Cancer Research for Children
Project location: ITALY
Project start date: January 2005 - Project end date: This project covers various years
Project number: 2005-13
Beneficiary: AIRC - Associazione Italiana per la Ricerca sul Cancro
May 2008 Summary (Please click on this link to open the detailed March 2008 Project Results)
Inter-Regional Projects on Paediatric Tumours 2005-2007
Ependynoma, medulloblastoma and other brain tumours are rare forms but very serious and above all scarcely researched.
Now, thanks to AIRC, Italian oncologists have formed a group to study and defeat them.
Nowadays many forms of tumours in children are successfully treated: particularly Leukaemia and lymphomas which in two out of three cases are completely cured. Until a few years ago, also bone sarcomas, that mostly affect adolescents, despite amputations of the limbs left very little hope. Today a high percentage of these patients are not only cured , but conserve their limbs. Often these ex young patients turn up after many years to visit their doctors with their fiancées or their own little kids.
Sadly, for other paediatric tumours it is a different matter. Only a very small number of children with tumours of the central nervous system survive five years after the first diagnosis. These young patients are really very unfortunate. Firstly because their illness is called cancer. Then because their tumour is still difficult to cure. And lastly because being a rare illness its hardly touched by the progress of research in medicine. For many of these young patients the troubles are never over and often over the years they are forced to pay a high price for the consequences of these tumours and the treatment they underwent.
This is a reality that leaves a deep wound in doctors although they are used to deal with suffering. So when four years ago these Paediatric Oncologists pointed out this serious problem, AIRC decided to invest in solving this moral drama by following these young patients with tumours of the central nervous system especially Ependynoma and medulloblastoma. A scientific task force was created to begin a research programme for a period of three years beginning 2005, to drastically improve the possible treatments for these children The aim was to investigate remedies and create new cures.
Starting from Basic research along with the Clinical research the road to follow is towards the identification of the damage in DNA that leads to the growth of tumours. The scope was to target the tumoral cells specifically to obtain prognostic information about their presence and ways to cure them trying medical drugs for their usefulness and discarding others as harmful. The most important factor of this work is gathering biological samples necessary for the research. These samples are difficult to collect and therefore need a strict collaboration between neuro-surgeons who take these samples from the young patients and anatomo-pathologists who must verify the diagnosis , center the histological tests and freeze the tissues that are sent to the research laboratories. With the AIRC project it has been possible to unite a large number of scientists to cooperate in this joint effort in Italy.
The seven groups of the task force against ependynoma, coordinated by Dr. Maura Massimo from the Istituto Nazionale Tumori of Milan, are from the Istitituto Pediatrico Gaslini of Genova, the Istituto Neurologico Carlo Besta of Milano, the Department of Paediatric and Adoloscent Sciences of the University of Torino, the Department of Paedriatics of the University of Padova, the Paediatric Hospital Meyer of Florence and the Istituto Medea di Bosisio Parini in Lecco which deals with the rehabilitation of the patients. These children have to be followed for a number of years especially because of the delicate zone hit by the tumours where the treatment may have negative consequences on the brain causing mental retarding or hampering motorial functioning, not easily foreseen. To individualize these defects in the early stages helps to recuperate these kids.
In the study of the Ependynoma tumour, the identification of a genetic anomaly which characterizes some tumours but not others has found two sub-types of tumours which need different cures. Having discovered this, a new programme of research has been planned (in which many European countries are participating) to find the appropriate treatment for every individual young patient by analysing genetically each single tumour.
The second project focused on medulloblastoma is coordinated by Professor Achille Iolascon from the University of Naples and Professor Andrea Pession from the University of Bologna and is composed of seven task forces from different parts of Italy - CEINGE in Napoli, the Dept. of Paediatric and Adolescent Sciences of the University of Torino, the Laboratories of Paediatric Oncohaemotology of the University of Bologna, the Paediatric Clinic in Monza and the Centre for Paediatric Haematology in Catania.
Medulloblastoma is a malignant tumour of the brain and can strike babies in the first few months of their lives. There have been cases where it was diagnosed in the echograph during pregnancy. This tumour develops in the cerebellum, the part of the brain that helps us maintain our balance, our position in space and coordinates our movements. Medulloblastoma represents over 20% of all tumours of the central nervous system and is frequently found in the paediatric age group.
The aim of this project, through genetic investigation, is to identify appropriate ways to cure these children with remedies that do not make their lives miserable during the therapy or cause sufferance as the aftermath of the therapy.
The group has has succeeded in identifying an alteration of chromosomes of the most aggressive form of the tumour. This alteration, present in 44% of the cases, is an alarm signal for the doctors and allows the selection of patients who need intensive treatment. Also, some mechanisms that regulate the function of the genes involved in the tumour have been identified. This control is predominantly influenced by microRNA, fragments of ribonucleic acid that are ideal targets for future effective medicines.
These are two ambitious and complex projects to accomplish and above all very costly for the type of research involved. The first three years have shown that with the determination and the competence of the researchers together with the enthusiasm and generosity of the public during the various fund raising activities it is possible to finance concretely projects that seem impossible.
Excellent results have been obtained and published in important international scientific journals which are the point of reference for oncologists all over the world.
Considering the results obtained in only three years, AIRC has decided to continue financing these two projects for another two years. We are half way across the ford but to successfully cross it we must again ask the public to be generous. The next two years will need more funding which AIRC must find. It is our moral duty to help attain this very important goal.