Oncology

Physician scientists and clinical investigators of the Herbert Irving Division of Child & Adolescent Oncology (HIDCAO) perform research to ensure that our patients have access to the latest, most innovative therapies. Existing and future projects are designed to lead to new treatments, new diagnostic methods, and strategies to prevent childhood cancer. Our research includes both laboratory-centered basic and translational ventures and clinical or patient based investigations in a wide spectrum of projects.

Ongoing Projects Include:

• Molecular pathogenesis of leukemia (Dr. Adolfo Ferrando): The goal of this research is to identify critical genes involved in the growth and survival of leukemia cells and to exploit this information for the development of molecularly tailored drugs that will result in the discovery of novel highly effective and less toxic therapies for children and adolescents with acute lymphoblastic leukemia.

• Molecular epidemiology (Dr. Manuela Orjuela): The goal of this research is to determine if a link exists between environmental exposures prior to birth and the development of pediatric cancers in general and more specifically acute leukemia. The study is based on the finding that antenatal maternal exposure to air pollutants including polycyclic aromatic hydrocarbons causes the development of chromosomal aberrations detected in cord blood samples. Thus, exposure to such chemicals, including cigarette smoke, during pregnancy may lead to a heightened cancer risk.

• Solid tumor biology (Drs. Darrell Yamashiro and Alice Lee): The goal of this research is to address a specific defect in differentiation in neuroblastoma, the dysregulation of inhibitors of differentiation, Id2 proteins and their target angiogenic genes.

• Brain tumors (Drs. Antonio Iavarrone and Anna Lasorella): The goal of this research is to identify molecular events engaged by Id2 and to establish the role of Id proteins in the natural progression of human nervous system tumors. Ultimately, the goal is to formulate the anti-Id molecules to be used as targeted therapeutic tools for these diseases.

• Molecular biology of tumor suppressor genes (Maria Luisa Sulis): The goal of this research is to characterize and determine the possible mechanisms of regulation of the PTEN tumor suppressor gene. This gene has been shown to play an important role in the regulation of the growth of cervical and prostate cancer as well as glioblastoma multiforme.

• The HIDCAO is a full member of the Children’s Oncology Group, the national consortium that directs clinical trials for children and adolescents diagnosed and treated for cancer.
• The HIDCAO is one of only 20 members of the National cancer Institute’s Children’s Oncology Group Phase I experimental therapeutics consortium
• The HIDCAO is a full member of the Dana Farber Cancer Institute childhood leukemia consortium that offers patients acute lymphoblastic leukemia the highest cure rates reported.
• The HIDCAO is a full member of the National Blood and Marrow Transplant Consortium.
• The HIDCAO participates in the Pediatric Brain Tumor consortium that offers patients with brain tumors the best chance for cure with markedly reduced long-term side effects.
• Sponsor of a novel therapeutic strategy for the treatment of neuroblastoma that utilizes chemotherapy, radiation therapy, surgery, stem cell transplants, immunotherapy, and biological modifiers.
• Sponsor of the first national clinical trail in children with cancer using bevacizumab, an anti-VEGF (vascular endothelial growth factor) agent that prevents blood vessel growth in refractory solid tumors.
• Sponsor of a study to measure folate-metabolizing enzymes, dietary folate intake, and correlate these results with survival and toxicity in children with acute lymphoblastic leukemia.
• Sponsor of a study to determine if the use of milk thistle will reduce liver toxicity in children treated for acute lymphoblastic leukemia.
• Sponsor of a study to determine whether the use of supplemental glutamine will reduce vincristine neuro-toxicity.
• Sponsor of a study to determine whether patients treated for Hodgkin’s disease with chemotherapy and/or radiotherapy have an increased risk of late cardiovascular toxicity.

October 2004: Pediatric Oncology Service Area Market Share

June 2004: Investigators find bone mass is reduced in childhood leukemia [more]

A team of clinical investigators led by researchers at the Herbert Irving Child & Adolescent Oncology Center reported the results of a “Study Comparing Bone Mass in Pediatric Patients with Acute Lymphoblastic Leukemia (ALL) to Healthy Controls” at the Eighth International Conference on Long-term Complications of Treatment of Children and Adolescents for Cancer at Niagara-On-The-Lake, Ontario, Canada. Drs. Kara Kelly, Michael Weiner, and Mary Horlick determined that bone results for all ALL patients on therapy compared to matched controls revealed lower values for total body bone mineral content, total body bone area, and total body bone mineral density. They also found that patients off of therapy for at least one year had values for bone mass that did not differ from the control group. A larger prospective trial is under way to identify which elements and phase of therapy may be responsible for these findings.

September 2004: Children with advanced Hodgkin’s disease respond favorably to new drug regimen [more]

The drug regimen BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) has shown to be a safe and effective treatment for children and adolescents with advanced Hodgkin’s disease according to Dr. Kara Kelly of the Morgan Stanley Children’s Hospital of NewYork Presbyterian. Dr. Kelly presented her findings at the Sixth International Symposium on Hodgkin’s Lymphoma in Cologne, Germany. The study conducted through the Children’s Oncology Group found that patients receiving BEACOPP had a 3-year 95% survival, compared with 80 to 85% survival for other regimens.  “While Hodgkin’s disease is one of the most curable cancers, treatments for advanced forms of the disease leave room for improvement. This trial demonstrates that children and adolescents with the disease can expect improved survival and recovery,” says Dr. Kelly. Dr. Michael Weiner, Director of the Herbert Irving Child & Adolescent Oncology Center at Columbia University Medical Center is a co-investigator in the study.

October 2004: James Garvin, MD, PhD to lead neuro-oncology [more]

James Garvin MD, PhD has been appointed to lead the section of pediatric neuro-oncology.  Dr. Garvin, Professor of Clinical Pediatrics at the College of Physicians and Surgeons of Columbia University was selected after an extensive national search. Dr. Garvin is a national leader in the field of brain tumor clinical investigation. He has been the principal investigator of a Children’s Cancer Group study for the treatment of ependymoma and is an active participant in the Pediatric Brain Tumor consortium. As section leader he will coordinate the efforts of the Children’s Hospital of NewYork’s multi-disciplinary team of neurosurgeons, radiation oncologists, and child neurology. Dr. Garvin will also have administrative responsibility for the newly created “Late Effects” enterprise that will address the issues of cancer survivorship for patients treated at the Herbert Irving Child & Adolescent Oncology Center.