World-first approach to tackling children’s brains tumours at CRUK Cambridge Institute could prevent need for surgery

A world-first approach to diagnosing and treating children’s brain tumours could help prevent the need for invasive and dangerous surgery.

The groundbreaking research at the Cancer Research UK (CRUK) Cambridge Institute is initially focused on medulloblastoma – one of the most common children’s brain tumours.

It affects about 50 children a year in the UK, accounting for 15 to 20 per cent of all child brain tumour diagnoses.

About seven in 10 (68.6 per cent) of children diagnosed with medulloblastoma in the UK survive the disease for five years or more but surgery, radiotherapy and chemotherapy can lead to long-term side effects that can devastate their quality of life.

Dr Jessica Taylor, from the CRUK Cambridge Institute at the University of Cambridge, is focused on research to ensure children not only survive but survive well.

With funding from Cancer Research UK and The Brain Tumour Charity, she is exploring a type of medulloblastoma called WNT - wingless and integrated - which refers to how the tumour cells look.

“WNT-medulloblastoma tumours typically grow in an area of the brain that is very difficult to operate on without damaging healthy brain,” she says. “The risk is not only from surgery, but also these tumours have an excess of blood vessels feeding the tumour, which are more likely to haemorrhage during surgery.

“Around 25 per cent of children who undergo surgery to this part of the brain can suffer from an increased risk of long-term effects such as memory problems, or speech issues.

"We are designing new antibodies that recognise specific proteins on the surface of WNT-medulloblastoma cells and bind to them. These antibodies will be labelled with a radiometal that is taken up by the tumour and we can see with a PET scan.

“If the tumour is visible on this scan, it would allow the health care team to know that this tumour is WNT-medulloblastoma, without removing the tumour surgically for analysis. We can then plan children’s treatment specifically for this subtype. For example, we know that WNT-medulloblastoma is highly curable with chemotherapy, which could help spare children the significant side effects of being treated with aggressive surgery."

Such techniques to distinguish different types of medulloblastoma also offer great potential for diagnosing and treating other brain cancers, as new bespoke radiotherapy treatments are also being explored as part of the project.

Dr Taylor aims to harness cells in the body to deliver targeted treatment using radioisotope therapy.

While traditional radiotherapy is given to children with brain tumours either to the area where the tumour was, if it was surgically removed, or to the whole brain or spinal cord, using radioisotope therapy enables radioactive medicines to be used treat some types of cancer through a drink, capsule or injection.

The radioisotope travels around the bloodstream to the tumour site, where it is taken up by the cancer cells and delivers a high dose of radiation that destroys them, while sparing healthy cells.

This lowers the chance of potentially life-changing impacts on the developing brain.

Dr Taylor intends to bind imaging antibodies to drugs and/or radioisotope therapy to simultaneously diagnose and treat tumours.

This ‘theranostic approach’ reduces the impact on patients and the hope is that through a translational approach to research, and collaborations with clinicians and researchers at the CRUK Cambridge Centre, and worldwide, will fast-track these new therapies to the clinic.

She added: "Through developing these new therapies, we are collecting huge amounts of data that will allow us to gain a clearer understanding as to why some children get brain tumours. We want to understand why children get these brain tumours in the first place. They’re too young to have been exposed to the environmental factors that contribute to adult cancers. Is paediatric brain cancer all about tiny missteps in development?

“Could we reverse engineer this pathway and fix it? If not, can we diagnose earlier and treat using kinder therapies that consider quality of life as well as survival? That’s something that really appeals to me. Our long-term aim is to either reduce or completely transform the therapeutic journey."

Dr Taylor is part-funded by Cancer Research UK’s RadNet network, which features seven centres of excellence in radiation, including Cambridge.

With millions of pounds in funding, they are developing next-generation radiotherapy to make it more personalised and targeted.

It represents the next steps for radiotherapy - the foundations for which were laid by Cancer Research UK scientists in the early 1900s. More than 1,000 children and young people in the UK receive radiotherapy today as part of their treatment each year.

Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, said: “As the evolution of radiotherapy shows, we’ve been at the forefront of cancer research for over 100 years. From making it more targeted to combining it with other treatments and reducing the number of doses needed, Cancer Research UK has changed clinical practice worldwide and made radiotherapy kinder and more effective. But we must go further and faster.

“We want to bring about a world where everybody lives longer, better lives, free from the fear of cancer - no matter who they are or where they’re from. Powered by public donations, the funding for Dr Taylor’s innovative work will further accelerate improvements in radiotherapy in the clinic and could potentially change the landscape of current brain tumour diagnosis and treatment.”

Around 420 children are diagnosed with brain tumours each year in the UK.

The Brain Tumour Charity chief scientific officer Dr Simon Newman said: "The Brain Tumour Charity is proud to be funding Dr Taylor's groundbreaking work which could make such a difference to families affected by one of the most common childhood brain tumours. She is part of The Brain Tumour Charity's pioneering Future Leaders programme which identifies and supports the next generation of brain tumour researchers, so we are pleased to see our funding making such an impact."

Support the future of cancer research at cruk.org/donate.