What side effects do they experience?
The side-effects of chemotherapy affect children as much as adults. The side effects can make them sick, make their hair fall out and make them lose weight. Their blood counts can be affected and they need treatment for infections and complications of the bone marrow being turned off by the treatment for a while. They almost always recover due to the technical skills of our medical and nursing staff who look after the children after each course of treatment. Sometimes we use very big doses of drugs which are life-threatening in their nature.
Why the need for ongoing research?
Children’s cancers need their own research because they’re different. Although they have names that say they’re a cancer, the vast majority of them are unique to childhood.
Over the last 30 years of my career we’ve collected a lot of information about how well we do things. It’s very easy to take measurements of how many people are alive, so survival rates are very powerful drivers for change.
Therefore, where there have been poor survival rates we’ve focused our efforts on trying to investigate new drug combinations, doing trials, testing new things – always using survival rates as our driver for change. That’s really been very, very successful. But that’s driven an intensification of the drug therapy we use, we’re now at the boundaries of tolerance.
So the next driver for change is how to do better with less toxicity and that’s where the research comes in. If we can find drugs that work well without lots of side-effects, then the next phase will be to make the drug treatment less burdensome for the child – and the family.
What is precision medicine?
To make better treatments with less toxicity we’ve got to work more cleverly. An enormous amount of research over the last 20 years has gone towards understanding the genetic mutations that are driving the cancers in children. If we understand the mutations that are driving the cancer, then we can design drugs that target those mutations, with the hope that they will turn the cancer off.
This is what we call precision medicine. It’s finding a target, finding a drug that hits that target and then giving it to people. The problem is that there are a lot of mutations – a lot of targets and we don’t have a bunch of new drugs to hit those targets. So we’re looking for new drugs that will hit those mutations and that are safe to use in children.
There lies the challenge in research now and for the future.
Professor David Walker BMedSci, BM, BS, FRCP, FRCPCH