiy V, Gifford AJ, Grebert-Wade D, Strong PA, Manouvrier E, Warby M, Thomas DM, Kirk J, Tucker K, O'Brien T, Alvaro F, McCowage GB, Dalla-Pozza L, Gottardo NG, Tapp H, Wood P, Khaw SL, Hansford JR, Moore AS, Norris MD, Trahair TN, Lock RB, Tyrrell V, Haber M, Marshall GM, Ziegler DS, Ekert PG, Cowley MJ. Whole genome, transcriptome and methylome profiling enhances actionable target discovery in high-risk pediatric cancer. Nat Med 2020; 26:1742-1753. [PMID: 33020650 DOI: 10.1038/s41591-020-1072-4] [Citation(s) in RCA: 161] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/20/2020] [Indexed: 02/08/2023]
Abstract
The Zero Childhood Cancer Program is a precision medicine program to benefit children with poor-outcome, rare, relapsed or refractory cancer. Using tumor and germline whole genome sequencing (WGS) and RNA sequencing (RNAseq) across 252 tumors from high-risk pediatric patients with cancer, we identified 968 reportable molecular aberrations (39.9% in WGS and RNAseq, 35.1% in WGS only and 25.0% in RNAseq only). Of these patients, 93.7% had at least one germline or somatic aberration, 71.4% had therapeutic targets and 5.2% had a change in diagnosis. WGS identified pathogenic cancer-predisposing variants in 16.2% of patients. In 76 central nervous system tumors, methylome analysis confirmed diagnosis in 71.1% of patients and contributed to a change of diagnosis in two patients (2.6%). To date, 43 patients have received a recommended therapy, 38 of whom could be evaluated, with 31% showing objective evidence of clinical benefit. Comprehensive molecular profiling resolved the molecular basis of virtually all high-risk cancers, leading to clinical benefit in some patients.
Collapse
Affiliation(s)
- Marie Wong
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Chelsea Mayoh
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
| | - Loretta M S Lau
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Dong-Anh Khuong-Quang
- Children's Cancer Centre, Royal Children's Hospital, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Mark Pinese
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Amit Kumar
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Paulette Barahona
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Emilie E Wilkie
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
| | - Patricia Sullivan
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Rachel Bowen-James
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Mustafa Syed
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | | | | | - Alexandra Sherstyuk
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Noemi A Bolanos
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Jonathan Baber
- Hartwig Medical Foundation, Amsterdam, The Netherlands
- Hartwig Medical Foundation Australia, Sydney, NSW, Australia
| | - Peter Priestley
- Hartwig Medical Foundation, Amsterdam, The Netherlands
- Hartwig Medical Foundation Australia, Sydney, NSW, Australia
| | - M Emmy M Dolman
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Emmy D G Fleuren
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
| | - Marie-Emilie Gauthier
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Emily V A Mould
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Velimir Gayevskiy
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Andrew J Gifford
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Dylan Grebert-Wade
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Patrick A Strong
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Elodie Manouvrier
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Meera Warby
- Cancer Centre for Children, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - David M Thomas
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Judy Kirk
- Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
- Sydney Medical School, University of Sydney Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Katherine Tucker
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
- Prince of Wales Hospital Clinical School, University of New South Wales, Randwick, NSW, Australia
| | - Tracey O'Brien
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Frank Alvaro
- John Hunter Children's Hospital, New Lambton Heights, NSW, Australia
| | - Geoffry B McCowage
- Cancer Centre for Children, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children's Hospital Westmead, Westmead, NSW, Australia
| | - Nicholas G Gottardo
- Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Nedlands, WA, Australia
- Brain Tumour Research Program, Telethon Kids Institute, Nedlands, WA, Australia
| | - Heather Tapp
- Women's and Children's Hospital, Adelaide, SA, Australia
| | - Paul Wood
- Monash Children's Hospital, Melbourne, VIC, Australia
| | - Seong-Lin Khaw
- Children's Cancer Centre, Royal Children's Hospital, Parkville, VIC, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Jordan R Hansford
- Children's Cancer Centre, Royal Children's Hospital, Parkville, VIC, Australia
| | - Andrew S Moore
- Oncology Service, Oncology Service, Queensland Children's Hospital, Brisbane, QLD, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Murray D Norris
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- University of New South Wales Centre for Childhood Cancer Research, UNSW Sydney, Kensington, NSW, Australia
| | - Toby N Trahair
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Richard B Lock
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
| | - Vanessa Tyrrell
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Michelle Haber
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
| | - Glenn M Marshall
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
| | - David S Ziegler
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia.
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia.
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia.
| | - Paul G Ekert
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia.
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia.
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia.
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - Mark J Cowley
- Children's Cancer Institute, Lowy Cancer Centre, UNSW Sydney, Kensington, NSW, Australia.
- School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia.
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
| |
Collapse
|
3
|
Haber M, Gamble L, Xiao L, Pandher R, Somers K, Murray J, Khan A, Yu D, Franshaw L, Burns MR, Tsoli M, Ehteda A, Cesare A, O’Connor A, Mussai F, de Santo C, Cheng P, Korotchkina L, Gurova K, Tyrrell V, Mould E, Lau L, Quang DAK, Mayoh C, Arndt G, Barahona P, Failes T, Fletcher J, Bolanos NF, Gauthier ME, Gifford A, Grebert-Wade D, Kamili A, Kumar A, Nagabushan S, O’Brien T, Strong P, Sherstyuk A, Thomas D, Trahair T, Tucker K, Warby M, Wong M, Xie J, Evans K, Lock R, Chernova OB, Henderson M, Gudkov AV, Ekert P, Cowley MJ, Marshall GM, Ziegler DS, Norris MD. Abstract IA13: Molecular targeted therapies and precision medicine for children with neuroblastoma and other refractory malignancies. Cancer Res 2020. [DOI: 10.1158/1538-7445.pedca19-ia13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite the increase in overall child cancer survival rates, pediatric malignancies such as high-risk neuroblastoma, high-risk leukemias (including MLL-translocated infant ALL), and aggressive brain tumors (including DIPG) remain refractory to current multimodal therapies. We have been developing new treatment approaches for these aggressive childhood cancers by (i) utilizing novel targeted therapies either alone or combined with other new agents or established chemotherapeutic drugs, and (ii) by developing new drugs that target key pathways in these child cancers.
In neuroblastoma, we have targeted polyamines, showing that combined inhibition of polyamine synthesis by the ODC1 inhibitor DFMO, and of polyamine uptake using the small-molecule drug AMXT 1501, is highly effective at inhibiting tumor growth in Th-MYCN transgenic mice. This combination also shows great efficacy in preclinical models of DIPG, and clinical trials for these diseases are now being planned. We are also targeting metabolism of arginine, the precursor of ornithine, using the pegylated-recombinant arginase BCT-100, which significantly delays tumor development and prolongs survival of neuroblastoma-prone Th-MYCN mice. We have further shown that combining BCT-100 with either DFMO or conventional chemotherapy results in increased survival benefit.
CBL0137 is a nontoxic novel anticancer drug currently in phase I trial for adult refractory and relapsed cancers. CBL0137 destabilizes nucleosomes and traps histone chaperone FACT into chromatin, thereby modulating several anticancer mechanisms. We have shown that CBL0137 is effective in mouse models of neuroblastoma, MLL-rearranged leukemia, and DIPG, and that its action is potentiated by the HDAC inhibitor, panobinostat. Moreover, we have developed OT-82, a novel nontoxic NAMPT inhibitor with impressive anticancer activity against mouse models of high-risk childhood ALL, potentiating standard-of-care drugs, and showing similar efficacy as the three-drug induction-type treatment used for pediatric ALL.
In addition, for all Australian children with high-risk malignancies, we have developed the Zero Childhood Cancer national precision medicine program. ZERO utilizes whole-genome and whole-transcriptome sequencing, methylation profiling, and where possible, in vitro and in vivo drug testing. To date (July 2019), 74% of 207 patients on the national clinical trial have received a Multidisciplinary Tumor Board recommendation (therapy, germline referral, or change of diagnosis), and of 25 patients with evaluable response data thus far who have received the ZERO recommended therapy, a significant proportion have had a complete response, partial response, or maintained stable disease. Moreover, early experience with drug efficacy studies suggests these data may corroborate genomic therapeutic recommendations and may also identify unanticipated active therapeutics.
Citation Format: Michelle Haber, Laura Gamble, Lin Xiao, Ruby Pandher, Klaartje Somers, Jayne Murray, Aaminah Khan, Denise Yu, Laura Franshaw, Mark R. Burns, Maria Tsoli, Anahid Ehteda, Anthony Cesare, Aisling O’Connor, Francis Mussai, Carmela de Santo, Paul Cheng, Lioubov Korotchkina, Katerina Gurova, Vanessa Tyrrell, Emily Mould, Loretta Lau, Dong Anh Khuong Quang, Chelsea Mayoh, Greg Arndt, Paulette Barahona, Tim Failes, Jamie Fletcher, Noemi Fuentes- Bolanos, Marie-Emilie Gauthier, Andrew Gifford, Dylan Grebert-Wade, Alvin Kamili, Amit Kumar, Sumanth Nagabushan, Tracey O’Brien, Patrick Strong, Alexandra Sherstyuk, David Thomas, Toby Trahair, Katherine Tucker, Meera Warby, Marie Wong, Jinhan Xie, Kathryn Evans, Richard Lock, Olga B. Chernova, Michelle Henderson, Andrei V Gudkov, Paul Ekert, Mark J. Cowley, Glenn M. Marshall, David S. Ziegler, Murray D. Norris. Molecular targeted therapies and precision medicine for children with neuroblastoma and other refractory malignancies [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr IA13.
Collapse
Affiliation(s)
| | - Laura Gamble
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Lin Xiao
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Ruby Pandher
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | | | - Jayne Murray
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Aaminah Khan
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Denise Yu
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | | | - Mark R. Burns
- 2Aminex Therapeutics, Aminex Therapeutics Inc., Kirkland, WA,
| | - Maria Tsoli
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Anahid Ehteda
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Anthony Cesare
- 3Children’s Medical Research Institute, Sydney, NSW, Australia,
| | | | - Francis Mussai
- 4Birmingham Children’s Hospital and the University of Birmingham, Birmingham, United Kingdom,
| | - Carmela de Santo
- 4Birmingham Children’s Hospital and the University of Birmingham, Birmingham, United Kingdom,
| | - Paul Cheng
- 5Bio-Cancer Treatment International, Hong Kong, Hong Kong,
| | | | | | | | - Emily Mould
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Loretta Lau
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 7Kid’s Cancer Centre, Sydney Children’s Hospital, NSW, Australia,
| | | | - Chelsea Mayoh
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Greg Arndt
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 9ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, NSW, Australia,
| | | | - Tim Failes
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 9ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, NSW, Australia,
| | | | | | | | - Andrew Gifford
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 10Department of Anatomical Pathology, Prince of Wales Hospital, Sydney, NSW, Australia,
| | | | - Alvin Kamili
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Amit Kumar
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 11Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
| | | | - Tracey O’Brien
- 7Kid’s Cancer Centre, Sydney Children’s Hospital, NSW, Australia,
| | | | | | - David Thomas
- 12Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW, Australia,
| | - Toby Trahair
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 7Kid’s Cancer Centre, Sydney Children’s Hospital, NSW, Australia,
| | - Katherine Tucker
- 13Hereditary Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia,
- 14Prince of Wales Medical School, University of New South Wales, Sydney, NSW, Australia,
| | - Meera Warby
- 13Hereditary Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia,
| | - Marie Wong
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Jinhan Xie
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Kathryn Evans
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | - Richard Lock
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
| | | | | | | | - Paul Ekert
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 8Murdoch Children’s Research Institute, Melbourne, VIC, Australia,
- 11Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
| | - Mark J. Cowley
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 12Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW, Australia,
| | - Glenn M. Marshall
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 7Kid’s Cancer Centre, Sydney Children’s Hospital, NSW, Australia,
| | - David S. Ziegler
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 7Kid’s Cancer Centre, Sydney Children’s Hospital, NSW, Australia,
| | - Murray D. Norris
- 1Children’s Cancer Institute, Sydney, NSW, Australia,
- 15UNSW Centre for Childhood Cancer Research, Sydney, NSW, Australia
| |
Collapse
|
4
|
Mould EV, Lau L, Arndt G, Barahona P, Cowley MJ, Ekert P, Failes T, Fletcher J, Gifford A, Grebert-Wade D, Haber M, Kamili A, Kumar A, Lock RB, Marshall GM, Mayoh C, Norris M, O'Brien T, Quang DAK, Strong P, Sherstyuk A, Trahair T, Tsoli M, Tucker K, Warby M, Wong M, Xie J, Ziegler DS, Tyrrell V. Abstract 3111: Zero Childhood Cancer: A comprehensive precision medicine platform for children with high-risk cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Molecular genomics analyses aim to identify subsets of patients harboring actionable aberrations as a pathway to improved targeted treatment selection. However, recent pan-cancer analyses of the molecular landscape of pediatric cancers1,2 have emphasized the stark contrast with adult cancers, with low mutation rates, distinct mutated genes and a prevalence of structural rearrangements suggesting that genomic analyses alone have limitations for translation into clinical benefit. The Zero Childhood Cancer (ZCC) program aims to assess the feasibility of precision medicine to identify targeted therapeutic agents for patients with high-risk (HR) pediatric malignancies (expected survival <30%). We combine comprehensive molecular profiling analysis [whole genome sequencing (tumor, germline DNA), deep sequencing of a 386 cancer associated gene panel, whole transcriptome (RNASeq), methylation profiling] with in vitro high-throughput drug screening (124 compound library, single agent) and patient-derived xenograft (PDX) drug efficacy testing. Results are curated and recommendations made by a national Multidisciplinary Tumor Board. Recommendations consist of targeted therapy, change of diagnosis or genetics referral for a germline cancer predisposition gene mutation. The national multicenter prospective trial (PRISM) opened in September 2017 at all 8 pediatric oncology centers around Australia, following the successful completion of a 2-year pilot feasibility study. PRISM has enrolled 131 patients to date (35% central nervous system tumors, 29% sarcoma, 13% leukemias/lymphomas, 6% neuroblastoma, 17% other rare or unknown cancers). The unique ZCC testing platform has resulted in at least one recommendation being issued for 67% of patients. Fifteen % of patients have a reportable germline cancer predisposition. We have developed an analytical pipeline to interrogate and cross-validate the full range of variants, structural abnormalities and mutational signatures identified in pediatric cancers and incorporate the molecular data with in vitro and in vivo drug sensitivity data where possible. The highest yield of reportable variants is derived from the integrated analysis of WGS and RNASeq; unique to ZCC compared to other pediatric precision medicine programs internationally. ZCC demonstrates the feasibility of a comprehensive precision medicine platform to identify treatment recommendations in HR pediatric cancer patients. The national trial is planned to run for 3 years, recruiting ~400 patients. In addition, ZCC is partnering nationally and internationally to conduct parallel research studies in immunoprofiling, liquid biopsy, psychosocial impact of precision medicine, health economics and health implementation. 1. Gröbner et al. Nature. 2018; 555(7696):321-327. 2. Ma et al. Nature. 2018; 555(7696):371-376.
Citation Format: Emily V. Mould, Loretta Lau, Greg Arndt, Paulette Barahona, Mark J. Cowley, Paul Ekert, Tim Failes, Jamie Fletcher, Andrew Gifford, Dylan Grebert-Wade, Michelle Haber, Alvin Kamili, Amit Kumar, Richard B. Lock, Glenn M. Marshall, Chelsea Mayoh, Murray Norris, Tracey O'Brien, Dong Anh Khuong Quang, Patrick Strong, Alexandra Sherstyuk, Toby Trahair, Maria Tsoli, Katherine Tucker, Meera Warby, Marie Wong, Jinhan Xie, David S. Ziegler, Vanessa Tyrrell. Zero Childhood Cancer: A comprehensive precision medicine platform for children with high-risk cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3111.
Collapse
Affiliation(s)
| | - Loretta Lau
- 2Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | - Greg Arndt
- 3ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, Australia
| | | | | | - Paul Ekert
- 4Murdoch Children’s Research Institute, Melbourne, Australia
| | - Tim Failes
- 3ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, Australia
| | | | | | | | | | | | - Amit Kumar
- 6Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | | | | - Tracey O'Brien
- 2Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | | | | | | | - Toby Trahair
- 2Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | - Maria Tsoli
- 1Children's Cancer Institute, Sydney, Australia
| | | | - Meera Warby
- 5Prince of Wales Hospital, Sydney, Australia
| | - Marie Wong
- 1Children's Cancer Institute, Sydney, Australia
| | - Jinhan Xie
- 1Children's Cancer Institute, Sydney, Australia
| | - David S. Ziegler
- 2Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | | |
Collapse
|
5
|
Tsoli M, Lau L, Barahona P, Mayoh C, Failes T, Wong M, Sherstyuk A, Gifford AJ, Kumar A, Mould E, Ung C, Tolhurst O, Gopalakrishnan A, Grebert-Wade D, Strong P, Trebilcock P, Lock R, Tyrrell V, Trahair T, Tucker K, Warby M, Arndt G, Norris M, Haber M, Marshall G, O’Brien T, Quang DAK, Cowley M, Ekert P, Ziegler DS. THER-23. RESULTS OF THE ZERO CHILDHOOD CANCER INTEGRATED PRECISION MEDICINE PLATFORM FOR PAEDIATRIC HIGH-RISK BRAIN TUMOURS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz036.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Maria Tsoli
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Loretta Lau
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | - Paulette Barahona
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Chelsea Mayoh
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Tim Failes
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, Australia
| | - Marie Wong
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Alexandra Sherstyuk
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Andrew J Gifford
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Department of Anatomical Pathology, Prince of Wales Hospital, Sydney, Australia
| | - Amit Kumar
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Emily Mould
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Caitlin Ung
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Ornella Tolhurst
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | | | - Dylan Grebert-Wade
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Patrick Strong
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Peter Trebilcock
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Richard Lock
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Vanessa Tyrrell
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Toby Trahair
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | - Katherine Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Meera Warby
- Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, Australia
| | - Greg Arndt
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- ACRF Drug Discovery Centre for Childhood Cancer, Lowy Cancer Research Centre, Sydney, Australia
| | - Murray Norris
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Michelle Haber
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
| | - Glenn Marshall
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | - Tracey O’Brien
- Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| | | | - Marc Cowley
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Cancer Division, Garvan Institute, Sydney, Australia
| | - Paul Ekert
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - David S Ziegler
- Children’s Cancer Institute, University of New South Wales, Sydney, Australia
- Kid’s Cancer Centre, Sydney Children’s Hospital, Sydney, Australia
| |
Collapse
|