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Treating childhood cancer while minimizing side effects - one drug at a time

Genetic tests that predict the risk of serious side effects to chemotherapy drugs are now available at 10 children’s hospitals across Canada. Led by BC Children’s Hospital researchers, this innovative programme has helped over 300 patients in BC alone.

The powerful drugs that treat cancer can be life-saving, but sometimes have severe unintended consequences. 

To help assess the risk for and minimize side effects of two common chemotherapy drugs, cisplatin and anthracyclines, Drs. Bruce Carleton, Colin Ross and Rod Rassekh have implemented the innovative Precision Medicine Programme, which tests patients for genetic variations that increase their risk of serious complications. 

Cisplatin is frequently used to treat children with leukemia, brain, bone and liver cancers. It can cause permanent hearing loss in some patients. Anthracyclines treat leukemia, bone tumours and other cancers, but can lead to heart damage that may result in heart failure and the need for a heart transplant. Children are at particular risk for these complications and live with the effects for the rest of their lives.

“An individual’s risk of suffering side effects from these drugs varies greatly based on genetics,” explained Dr. Carleton, director of the Pharmaceutical Outcomes Programme at BC Children’s. “Genomic testing allows us to create an individual drug therapy genetic risk assessment for every patient, which helps doctors and families make more informed decisions about treatment.”

Newly diagnosed oncology patients at BC Children’s Hospital already receive and nine other children’s hospitals across Canada (in Edmonton, Calgary, Saskatoon, Winnipeg, Toronto, Ottawa, London, Montréal and Halifax) will now receive this state-of-the-art testing. Using the results, each child’s care team can develop a personalized treatment plan that balances the risks of side effects with the therapeutic benefits of these life-saving drugs. So far, 312 patients at BC Children’s have been tested alone.

“We often think about drugs working or not working,” said Dr. Carleton. “But we also need to think about drugs harming kids. If families know in advance the likelihood of their child developing a life-threatening side effect, they can ask questions and assess their options.

“These are life-saving drugs that sometimes cause harm. Genomic testing is a powerful tool to help children who have to take these medications live the longest, healthiest lives possible.”

The Precision Medicine Programme is led by BC Children’s researchers Drs. Bruce Carleton, Colin Ross and Rod Rassekh.

Learn more about this work on the BC Children's Hospital Research website.
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