Zero Childhood Cancer precision medicine program expands to include all young Australians with cancer

Zero Childhood Cancer precision medicine program expands to include all young Australians with cancer The Zero Childhood Cancer Program (ZERO), Australia’s world leading precision medicine program for children with cancer, will this month begin a progressive expansion to become available to all Australians aged 0 to 18 years with cancer, by the end of the year.

Since 2017, ZERO − led in partnership by Children’s Cancer Institute and the Kids Cancer Centre at Sydney Children’s Hospital, Randwick − has offered precision medicine to Australian children with the highest-risk cancers, those who face less than 30 per cent chance of survival.

Now, thanks to funding from the Australian Government and Minderoo Foundation, ZERO is being expanded to be available to children diagnosed with any type of cancer, irrespective of their cancer risk. The expansion will be done in stages, starting with all children diagnosed with brain cancer, then rolling out to all other types of childhood cancers as the year progresses.

A true team effort, ZERO includes all nine of Australia’s children’s hospitals as well as 22 national and international research partners, and is based on the premise that every child’s cancer is unique. Sophisticated genomic analysis is performed for each child enrolled on the Program, allowing scientists to look for genetic alterations that may be driving the cancer’s growth, then search for drugs capable of targeting those alterations. This information is returned to the clinicians treating the child, to help inform their decision-making.

“The expansion of ZERO to be available to all Australian children with cancer is something we’ve all been working towards for a long time, so it’s extremely exciting to now see it unfolding,” said Professor Michelle Haber AM, Executive Director of Children’s Cancer Institute.

“Analysing each child’s cancer at a genomic level is providing unprecedented and extremely valuable insights into childhood cancer. For example, finding out which genetic changes drive these cancers will allow us to develop new targeted therapies matched to these changes. In the expanded ZERO, genomic analysis will occur from the time of diagnosis for every child enrolled, allowing us to track the way each child’s cancer changes in response to treatment. Analysing the cancer journey of up to 1000 young Australians each year in this way will add volumes to our understanding of childhood cancer, for the benefit of all children diagnosed with cancer in the future.”

“The more children who participate in ZERO, the more we learn. In this way, children being treated for cancer today are actually helping the children of tomorrow.” As explained by Professor David Ziegler, Chair of Clinical Trials for ZERO, Paediatric Oncologist at Kids Cancer Centre, Sydney Children’s Hospital, and Group Leader at Children’s Cancer Institute, the precision medicine approach taken by ZERO represents a fundamental change in the way cancer is treated.

“Analysing a child’s cancer at a genomic level can lead to a whole new way of understanding that child’s cancer. This can lead to a more accurate diagnosis, prognosis and risk stratification, and in some cases, a refined treatment approach.”

“In ZERO’s first national precision medicine trial, we saw some very promising results in children with the highest risk cancers. Some children are alive today who would have died had they not been enrolled on ZERO, while some others had precious months added to their life by changing their treatments. ZERO’s expansion will now allow us to investigate the potential of precision medicine to help all young patients with cancer, regardless of their risk profile.”

Professor David Eisenstat, Head of Department, Children’s Cancer Centre, The Royal Children’s Hospital, Melbourne, commented “ZERO is a truly national program, and all Australian children’s hospitals are playing a critical part. With ZERO now expanding, every Australian child diagnosed with cancer, no matter where they live, will have the opportunity to benefit from precision medicine.”

“Here in Melbourne, we have several children who have benefited from targeted therapies identified through ZERO, including Kristian Kozul. Kristian has an aggressive brain cancer and without the targeted therapy ZERO identified, it is unlikely he would have survived. To see him doing so well today is beyond all our expectations.”

Kristian Kozul was just 15 months old when he began having seizures. No one could determine what was wrong with Kristian until a biopsy at the Royal Children’s Hospital led to the diagnosis of cancer − a rare brain tumour known as anaplastic astrocytoma. Kristian began intensive treatment. However, after five months of chemotherapy, the aggressive tumour had not shrunk but instead had grown bigger.

Kristian was given less than a year to live − a devastating prognosis for a young child. With Kristian being too young for radiation, and having no other options available to them, his parents agreed to him doing a genetic sequencing test as part of the Zero Childhood Cancer Program.

The test was successful in identifying a rare genetic mutation and in November 2017, Kristian, then two years old, was enrolled in a clinical trial open at Sydney Children’s Hospital to test a drug targeting that same mutation. After just weeks of treatment, an MRI scan showed that his tumour had stopped growing.

Today, more than five years later, Kristian is not only alive but is thriving. He has started school and is enjoying life to the full.

“Kristian continues to grow and develop each day. He has come such a long way and continues to amaze us. We know that if it wasn’t for ZERO, our little boy wouldn’t be with us today, and we couldn’t be more grateful,” said Kristian’s mum Maria.

Excerpt from CCI. ACRF has been backing CCI since 2001, providing over $9.2 million in funding to enable cutting edge research programs.