Stories about: neuroblastoma

ctDNA: Bringing ‘liquid biopsies’ to pediatric solid tumors

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Brian Crompton studies the use of ctDNA as an alternative way to biopsy pediatric solid tumors
Brian Crompton with Stephanie Meyer (left) and Kellsey Wuerthele (PHOTO: JOHN DEPUTY)

Our blood carries tiny amounts of DNA from broken-up cells. If we have cancer, some of that DNA comes from tumor cells. Studies performed with adult cancers have shown that this circulating tumor DNA (ctDNA) may offer crucial clues about tumor genetic mutations and how tumors respond to treatment.

Brian Crompton, MD, with colleagues at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and elsewhere, is now working to bring ctDNA “liquid biopsies” to pediatric solid tumors as well. The researchers hope that these blood tests will eventually improve early detection, choice of treatment and monitoring of young patients with these diseases without having to sample the tumor itself. …

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Taking a sideswipe at high-risk neuroblastoma

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Microscopy image of human neuroblastoma cells.
Human neuroblastoma cells.

Cancer and other diseases are now understood to spring from a complex interplay of biological factors rather than any one isolated origin. New research reveals that an equally-nuanced approach to treating high-risk neuroblastoma may be the most effective way to curb tumor growth.

One challenge in treating pediatric cancers like neuroblastoma is that they are not initiated from the same kinds of genetic mutations as adult cancers, which usually arise from mutations related to an accumulation of DNA replication errors or environmental factors. In contrast, childhood cancers more often stem from genetic duplications, deletions or translocations, the latter of which occurs when a gene sequence switches its location from one chromosome to another. …

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New cancer target, let-7, unifies theories on neuroblastoma’s origins

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Striking the nerve tissue, neuroblastoma is the most common cancer in infants and toddlers. Great strides have been made in its treatment, but advanced cases still are often fatal, and children who survive often face life-long physical and intellectual challenges related to their treatment.

A study published online by Nature last week, led by researchers at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, finds that a microRNA called let-7 is central in curbing neuroblastoma. The study unifies several theories about neuroblastoma and could bring focus to efforts to find a targeted, nontoxic alternative to chemotherapy.

The findings also have implications for other solid tumors in which let-7 is lost, such as Wilms tumor, lung, breast, ovarian and cervical cancers, says first author John Powers, PhD, of the Division of Pediatric Hematology/Oncology at Boston Children’s Hospital. …

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Double stem cell transplant and other tools are helping children survive neuroblastoma

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Emily Coughlin during her neuroblastoma treatment

When Emily Coughlin complained of a sore knee in May 2009, doctors initially suspected Lyme disease. After antibiotics failed to relieve the pain, Emily was diagnosed with neuroblastoma, a cancer that begins in nerve cells outside the brain, just shy of her fourth birthday. Though neuroblastomia is rare — about 700 new cases occur annually in the United States — it is the most common cancer in infants and toddlers.

In the early 1990s, when Lisa Diller, MD, was starting her career at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Emily would have faced five-year survival odds of less than 15 percent. “It was a devastating diagnosis,” recalls Diller, now chief medical officer of Dana-Farber/Boston Children’s. …

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Curing neuroblastoma by making it grow up

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Boy standing against a wall measuring how much he has grown
All things must grow up. But when nerve cells don't, they turn into neuroblastomas. What if we could get them to grow up again?
For decades, the central paradigm behind the treatment of most tumors has been “get it out”—or, if you can’t, kill it. But note that I said most tumors. For some, the best course isn’t necessarily one that focuses on killing the tumor, but one that also makes it grow up.

The cells of tumors like neuroblastoma or some kinds of acute leukemia aren’t necessarily wildly growing invaders full of murderous mutations. Rather, they’re immature. Instead of following the normal developmental path from stem cell to mature nerve (in the case of neuroblastoma) or white blood cell (in leukemia), something prevents the cells from maturing fully.

Mature or not, the cells can still grow without pause, quickly forming tumors or crowding healthy cells out.

The techniques for making cancer cells mature—or differentiate—differ greatly from those for making cancer cells die. But they hold promise for better, less toxic cures, especially for children with neuroblastoma, which next to brain tumors is the most common solid tumor of children. …

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Patients can innovate too: Putting a wrap on PICC lines

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Saoirse Fitzgerald taking a walk wearing her CareAline wrap. The wrap, designed by her mother, helped keep her central line secure. (Mike & Kezia Fitzgerald)

Over the last year and a half I’ve written 70-plus stories about innovations by doctors, nurses and other staff at Boston Children’s Hospital. I haven’t yet written a story about a patient innovation. But that doesn’t mean that patients and their families aren’t out there innovating.

Case in point: Kezia Fitzgerald saw pretty quickly that there was a problem she might be able to fix. Her daughter Saoirse (pronounced Seer-sha), who had been diagnosed with neuroblastoma, had just had a PICC line put into her arm at Dana-Farber/Children’s Hospital Cancer Center to infuse drugs and fluids. Within a day, Saoirse was tugging at the line, trying to pull off the tape that was keeping it in place. “It was irritating her skin pretty badly,” Kezia says. “She was really uncomfortable.”

Kezia, herself at the time fighting Hodgkin lymphoma (read the family’s story on our sister blog, Thriving), wanted to make her daughter as comfortable as she could. …

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