Update from the Paediatric Oncology Research Unit

Through the generosity of individual donors, as well as the dedication of participants in our annual 10,000 Paces for 10,000 Faces fundraising walk/run, we are able to support the work of the Paediatric Oncology Research Unit at Children’s Hospital, London Health Sciences Centre. Specifically, we fund a clinical research assistant (CRA) who has been crucial to the work of the Unit. In the words of Lead investigator Dr. Alexandra Zorzi, MD FRCPC, Division Head of Paediatric Hematology/Oncology, “I cannot emphasize ENOUGH that this research would NOT be possible without the support of Childcan and the CRA that it funds.”

In our words, it would not be possible without the incredible community support we see for our Childcan children and families. Thank you!!

Dr. Zorzi recently provided an update on the progress that the Unit has made. We are proud to support the amazing work that Dr. Zorzi and the team are doing. With sincere gratitude to all who enable us to do that, we share this update with you.

Dr. Zorzi:
“Our clinical research assistant is so dedicated and inspired by our work. She is a perfect fit and embraced all of our initiatives. As a result, we have made a lot of progress in broadening the scope of research and clinical trials we offer here at Children’s Hospital, London Health Sciences Centre.

CLINICAL TRIALS
1. TOPAZ: Phase I enrichment study of low dose metronomic topotecan and pazopanib in paediatric patients with recurrent or refractory solid tumours. This is the first early phase trial to EVER open in London for pediatric oncology! The study is now completed. Locally, we screened four patients, had one patient enrolled and received study therapy. We are currently undergoing local data review and undergoing an audit in November by the C17.

2. Avelumab: Open label phase I/II study to evaluate pharmacokinetics pharmacodynamics, safety and anticancer activity of Avelumab in paediatric subjects from birth to less than 18 years of age with refractory or relapsed solid tumours and lymphoma. This study is open. We are the second centre in Canada and FIRST in Ontario to open this trial. We have screened three patients, but none have been enrolled to date.

RESEARCH
1. PROFYLE: Precision oncology for young people. This is a national tumour sequencing initiative to better characterize a child’s tumour and identify its unique fingerprint. We hope to use this information to identify possible specific medications/treatment options for a patient’s tumour, follow the tumour’s response, gain information about the patient’s prognosis and understand the cause of the child’s cancer. We have enrolled 20 patients. There have been various results of this initiative for our local patients; including identifying patients that are at a genetic risk of developing cancer, we have further clarified or changed a diagnosis of patients that are enrolled, as well as discovered a targeted drug to match a tumour’s genetic make-up which has greatly impacted the patient and their prognosis. I am also very active on the clinical trial and therapeutics committee of PROFYLE to ensure that London is able to lead some investigation but ensure our centre is a participating centre for clinical drug trials that result from this. I can’t tell you the amount of work our CRA and I have poured into this project. Without Childcan support, we would not have been able to dedicate the resources to it. Thank you.

2. Pharmacogenomic Predictors of Drug Response in Pediatric Oncology. This project aims to understand the patient’s genetics and drug response and/or toxicity they experience to a drug. To date we have enrolled 130 patients on the main study. We have recently opened a subsidy of this project to look at a specific drug used in acute lymphoblastic leukemia and enrolled 60 patients onto that as well. We presented our pilot data at the Pediatric Oncology Group of Ontario (POGO) symposium last November with oral platform presentation. We are hoping to have a publication out by the new year on this. Moreover, we are expanding to include other Ontario sites to increase our numbers and make the data more robust. Ottawa and Hamilton are very interested in joining this project so that is underway. We are starting our second big project within this one, looking at the effectiveness of anti nauseants and genetic determinants of that.

3. Pharmacometabolomic of Kidney Injury in Paediatric patients: This project is looking to understand kidney injury caused by chemotherapy and identify markers in the patient’s urine that may predict which patients are at most risk. We have collaborated with other centres in Canada on this and are hoping to have some pilot data ready for publication this fall. We recently were awarded a very large CIHR grant to further this project.

4. Through my involvement with the Developmental Therapeutics Committee on a National level, I am currently writing a study protocol to look at another specific targeted drug to be used in pediatric oncology patients. As always, I continue to advocate that the children of Southwestern Ontario have access to this study and trials like it locally. Thankfully I know that I have the research administrative support to make this happen, and that is a direct result of our Childcan partnership and funding. THANK YOU.”