#GoForGoldCycle2022 covered 400 km and raised €1,500!

In September, we set ourselves the “#GoForGoldCycle2022” challenge for Childhood Cancer Awareness.

We started #GoForGoldCycle2022 at 9 am and finished at 7 pm on September 21, 2022. Each bike peddled 200km, totalling 400 km on a day.

We were delighted to see the RCSI main building glowing Gold to celebrate Childhood Cancer Awareness Month and acknowledge that every child with cancer, their heartbroken but resilient parents, siblings and family members, their friends, and all doctors, nurses and carers who go far and beyond to offer the best available treatment and support, all scientists, patient advocates and charities who work hard to improve current treatment protocols, find new drugs and request changes in the way childhood cancer are dealt with.

We closed the GoFundMe in October and counted the charity buckets. We are delighted to announce we raised a grand total of €1500! We are over the moon with this sum. 

Our three chosen charities: Children’s Health Foundation Crumlin (formerly CMRF), the Conor Foley Neuroblastoma Cancer Research Foundation, and Neuroblastoma UK, each received ~ €500. 

We’d like to say a big thank you to everyone who donated and contributed their cycling skills. It will make a huge difference for these charities, especially this year, paving the way to better treatment options for children with cancer.

#GoForGoldCycle2022

We are the Cancer Bioengineering Group, and September is a very special month for us as it is Childhood Cancer Awareness Month. Childhood cancer is the 2nd leading cause of death in children after accidents. Our group researches childhood cancer neuroblastoma, a cancer of immature nerve cells. Neuroblastoma is responsible for approximately 15% of all childhood cancer deaths. Despite intensive multimodal treatment, as many as 1 in 5 children with the aggressive disease do not respond, and up to 50% of children that do respond experience disease recurrence with many metastatic tumours resistant to many drugs and more aggressive tumour behaviour that all too frequently results in death.

This is what we want to change! We believe that every child deserves a future, and our team of postgraduate researchers led by Dr Olga Piskareva is dedicated to strengthening our knowledge of this disease and identifying new potential ways to tackle it, as well as taking part in fundraising activities so our group and others can continue with this research.  

On Wednesday, the 21st of September, RCSI 123 SSG will #GoGold in support of this cause. Please come by to see the RCSI building lit up and share your pictures on social media with the hashtag #ChildhoodCancerAwarenessMonth to raise awareness.

How are you, PI?

Yeah, our (my) blogging is sporadic. The pattern is well recognisable – more posts with success stories or accomplishments or about the key activities. It is easy to share :). Please excuse us (me) when we are off the radar, but we remember our supporters and readers. We are back on track to celebrate Childhood Cancer Awareness Month this September.

So, how did my summer go? Well, nothing to complain about. I had time to go back to the labs, pick up on the outstanding task, and take on the white coat. Indeed, it comes with some assurance as well as troubleshooting. Some days were better than others. Some experiments worked, and another was inconsistent or inconclusive.

A fancy photo, but the routine cell culture itself can be very boring.

Where did I pick it up? This research journey is one year old already. 🙂 This project is focused on validation our 3D neuroblastoma model to test novel therapeutics. We set an experiment that required different expertise and contribution from every team member. In an ideal world, it was supposed to finish in 6 months. But the reality doesn’t stop to shake you. Various components have been delayed sometimes due to unforeseen circumstances (e.g. a broken equipment or out of stock reagent) or due to the lack of manpower or miscommunication at a given time. Eventually, we put the work on hold in October 2021, when we completed ~60%. Another go to continue was taken in April 2022. No luck! Then plan B was activated, and I have been back in the labs. Despite these challenges, this time has not been lost. We developed new ideas to complement the original plan. Now, the crucial 20% has to be done and dusted within 2 weeks time before teaching starts. Wish us a luck!

After the challenge of leading the Foundation Year Medicine Cycle, I am 100% positive that I love research with all up and downs. This routine is fascinating, it is not static. One day differs from another. Research questions are flowing in non-stop…

September 2022 is Childhood Cancer Awareness Month

Today marks the start of Childhood Cancer Awareness Month, which we celebrate every year to support and learn more about kids with cancer, their loving families, the doctors and caregivers who look after them and treat them, the young survivors of cancer and those kids and teens who lost their battle, and the scientists who working hard to find a way to stop childhood cancer.

Childhood cancer is an umbrella term for many other types of this disease. Every 100th cancer patient is a child. Cancer is the 2nd most common cause of death among children after accidents. When it comes to a disease, we have to acknowledge that children are not little adults. They are constantly developing. So their diseases have different ways of progressing and responding to treatment. The causes of childhood cancer, including neuroblastoma, are not known. It would be right to expect more blind alleys and failed ideas in understanding these cancers. To address these challenges, more curiosity-driven and translationally focused research is needed.

The illustration was created by Luiza Erthal

The most common childhood cancers:

  • Leukaemia and lymphoma (blood cancers)
  • Brain and other central nervous system tumours
  • Muscle cancer (rhabdomyosarcoma)
  • Kidney cancer (Wilms tumour)
  • Neuroblastoma (tumour of the non-central nervous system)
  • Bone cancer (osteosarcoma)
  • Testicular and ovarian tumours (gonadal germ cell tumours)

Not quite all back to in-person – the EFEM student Symposium 2022

Despite our last blog post celebrating the regained opportunity to meet with other researchers in person and all the benefits that come with it I just had the pleasure of presenting at the first European Federation for Experimental Morphology (EFEM) Student Symposium online.

While it would have been easy for me to attend in person, as the event was hosted and organised here at RCSI, not many others would have had it quite so easy. As the name suggests, researchers from all across Europe attended. Every EFEM associated anatomical society across Europe and RCSI, as the host institution, had the opportunity to select two members to present. I was honoured to be chosen to represent RCSI. Overall, 15 different countries were represented in the student talks which made for a diverse mix that was particularly nice for the bit of organized fun at the end of the first day which encouraged networking.

Especially, because having only begun my PhD this past year I felt the category Preliminary Results and Outlook aimed at Undergrads, Masters and early-stage PhD students perfectly suited the stage of my project. This was also a brilliant way to see what other students at my level were doing in the field of anatomical research all across Europe. Having this chance to see research in progress was refreshing and uplifting contrasted with the usually more rounded later stage presentations. Having studied anatomy in my undergraduate degree I was also delighted to simply engage with more conventional anatomical research than I currently do myself.

Ronja Struck, 1Yr PhD student at the EFEM Student Symposium 2022

A wonderful opportunity to gain insights into, for example, the implicit knowledge of academia was the career development part of the conference. Talks about academia, industry and publishing offered a chance to get an inside view of those career paths at different positions within them. Especially the typical day in a research journal’s editor provided a new perspective on what is important when writing papers and will have lasting benefits for me and my scientific writing.

But by far the reason why I’ll remember this conference for the longest time is that being awarded runner up in the category Preliminary Results and Outlook reassured me that I am on the right track and that there is purpose in what I do. Despite the online format of the conference, I had the honour of receiving my prize in person, because Prof. Fabio Quondamatteo, the organiser of the event is based at RCSI.

Overall, the two days were an important step in consolidating my faith in my work and the career path that I have chosen.

Written by Ronja Struck, the IRC-CFNCRF funded PhD student

First Research Meeting For A Medical Student

At the beginning of my career, I worked for two years in a Ukrainian company organizing international industrial conferences. So I have insider knowledge of how the conference works, and that the determining factor for the success is the active communication between the participants. And at the RCSI research day and Cork IACR conference, this component was perfect. At both events, I presented my poster and had a chance to discuss the recent advances in neuroblastoma epigenetic drug research. During RCSI Research day, I was excited to learn about the accomplishments of other undergraduate studies and was thrilled to learn that my classmate is participating in research too. He had developed an online recourse to practice cardiac auscultation, which is extremely useful for my medical studies. But professionally, I enjoyed the cancer research posters and presentations at the IACR conference and was eager to meet the researchers working on medulloblastoma, a paediatric neural cell cancer, and the research team from UCD, the neighbours of our university who worked on breast cancer. It was the most valuable opportunity to take a glimpse into other research, become inspired by the most ingenious methods, and cultivate professional knowledge and personal connections – I am so lucky I have been at RCSI Research day and the IACR conference! I have greatly enjoyed my time, and I am looking forward to (hopefully) going to the next year’s conferences again.

Written by Nadiya Bayeva

Welcome to the Cancer Bioengineering Group!

It is time for a full group presentation here at the blog! Throughout the month we shared about our group members and their research focus on Twitter. Now, we would like to share more about the group here and invite you to keep following us on social media. 

The Cancer BioEngineering Group is a research group led by Dr Olga Piskareva at the Royal College of Surgeons in Ireland. The group has 6 PhD students developing research projects around neuroblastoma biology.  

Our projects address topics related to neuroblastoma microenvironment, cell interactions, tumour resistance and the development of new therapies. To do that we use 3D in vitro models, identify immunotherapeutic targets and evaluate extracellular vesicles.  

We are a dynamic group proud to be engaged in research, science communication and patient involvement. We do that through different initiatives.  

We support and collaborate with several neuroblastoma charities around Ireland and internationally such as the Conor Foley Neuroblastoma Foundation, the National Children Research Centre, the Children’s Health Foundation Crumlin and the Neuroblastoma UK. Moreover, our projects are funded by the Irish Research Council in partnership with these charities and by RCSI StAR PhD programmes.  

We promote neuroblastoma awareness through different activities. For instance, last September at the Childhood Cancer Awareness month we promoted a hiking challenge to raise money and increase awareness of neuroblastoma. We hiked for 30km at Wicklow mountains in a day and raised over € 2,000 for neuroblastoma research charities.  

We are also present in social media, creating content in the form of blog posts and tweets to share the science we are doing.  

We are always happy to answer questions and interact with the public. Follow us on our social media channels and read our blog to know more about us and our research.  

Thanks for reading and we go ahead with neuroblastoma research! 

Written by Luiza Erthal

#AskLuiza: Is there any vaccine to treat or prevent neuroblastoma relapse?

Anti-cancer vaccines teach the body’s immune system to identify and attack tumour cells. They are a type of immunotherapy and can be used to treat cancer or prevent tumour recurrence. Therefore, they are typically used in patients that have already received other treatments such as surgery, chemotherapy or radiotherapy.

Although anti-cancer vaccines have been gaining more attention over the years, few are being developed for paediatric tumours. From 594 clinical trials in neuroblastoma at clinicaltrials.gov, only 12 active trials are evaluating vaccines. Furthermore, these vaccines are still considered investigational products. They do not have the approval for use granted by health authorities. Therefore, these drugs are available for patients that enter into clinical trials.

An example of these vaccines is the bivalent vaccine for high-risk neuroblastoma developed in the Memorial Sloan Kettering Cancer Center in the US, collaborating with the biopharmaceutical company Y-mAbs Therapeutics. This vaccine is called bivalent because it has two proteins specifically present on the surface of neuroblastoma cells.

The rationale behind the treatment using this vaccine is that the body will be stimulated to produce antibodies against these two proteins. These antibodies will recognise and attach to neuroblastoma cancer cells, thus signalling to the immune system that these cells need to be eliminated.
A phase II trial evaluates vaccine efficacy in 374 patients who received seven subcutaneous injections of the vaccine in combination with an oral intake of an adjuvant, called β-glucan, that boosts the immune system1. The adjuvant intake started either on the first vaccine injection or on the third injection every two weeks until the end of the vaccine schedule. The study aims to analyse the anti-tumour effect of the vaccine and the immune response generated by the vaccine plus β-glucan therapy. The study is estimated to be completed by 2023.
The trials active for neuroblastoma vaccines are phase I or II. After these phases, there are still phases III and IV to complete the evaluation and continue monitoring these therapies. Therefore, in a few more years, we will know if neuroblastoma vaccines will be successful or not.

Written by Luiza Erthal

Reference

1.         Memorial Sloan Kettering Cancer Center. Phase I/II Trial of a Bivalent Vaccine With Escalating Doses of the Immunological Adjuvant OPT-821, in Combination With Oral β-glucan for High-Risk Neuroblastoma. https://clinicaltrials.gov/ct2/show/NCT00911560 (2021).

#AskLuiza: What are the main differences between cancers in adults and children?

Looking carefully we can easily see that children are very different from adults. They have different needs, desires, likes and dislikes. Not surprisingly, the children body is also very different in their functioning and response to medical needs. Therefore, cancer in children has many different characteristics when compared to cancer in adults. Childhood cancer is different in terms of the most common types, the causes, the treatment and the course of the disease.  

Firstly, childhood cancer is rare and this sometimes impairs an early diagnosis. Therefore more aggressive diseases tend to be present at the time of diagnosis. Nevertheless, there are specific types of cancer that are more common in children, which helps in the diagnosis. They are cancers affecting the blood and lymph nodes (leukaemia and lymphoma), the brain (astrocytoma), the liver and the bones (osteosarcoma). These types of cancer are less common in adults.  

Another important difference between adult and childhood cancer is the leading cause of the disease.  Most of the time the cause of childhood cancer is unknown, although genetic contributions related to overexpression or deletion of genes can be determined. On the other hand, adult cancers are frequently associated with alterations in the DNA (mutations) as well as lifestyle.  

The treatment plays an important role in the differences between adult and childhood cancers. Usually, similar treatments are used for both adults and children, including chemotherapy, radiotherapy, surgery, transplants and immune therapy, according to the type of cancer and its stage.  However, the doses and types of drugs may differ between them. The differences in the treatment go beyond the doses and encompass the mechanisms of action and possible long term toxicities of drugs. For example, the use of drugs that damage DNA can be prohibitive in children due to the increased risk of secondary cancers in the future.   

In conclusion, specific types of cancer are more common in children and the cause of this disease is frequently unknown. Fortunately, children have great possibilities to survive cancers but the treatment needs to be carefully chosen and its long-term effect on the body have to be monitored for their whole life.  

Written by Luiza Erthal

References 

Kattner, P. et al. Compare and contrast: pediatric cancer versus adult malignancies. CancerMetastasis Rev. 38, 673–682 (2019). 

How Childhood Cancers Differ From Adult Cancers. Available at https://www.winchesterhospital.org/health-library/article?id=30409  

Accessed  November 18, 2021. 

How childhood cancers are different from adult cancers. Available at https://medlineplus.gov/ency/patientinstructions/000845.htm  

Accessed November 18, 2021. 

How is Childhood Cancer Different from Adult Cancer? Available at https://www.acco.org/blog/childhood-cancer-differs-from-adult-cancer/  

Accessed November 18, 2021. 

#AskLuiza: What is the progress in DMFO therapy trials?

Neuroblastoma relapse is one of the greatest challenges to complete cure for children with high-risk disease. At least 40% of high-risk neuroblastoma patients will experience cancer relapse 4 years after intense treatment, which includes a combination of chemotherapy, surgery, irradiation and the self-transplantation of stem cells (consolidation therapy). 

To overcome this problem improved maintenance therapy is needed. These are therapies administered to patients after the end of the initial treatment to prevent tumour relapse. Frequently, maintenance therapy for neuroblastoma includes immunotherapies such as antibodies against GD-2 and cytokines and 13-cis-retinoic acid. Although these therapies have some positive effects, the rate of relapse is still high.  Therefore, other options to prevent relapse are needed.  

Recently, a phase II clinical trial evaluated the effect of Difluoromethylornithine (DFMO) on event-free survival (EFS) and overall survival (OS) of high-risk neuroblastoma patients1Event-free survival means the length of time that the patient remains free of cancer after the end of treatment, while overall survival means the length of time that the patient is alive after the diagnosis or the start of treatment. The measurement of event-free survival and overall survival provides a good indication of the treatment effect.  

In this clinical trial report the therapy efficacy on 81 patients that received immunotherapy treatment with dinutuximab and started DFMO maintenance therapy at least 120 days after completion of treatment were compared to the efficacy (based on medical records) from a group of 76 patients that got the same treatment but without the maintenance with DFMO.  

DFMO inhibit the ornithine decarboxylase pathway, which is related to cell growth and decreased cell death, thus preventing cells to become cancerous and tumour progression. The results demonstrated that maintenance therapy with DFMO provided 85% of 5-year event-free survival compared to 65% for no-DFMO maintenance therapy, and 95% 5-year OS compared to 81% no-DFMO therapy2.  

In conclusion, this study results suggest a benefit provided by the DFMO therapy in preventing neuroblastoma relapse. The researchers suggest that early therapy with DFMO may further improve these results.  Therefore, more clinical trials evaluating this possibility are being conducted3,4.  

Written by Luiza Erthal

References 

1. SaulnierSholler, G. A Phase II Preventative Trial of DFMO (Eflornithine HCl) as a Single Agent in Patients With High Risk Neuroblastoma in Remission. https://clinicaltrials.gov/ct2/show/NCT02395666 (2020). 

2. Lewis, E. C. et al. A subset analysis of a phase II trial evaluating the use of DFMO as maintenance therapy for high‐risk neuroblastoma. Int. J. Cancer 147, 3152–3159 (2020). 

3. SaulnierSholler, G. Phase II Trial of Eflornithine (DFMO) and Etoposide for Relapsed/Refractory Neuroblastoma. https://clinicaltrials.gov/ct2/show/NCT04301843 (2021). 

4. SaulnierSholler, G. NMTT- Neuroblastoma Maintenance Therapy Trial Using Difluoromethylornithine (DFMO). https://clinicaltrials.gov/ct2/show/NCT02679144 (2021).