Around 80% of sufferers now survive and this is a result of laboratory research that has led to a far better understanding of the causes of cancer and the development of new drugs and techniques.This knowledge is then applied in clinical trials that are available for the majority of children with malignant disease.
The Liverpool childhood oncology research theme is wide-ranging and addresses the two main challenges for paediatric cancer – improving the survival rate of patients with aggressive tumour types and decreasing toxicity from treatments like chemotherapy and radiotherapy.
Working in partnership
Clinicians at Alder Hey have a long-standing and productive relationship with scientists at the University of Liverpool. Research focuses on the processes by which tumour cells become more aggressive and spread throughout the body (metastasis) and why tumour cells become resistant to chemotherapy.
At present we are principally investigating tumour hypoxia. Tumours require a blood supply to grow and as this happens, the centre of a tumour mass may become develop areas of low oxygen (hypoxia). Although this may limit the growth of tumours, hypoxic cells become more resistant to chemotherapy. This line of research is focused on neuroblastoma, a solid tumour in young children, and two highly malignant brain tumours, medulloblastoma and glioblastoma.
Clinical research in this theme aims to lead and support clinical trials and to conduct novel in-house research that will have a clear benefit for children with cancer. Alder Hey continues to have an excellent record of participation in national/international trials. We consistently achieve more than 90% entry of patients into available main line trials. We have a strong commitment to early phase (drug development) trials as one of ten member centres of the UK Paediatric Experimental Cancer Medicine network and a member of the European Innovative Therapies in Childhood Cancer group.
Neuro-oncology – research into brain tumours
The Alder Hey brain tumour service has an international reputation of excellence and our clinicians have a major influence in the development of paediatric neuro-oncology. With research into ‘Posterior Fossa Syndrome’ we have undertaken the world’s first systematic comparison of ataxia scales and a novel investigation of so-called socio-cognitive functioning in survivors of posterior fossa tumours.
Alder Hey has the UK’s only high field (3 Tesla) intraoperative MRI facility so we have a very strong programme of research in MRI imaging in paediatric neuro-oncology. This includes the world’s first study of the utility of injectable small gas bubbles (microbubbles) as an MRI contrast agent and the investigation of a novel MRI technique called arterial spin labelling in CNS tumour imaging.
Researching the side effects of chemotherapy
We are currently investigating two chemical tests for chemotherapy effects on the kidney that may help detect damage early and prevent long-term damage. We are also leading on a new project investigating two new tests (bacterial DNA and APTT waveform) that may help in the diagnosis and management of often life-threatening bacterial infections that are associated with the use of central venous catheters.
In collaboration with Professor Munir Pirmohamed at the University of Liverpool, a programme of research is being developed to explore genetic differences (pharmacogenetics) in individual patients that determine whether or not they are prone to developing particular side-effects of chemotherapy.
As part of our research into the side effects of chemotherapy and alongside the Better and Safer Medicines for Children research theme, we have recently begun working with Professor William Hope at the University of Liverpool to apply new techniques to determine how drugs are handled in the body (pharmacokinetics).