Neuroblastoma: helping children’s immune systems to fight high-risk cancers

Around 100 children are diagnosed with a type of cancer called neuroblastoma each year in the UK.^1,2 Most are young – less than five years old.^1,3 While many children with this cancer do well, others lose their lives despite going through gruelling treatment that can have severe side effects. Professor John Anderson, of University College London’s Institute of Child Health, is developing a way to programme children’s own immune systems to recognise and destroy cancer cells, while sparing healthy cells. He hopes this will one day help free children from the side effects of existing treatments and save more children’s lives.

This is a joint project which is being funded by Action Medical Research, Great Ormond Street Hospital Children's Charity and Neuroblastoma UK.​

How are children’s lives affected now?

When children are diagnosed with neuroblastoma, their chances of making a good recovery vary considerably. Most children with low-risk disease will be cured.^4-6 Sadly, though, the outlook is less certain for children with high-risk disease.

“Children with high-risk neuroblastoma need extremely intensive chemotherapy and radiotherapy, along with other treatments,” says Professor Anderson. “The children spend a long time in hospital and they can get a lot of side effects. For example, chemotherapy, which involves frequent injections, can make children feel sick and cause them to lose weight, sometimes meaning they have to be fed through a tube. Longer-term side effects are possible too.”

“Children’s treatment normally lasts for a year,” says Professor Anderson. “Sadly, despite the intensity of treatment, high-risk neuroblastoma can be hard to cure and many children still go on to lose their lives.”⁶

Safer, more effective treatments are urgently needed.

How could this research help?

“We’re developing a new treatment for children with high-risk neuroblastoma, which harnesses the power of children’s own immune systems to combat their disease,” says Professor Anderson.

The new treatment is called chimeric antigen receptor (CAR) T cell therapy. It will involve collecting immune cells called T cells from a child’s blood, modifying them so they recognise and kill cancer cells, and putting them back into the child’s bloodstream. This approach has already proved successful in leukaemia and lymphoma.

“We’re investigating, in the laboratory, how to make CAR T cell therapy as safe and effective as possible for children with high-risk neuroblastoma,” says Professor Anderson. “We think we’ve found a way to create CAR T cells that are better at killing cancer cells, which could give children more chance of a cure, and less likely to attack healthy cells, which could spare children from unpleasant side effects. If we’re right, clinical trials could soon follow.”

References

1. NHS Choices. Neuroblastoma. http://www.nhs.uk/conditions/neuroblastoma/Pages/Introduction.aspx Website accessed 26 August 2015.

2. The Neuroblastoma Society. Home page. http://neuroblastoma.org.uk/ Website accessed 26 August 2015.

3. The Neuroblastoma Society. Neuroblastoma FAQs. http://neuroblastoma.org.uk/families/neuroblastoma-faqs/ Website accessed 26 August 2015.

4. Cole KA et al. New Strategies in Refractory and Recurrent Neuroblastoma:

Translational Opportunities to Impact Patient Outcome. Clin Cancer Res 2012; 18: 2423-28.

5. Park JR et al. Children’s Oncology Group’s 2013 Blueprint for Research: Neuroblastoma. Pediatr Blood Cancer 2013; 60: 985–993.

6. American Cancer Society. Survival rates for neuroblastoma based on risk groups. http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastoma-survival-rates Website accessed 6 October 2015.