The survival rate for childhood cancer has dramatically increased from just 15 per cent in the 1950s to an impressive 85 per cent today. With such an increase in rates, you might wonder why research time and money continues to be devoted to the disease. The answer is simple: the remaining 15 per cent.
“There are still children who don’t survive childhood cancer. In addition, even if they survive, they sometimes have quite severe late effects as a result of treatment. Or if they’ve relapsed, those cancers are often very difficult to cure,” says Dr. Conrad Fernandez, head of the Division of Hematology & Oncology at the IWK Health Centre. “For those reasons, research is a really crucial part of what we do,” says Fernandez.
At any point in time, pediatric oncology at the IWK has about 60-70 trials open with roughly 40 per cent of IWK patients participating. As well, the IWK is part of the Children’s Oncology Group (COG), an international organization with more than 225 participating centres.
“We could never answer the questions we want to ask about childhood cancer without using the strength of numbers offered by an organization like the COG,” says Fernandez.
In researching rare diseases like childhood cancer, Fernandez says the only way to make progress it to do collaborative research.
“Even the biggest centres in Canada can’t make inroads in many types of childhood cancer by themselves. It has to be national, or even better, international, collaboration,” says Fernandez. “We’ve learned a tremendous amount over the last decade, but there’s a long way to go in terms of understanding this very complex disease.”
On a constant mission to further their understanding, researchers at the IWK are searching for new discoveries through a multitude of studies including PROFYLE, a $25 million national project that Fernandez and his IWK colleague and fellow oncologist, Dr. Jason Berman, are involved in.
“PROFYLE aims to molecularly profile patients’ tumours to determine whether there’s a particular genetic change that could be targeted by a drug,” Fernandez says. “Because the known treatments that we have now are relatively ineffective for patients with high risk disease, the hope is that by using the molecular profile we can match it to drugs that will be more effective in treating those cancers.”
PROFYLE uses precision medicine and is the first of its kind to look at cancer profiling in children in Canada. It was approved at the IWK in December 2018, one of 16 participating centres across Canada. The patients studied in PROFYLE in particular have high risk cancers, in this case meaning a survival rate of less than 50 per cent.
Although there are other molecular profiling projects underway in places around the world, there are two unique appeals to PROFYLE. “This study has a large ethics component to explore the many challenges that arise in this new area of medicine,” says Fernandez, who also serves as the lead of the ethics node for PROFYLE. “The second really important component, which Dr. Jason Berman leads, is a modeling component. That means we can take the cancer from the child and put it into an animal. We can then examine how it behaves and expose it to a variety of cancer drugs to study the effect with the hope that one day, we can tailor the treatments we’re using to give the best result for the child.”
When considering the future of cancer care and research, Fernandez says “I think there will be much more precision and as a result, I think we’re likely to be better at curing cancer and avoiding late effects. I have real hope that’s going to be the case.”
February 4 is World Cancer Day. World Cancer Day is an initiative of the Union for International Cancer Control (UICC).
Photo source: https://www.tfri.ca/en/profyle/how-it-works