New genomic testing guides treatment for children with cancer

Issue: BCMJ, Vol. 58, No. 10, December 2016, page(s) 584, 591 Pulsimeter

As of October this year, new oncology patients at BC Children’s Hospital receive testing for genetic variations that increase the risk of serious complications from the chemotherapy drugs cisplatin and anthracyclines. An individual’s risk of suffering side effects for these drugs varies greatly based on genetics. For example, the risk of heart damage from anythracylines is between 14% and 89% depending on a person’s genetics.

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 tumors, 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.

With the results of this testing, each child’s care team can develop a personalized treatment plan that balances the risks of side effects with the therapeutic benefits of these drugs.

Leading the program are Dr Bruce Carleton, director of the Pharmaceutical Outcomes Programme at BC Children’s Hospital and a professor in the Department of Pediatrics at the University of British Columbia, and Dr Rod Rassekh, an investigator and oncologist at BC Children’s Hospital and a clinical assistant professor in the Department of Pediatrics at the University of British Columbia. Drs Carlton and Rassekh and their colleagues are working to expand the testing program to hospitals across Canada and to patient groups beyond oncology. They are currently collaborating with clinicians and researchers at hospitals in Calgary, Winnipeg, Toronto, London, Ottawa, and Montreal on the groundwork and logistics necessary to offer testing at treatment centres in those cities.