For a small portion of children undergoing chemotherapy, a vital chemo drug also damages their hearts. Now, a new Australian study is trying to identify the children at risk so they can be given protective medication or not be prescribed the drug.
Patient recruitment for the Australian Cardio Oncology Registry/Bio-bank (ACOR) study is set to begin in January 2019.
Dr Rachel Conyers, a paediatric oncologist at the Murdoch Children’s Research Institute, leads the ACOR. And independent national charity The Kids’ Cancer Project is funding the Victorian leg of the research.
Read more: Understanding the genetic basis of chemotherapy-induced cardiomyopathy.
“Our ultimate goal is that when a child is diagnosed, we will be able to run a genetic test to see if they are at risk of heart toxicity,” Dr Conyers said.
“If they are, then we will be able to use protective medication or perhaps even avoid the drug entirely.”
The chemotherapeutic drug class, anthracyclines, is used to treat more than 70 per cent of childhood and adolescent malignancies and has boosted childhood cancer survival rates dramatically.
Unfortunately, a side effect of anthracyclines is irreversible and sometimes fatal heart damage for seven percent of the patients.
Dr Conyers conducted a retrospective study of 300 children who had been patients two of Melbourne’s leading paediatric medical institutions; The Royal Children’s Hospital and Monash Children’s Hospital. Most had acute lymphoblastic leukemia, with a small proportion suffering other cancers like bone sarcomas.
“We did whole exome sequencing on the patients who suffered heart toxicity and we think that some genes are causing this, but we need to look at more patients before we know conclusively,” she said.
The next stage of the study is to recruit young people set to be treated with anthracyclines and to then follow their progress across some years.
“Nationally we are anticipating recruiting about 800 children, but we will also be enrolling people aged up to 35 years old,” Dr Conyers said.
“We are confident we will eventually crack the special genetic markers of individuals likely to develop heart disease, and so in the future we can introduce measures to protect them.”
Dr Conyers said this is the first major cardio-oncology research project to be undertaken in Australia, “This has never before been done in paediatrics, we should start to recruit patients in January.”
Dr Conyers’ research is also being financed by the Royal Australasian College of Physicians and The Royal Children’s Hospital Foundation.
Read more: In Focus: Murdoch Children's Research Institute.
She is working with Dr David Elliot, who heads the cell biology team at the Murdoch Children’s Research Institute.
Anyone wanting learn more about this study or the registration process should visit the ACOR website, firstname.lastname@example.org.
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