Although cure rates for children with cancer are increasing, cancer treatments can cause permanent deterioration of brain functions leading to impairments in attention, concentration, memory and learning. As a result, these changes can lead to challenges with school, obtaining future employment and overall quality of life into adulthood, even though cancer treatment may have been successful. With the aid of a $3.4 million, five-year National Institutes of Health grant (R01CA220568), Peter D. Cole, MD, chief of pediatric hematology/oncology and the Embrace Kids Foundation Endowed Chair in Pediatric Hematology/Oncology at Rutgers Cancer Institute of New Jersey, and colleagues are exploring an approach that would detect these changes among children with acute lymphoblastic leukemia (ALL) early during treatment.
At focus is the examination of biomarkers associated with treatment-related neurocognitive decline. Dr. Cole, who is a co-principal investigator on the study and a professor of pediatrics at Rutgers Robert Wood Johnson Medical School says the goal is to identify a subset of patients who would benefit from a behavioral intervention or treatment clinical trial.
"While more than 85 percent of children with ALL can expect to be cured, many experience serious side effects. In some cases the treatment-related organ damage can be permanent. They are all receiving the same type of treatment, so the question is 'why are some experiencing these deficits and not others?'" notes Cole, who leads precision medicine and immunotherapy investigation in the Hugs for Brady Foundation Pediatric Cancer Research Laboratory at Rutgers Cancer Institute. "What we aim to do in this study is identify those patients at a time when a proactive intervention might prevent permanent treatment-induced cognitive deficits."
This research stems from previous work Cole conducted nearly two decades ago at Rutgers Cancer Institute in collaboration with his mentor and colleague Barton Kamen, MD, PhD, who was the head of pediatric hematology/oncology during that time. That investigation elucidated biomarkers that indicate neuro inflammation, oxidative damage and other changes.
As part of this current study, cerebrospinal fluid and genomic DNA will be collected from 450 pediatric ALL patients accrued through nine sites that are part of the Dana Farber Cancer Institute ALL Consortium. Cole and collaborators from other centers are exploring whether there could be genetic or inherited factors related to oxidative stress and damage that contribute to cognitive defects brought on by treatment.
As an investigator, it's exciting to see these types of advances over a course of a career. We anticipate the results of this study will provide a foundation to improve the safety of cancer drugs and potentially guide clinical trials of protective interventions aimed at reducing the permanent side effects brought on by curative treatment for leukemia."
Peter D. Cole, MD, chief of pediatric hematology/oncology, Rutgers Cancer Institute of New Jersey
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