A “game-changing” liquid biopsy program, the first of its kind in Australia, is set to provide clinicians access to an important and innovative tool for monitoring treatment responses and predicting relapse in children with cancer.
Each year more than 1000 Australian children and young people are diagnosed with cancer. Accurate diagnosis of their cancer is usually based on a surgical biopsy of the tumour – an invasive and sometimes high-risk procedure.
Once diagnosed, the child’s cancer requires constant evaluation to monitor the effectiveness of treatment and identify impending relapse. However, current approaches are not sensitive enough to effectively identify treatment failure in advance of relapse occurring, by which time it might be too late to introduce new treatments which could save a child’s life.
Repeated surgical biopsies, which could provide the information needed to more accurately monitor treatment response and determine the need for the introduction of alternate, more effective treatments, are neither practical nor ethical due to their invasive nature.
The Australian Cancer Research Foundation (ACRF) Child Cancer Liquid Biopsy Program, which officially launched today in Sydney, represents a revolution in cancer sampling and monitoring.
Using cutting edge science and technology the program uses a simple blood test to provide a window into the tumour throughout a child’s cancer journey, to obtain urgently needed information on treatment response and progression of the tumour.
This test can identify the presence and level of circulating tumour cells and/or tumour DNA in blood to monitor, with a high level of sensitivity, whether or not the child is responding well to treatment. It can also provide complex genetic information on the tumour that can be used to predict imminent relapse and guide subsequent treatment recommendations in real time.
Professor Michelle Haber AM, Executive Director of Children’s Cancer Institute, says this revolutionary approach to cancer sampling and monitoring has the potential to be a “game changer” for children diagnosed with high-risk cancers.
“Liquid biopsy is a hugely exciting development in cancer sampling, that has the potential to dramatically enhance our ability to make personalised treatment recommendations that give each child the best possible chance of survival. Currently, when a child is diagnosed with cancer all molecular information is collected from the initial surgical tumour biopsy, and that is used to guide treatment. But we know that the tumour cells can change their biology in response to therapy, so the treatment that is given at the start of the cancer journey may no longer be the best treatment as the tumour cells mutate. That is why patients often initially respond to treatment but subsequently relapse.
“Being able to take repeated blood samples, or “liquid biopsies”, to monitor the presence and the levels of cancer cells and cancer DNA in the blood over time, and to track genetic changes in the cancer, provides valuable information about the cancer, and can also reveal evidence of impending clinical relapse before it occurs. More importantly, the information acquired from the liquid biopsy, may suggest a better personalised treatment by identifying new molecular targets that have developed in the tumour as it mutates over time.” says Professor Haber.
Professor Haber says the ACRF liquid biopsy program will be critical in helping to improve not only the effectiveness and timeliness of treatments but in reducing the number of invasive procedures that children with cancer will have to undergo.
“The safer and quicker the tests are, the more frequently they can be repeated to monitor the progress of the cancer most effectively,” she says.
The program launch has been made possible thanks to a $3.5 million grant awarded from ACRF to Children’s Cancer Institute in 2019 for cutting edge technology and equipment to monitor and analyse circulating tumour cells and tumour DNA with great sensitivity and specificity.
The ACRF Child Cancer Liquid Biopsy Program will initially focus on children with the following types of cancers:
ACRF’s CEO, Kerry Strydom says, “Australian Cancer Research Foundation backs brilliant cancer research and cutting-edge technology that drives innovation and save lives. The ACRF Child Cancer Liquid Biopsy Program is a wonderful example of how technology can improve the way we manage a cancer diagnosis and treatment.
“This new program will result in minimising the level of invasive testing that children with cancer need to undergo – a significant milestone in the treatment of childhood cancer, and could also lead to new therapies for some of the most difficult-to-treat and deadly childhood cancers, as well as improve the quality of life for those children that do survive.
“We are honoured to magnify our support to better prevent, detect and treat childhood cancers.” says Kerry.
The ACRF Child Cancer Liquid Biopsy Program has been further supported by Cancer Institute NSW, who have provided funding for technical specialists to work in this progressive and innovative lab.