Paediatric Haematology - Oncology and Children’s Cancer Centre
Our research is divided between laboratory based research and clinical trial research.
Molecular Therapeutics and DNA methylation; The Hudson Monash Paediatric Cancer Precision Medicine Program
Advances in genetic and molecular biology in recent years has resulted in significant changes in how we treat childhood cancer. Whereas previous diagnosis and prognosis was largely made on pathological findings it is now accepted that detailed molecular analysis can be more accurate and informative. The ideal is to develop more precise risk stratification by determining the biological characteristics of the tumour, the genetic make-up of the patient, the immunological components of both that are important, and ultimately help with decisions on which treatments are best. So, by taking into account an individual patient’s tumour molecular profile, histopathology and tumour genetics, and putting this together with the patient’s clinical information, a significantly more informed decision can be made for the purposes of prognosis and risk stratification that can guide treatment. This is a joint initiative with the Hudson Institute of Medical Research and is the Hudson Monash Paediatric Cancer Precision Medicine Program.
Methylation profiling is becoming one of the most rapid and informative molecular tests in assessing the epigenetic landscape, particularly in brain tumours. With tumour genetic testing, the initial focus has been to look for somatic mutations (mutations present in the tumour but not in normal cells); it is known that germline mutations are often identified as well, which could potentially represent the underlying reason for an individual’s predisposition to the cancer he or she got in the first place. Our research laboratory at Monash is the Australian central reference site for methylation analysis of paediatric brain cancers.
Availability of suitably collected patient specimens underpins future laboratory and clinical research. In order to avoid the exhaustion of limited and rare patient samples, steps to create renewable tumour resources that accurately reflect the originating material are made. The establishment and maintenance of a ‘living biobank’ consisting of primary cell lines, organoid cultures and patient-derived xenografts is routine, and we have over 300 samples currently catalogued and banked. Our first organoids are also being established. We are part of a national biobanking framework through the Australian and New Zealand Childhood Haematology and Oncology Group (ANZCHOG).
We are members of the Children’s Oncology Group (COG) of North America, and the Australian Children’s Cancer Trials consortium. We currently have 15 open clinical trials across a range of childhood cancers, with an accrual rate of over 90% of patients onto studies for which they are eligible. Other research is aimed at minimizing potential late effects. We are currently collecting data on late effects of childhood cancer, bone health in cancer survivors, rates of obesity in children who have been treated for leukaemia, and in collaboration with COG, fertility preservation for teenagers treated for cancer.
Other collaborative research
Epigenetics of childhood cancer with colleagues at the Royal Children’s Hospital, clinical aspects of sleep in childhood cancer with the Ritchie Institute, and long term cognitive effects of treatment for childhood acute lymphoblastic leukaemia with researchers at the Royal Children’s Hospital.