Image: Professor Louis Chesler at the ICR

Leading charities Children with Cancer UK and Cancer Research UK will co-fund a major £5.5 million research programme to advance precision medicine for children and young people whose cancer has returned.

The Stratified Medicine Paediatrics 2 (SMPaeds2) research programme will be led by Professor Louis Chesler at The Institute of Cancer Research, London, alongside his co-leads, Professor Darren Hargrave at Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) and Dr Isidro Cortes Ciriano at the European Molecular Biology Laboratory’s European Bioinformatics Institute (EMBL-EBI). 

SMPaeds2 will investigate blood cancers and solid tumours in children and young people, including in the brain, muscle and bone, which can be more difficult to access, diagnose and treat.

Precision medicine is an approach which involves delivering treatments tailored to the individual patient. In cancer, this considers the specific changes in an individual patient’s tumour, allowing for more effective treatment whilst reducing long-term side effects. However, there remain barriers to the development and availability of precision cancer medicines for children and young people. This is in part due to childhood tumours having fewer genetic changes compared to adult tumours.

Developing and studying new tests to match children to the best treatment

SMPaeds2 aims to develop and study new tests that will build upon the success of the first phase of the programme, Stratified Medicine Paediatrics (SMPaeds1), which established the UK’s first National Molecular Tumour profiling platform for relapsed childhood cancer. Molecular tumour profiling maps the unique changes in the DNA of a person’s tumour, giving doctors information to help match the patient to the best treatment or clinical trial for their individual cancer. 

The advanced genetic tests and analyses that SMPaeds2 will develop will provide scientists with unprecedented insights into the biology of relapsed childhood cancers, aiding precision medicine today and unlocking the potential to develop new and better precision therapies in the future. There is limited advanced testing of children’s tissue biopsy and blood for relapsed cancers.

SMPaeds2 will work alongside the NHS to develop ‘liquid-based’ cancer tests that require little or no tissue, and instead work in blood and other body fluids, offering more information in less time. The hope is to be able to reduce or eliminate the need for invasive biopsies entirely.

Developing tests that could detect or predict relapse earlier

Diagnostic cancer tests developed by SMPaeds1 were implemented by NHS England for Standard of Care clinical use in 2020, representing a major success for young cancer patients. However, there is a continued need to diagnose children and young people with greater speed and precision.

Within five years, it is hoped that new tests developed by SMPaeds2 will help doctors to detect or even predict childhood cancer relapse earlier, as well as lead to the development of new precision medicines. It could also allow them to monitor how a patient is responding to treatment in-real time, meaning they could change or adapt the individual treatment approach if a treatment isn’t working.   

Survival rates for children’s cancers are improving. Fifty years ago, 6 in 10 children diagnosed with cancer died; today more than 8 in 10 children diagnosed with cancer in the UK survive. However, cancer is still a leading causes of death for children aged 0-14 in the UK.

All children with cancer in the UK should have access to precision medicine

Jo Elvin, CEO at Children with Cancer UK, said:

“We’re delighted to continue funding this pioneering research project into its second phase, which could mark a real step-change in the way childhood cancer relapse is diagnosed, monitored and treated. SMPaeds2 will identify specific patterns of childhood cancer relapse, highlight resistance to treatment and provide an infrastructure by which all children seeking experimental therapy on future clinical trials can be rapidly diagnosed and monitored.

“The data generated by SMPaeds2 will support the development of next-generation clinical trials, to help deliver more effective, targeted treatment. Our ambition is that all children diagnosed with cancer in the UK have access to precision medicine and this pioneering research will play a crucial role in making that a reality for young cancer patients.”

Michelle Mitchell OBE, CEO at Cancer Research UK, said:

“Cancer in children and young people is different to cancer in adults and presents a unique set of challenges that we must overcome. We’re taking on these challenges through transformational initiatives like the Stratified Medicine Paediatrics programmes.

“This programme aims to maximise new technological advancements to profile young patients’ cancers less invasively, more quickly and in more detail than ever before.

“This will allow patients to continue to be matched to the best possible treatment for their individual cancer, unlock the ability to study these cancers in unprecedented detail and help develop new and better treatments for children and young people that cause fewer long-term side effects.

“We are delighted to co-fund these pioneering programmes with our partners, Children with Cancer UK.

“By working together, we are determined to overcome the challenges and ultimately help more children and young people survive cancer with a better quality of life.”

Professor Louis Chesler, Professor of Paediatric Cancer Biology at The Institute of Cancer Research, London, and Consultant in Paediatric Oncology at The Royal Marsden NHS Foundation Trust, says:

“Through this programme, which brings together some of the UK’s leading experts, we are pushing the frontiers of treatment for childhood cancers – bringing us closer to a reality where every child with cancer receives treatment that is tailored to the unique biology of their cancer, and where it’s possible to identify these treatments through a simple blood test, rather than an invasive biopsy.

“Beyond the more immediate impact, this collaborative programme could also unveil crucial insights into the biology of childhood cancers and highlight areas for future scientific discovery, to help drive the development of new and more effective treatments.

“We’re immensely grateful to Children with Cancer UK and Cancer Research UK, and their supporters, for making this ambitious research programme possible. This programme would also not be possible without the support of the 20 treatment centres, their patients and their families. Together, we hope this programme will secure a brighter future for children with cancer.”

SMPaeds2 is a collaboration between The Institute of Cancer Research (ICR), Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH), the European Molecular Biology Laboratory’s European Bioinformatics Institute (EMBL-EBI), University College London (UCL), the University of Birmingham, Birmingham Cancer Research UK Clinical Trials Unit (University of Birmingham), Cancer Grand Challenges Rosetta team, The National Physical Laboratory, The Francis Crick Institute, Genomics England, Genomics Medicine Services Alliance (North London Genomics Hub), the University of Nottingham, Newcastle University, the Experimental Cancer Medicine Centres and the dedicated Stratified Medicine Paediatrics parent and patient representatives.