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Personalised treatments for childhood cancers

Beyond chemotherapy lies a complex world of treatment pathways. We met with Dr Dhanya Sooraj, Postdoctoral Research Fellow at Hudson Institute of Medical Research to discuss new technologies helping personalise cancer therapy for children being treated for brain cancers and solid tumours.

Dhanya brings extensive molecular biology and data analysis skills to the Hudson Monash Paediatric Precision Medicine Program that aims to identify treatment that works best for each child, reducing their treatment side effects and improving long term overall survival.

A technology led international collaboration

Committing more than $5 million in funding towards the program over five years, Dr Dhanya Sooraj is the Children’s Cancer Foundation Postdoctoral Research Fellow on the project.

The program uses the latest technology to grow mini (3D and 2D) versions of patient tumours in a laboratory.

Scientists then utilise these mini-tumours to screen against thousands of cancer drugs to see which ones have the greatest impact on growth and with fewest side effects. In parallel, these mini tumors are genetically screened to identify the growth promoting targets.  Our HMPPMP team combine pharmaceutical sensitivity data with the detailed genomic data, and the results are used by doctors to prescribe more effective, better targeted treatments for patients in a much shorter timeframe.

The program involves a broader team of researchers, clinicians, pathologists and technicians from both Hudson Institute, Monash University and Monash Health with research collaborations both nationally and internationally.

The role of a postdoctoral research fellow

Dhanya’s role includes the development of research design and plans, presentations of findings at scientific conferences and submission of research publications to peer reviewed journals.

“At the Hudson Monash Paediatric Precision Medicine Program our focus is on developing a more tailored or personalised treatment approach with less side effects,” she says.

“So basically, I lead, design and implement experiments which will generate systematic progress towards discoveries which might hopefully lead to a better treatment outcome.”

She has spent more than 10 years in medical research, specialising in cancer.

“I’m basically, a curious person. I have a passion and curiosity in understanding the genetic and functional complexities of cancer.”

Dhanya mentions in her interview

Many childhood cancers have no cure and one in five children diagnosed with cancer will die. Research has shown that no two childhood cancers are alike. Each child’s cancer has its own unique molecular fingerprint.

“It’s really intriguing to understand the pathway driving the genetic abnormalities, especially in paediatric tumours. Some of them are really rare forms,” says Dhanya.

The future of paediatric cancer and precision medicine

The advancements in paediatric precision medicine are offering hope for the future. Dhanya says that by using the latest drug screening technology on mini-tumours in the laboratory, young patients hoping to get more effective treatment plans more quickly. She says the speed of treatment is often vital for childhood cancers.

“For example you can wait and watch for prostate cancer from its benign stage to malignancy – whereas with brain tumours, especially the paediatric tumours, we don’t have that option.

“That’s where this personalised approach is more important because we just have to come up with more effective and more specific answers for these patients.”

“This is a long-term approach where we can get shot of this tumour forever before it gets to spread to other areas.”

Moreover, the drugs that are screened against the mini-tumours have mostly cleared the trial stage and are already in clinical use. Many of these drugs were developed for adult cancers; but with the advanced and improved screening strategies we are expecting a single drug or a combination of these drugs could also show a better impact on childhood cancers.

Moving towards targeted treatments, in a short timeframe

“We’re trying to repurpose existing drugs or compounds so that we don’t have to wait to go through clinical trials with these patients who are actually in desperate need of treatment,” says Dr Sooraj.

“From combined genetic and pharmacological screening of mini tumors, we are expecting to understand what is sensitive or not sensitive in the first two months from diagnosis.”

Another major advantage of developing a mini-tumour sample from each patient which can be studied and tested in the laboratory is that the scientists and doctors can predict possible side effects from drug treatments.

The research has also shown that the cancers changes with the treatments, and some treatments ineffective over time.

“Over time, after the first or second cycle of treatments these tumours can actually acquire mutations,” says Dhanya. “ May be due to the treatment, or may be the way the cancer is actually growing, it’s more complex than we think”.

“So, with HMPPMP program, the multifaceted and combined genetic and pharmacological approaches, we are hoping to predict with high confidence what will be the best treatment options for that unique type of paediatric cancers; primary or relapsed.”

“The process of screening cancer compounds against each patient tumor samples sped up enormously by using the automated, biomek robot system which is funded by the Children’s Cancer Foundation. It’s a huge advance.”

Photo credit: Hudson Institute

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