Experts call for more research into treatments for children's brain tumours

More independent study is needed into the biology of children's brain tumours if effective treatments are to be developed, experts at The University of Nottingham have said in a leading journal.

Dr Paul Scotting and Professor David Walker, in the University’s Children’s Brain Tumour Research Centre, along with colleague Dr Giorgio Perilongo of the University Hospital of Padua, argue that, because the biology, genetics and environment of childhood solid tumours (CSTs) set them apart from adult tumours, the development of more specialised treatments should be the highest priority.

Their opinions are published in the Perspectives section of June’s edition of Nature Reviews Cancer.

Dr Paul Scotting said: “Childhood tumours grow in immature tissues, allowing them to develop in a way that doesn’t happen in the adult body. Cells may not need to be as abnormal to become cancerous as cells that cause adult cancers. The flip side is that CSTs might actually be more susceptible to therapies as long as we are using treatments that are specifically tailored to them.”

In Western countries, cancers that occur in children under 15 years of age account for around two per cent of all cancer cases. Leukaemia accounts for roughly one-third of childhood cancers, 13 per cent are lymphomas and the rest (about half of all childhood cancers) are CSTs. Estimated three-year survival rates in Western countries have steadily risen from the 1960s and now exceed 80 per cent. However, the treatments used to treat CSTs can have devastating long-term effects for the young patients and their families.

As mainstream cancer therapies such as radiotherapy and chemotherapy - usually developed to treat adult cancers - target cells that are dividing out of control to create tumours, they can have severe consequences for children’s organs, which are still growing.

The greatest problem is caused when such crude treatments are used for conditions affecting the central nervous system and the brain - the treatments indiscriminately kill both cancerous and healthy cells, disrupting the development of the growing tissues and often leading to long-term disability for the young patient.

The experts are calling for more research into the biology of CST’s to develop targeted therapies that will kill the cancerous cells, while leaving the healthy cells unaffected and able to continue developing normally.

Dr Scotting added: “In children, whenever you are trying to treat them and their tissues are still growing there are going to be huge problems.

“The only way to push research forward in this area is if we learn more about the nature of children’s cancers and understand how the cancer cells work. The key is to use a mechanism within the cell itself.

“Cells are full of molecular switches and the trick will be to find one, or a combination of several, which we can flick that will kill the cancerous cell or stop it behaving badly.”

This work is the focus of The University of Nottingham’s Children’s Brain Tumour Research Centre, which is now the biggest research centre in the UK working solely on the study of childhood brain tumours.

The centre has recently been strengthened by the appointment of a new Professor of Paediatric Neuro-oncology and Cancer Biology, Richard Grundy, who joins Nottingham from the University of Birmingham. His role will be divided into two areas: as a physician organising and delivering the best treatments to children with cancer, particularly brain tumours, and bridging the gap between purely scientific/clinical research and the patients, children with brain tumours.

Professor Grundy said: “My reason for coming to Nottingham was that there is already a constellation of talent working at the University and Queen’s Medical Centre to work with across a whole range of disciplines both clinical and scientific.

“What the Children’s Brain Tumour Research Centre does is to bring together people who already have an interest in children’s brain tumours and forge stronger links to make the best use of all this available talent. This is essential if we are to make progress against this important and challenging set of diseases to which we currently lose 10,000 life years every year in England and Wales alone.”