Displaying items by tag: Research

2:15 – 3:15 pm Saturday, September 15

DSRCT: A Pediatric Oncology Rarity (230)

1CNE  Desmoplastic small round cell tumor (DSRCT) is one of the rarest pediatric tumors and was only recently classified in 1989. Categorized under sarcomas, DSRCT under the microscopic is a fusion of a both a wilms and ewing sarcoma gene. Although known as a mostly surgical tumor, chemotherapy, radiation, and new treatments like immunotherapy are vital in the battle against this fatal disease. DSRCT is known mostly in the adolescent and young adult population, where the rate of occurrence is predominantly in males. In a retrospective cohort analysis published in 2014 from the Journal of Cancer Epidemiology, the 5-year survival rate was found to be just 33.3% (Lettieri, Garcia-Filion, Hingorani, 2014). Factors impacting survival rate are the overall oncology role to treatment and management.

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11:30 am – 12:30 pm Saturday, September 15

COG Clinical Trials: Empowered Nurses the Key to their Success (C229)

coglogo1CNE  In pediatric oncology, clinical trials are conducted to improve survival rates, understand disease biology, and prevent or improve management of treatment-related acute and long-term side effects. The majority of children newly diagnosed with cancer in North America are treated on Children’s Oncology Group (COG) clinical trials. In the last 50 years clinical trials in pediatric oncology have increased the overall 5-year survival rate from under 10% to over 80% today. Nurses are an integral part of the success of these trials.

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3:15 – 4:15 pm Friday, September 14

New Hope Through Clinical Trials in Low Grade Gliomas: From Diagnosis, Standard Treatment Modalities, to BRAF/MEK Inhibitors (221)

1CNE  Low grade gliomas (LGG) are the most common type of pediatric brain tumor (Jones et al., 2017). Depending upon tumor location, many patients undergo surgical resection. If a gross total resection is achieved, patients receive MRI imaging. However, patients who have an incomplete resection or a recurrence receive additional therapy. Young patients with developing brains receive chemotherapy. Older patients may receive radiation. There are multiple agents or combination of agents that are administered in patients with LGG. Standard frontline chemotherapies are either Carboplatin and Vincristine or TPCV (Thioguanine, Lomustine, Procarbazine, and Vincristine). Other traditional single-agent therapies include Temodar, Vinblastine, or Vinorelbine. BRAF/MEK inhibitors (trametinib, dabrafenib, vemurafenib, and selumetinib) are currently being used in clinical trials (Penman, Faulkner, Lowis, & Kurian, 2015).

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11:00 am – Noon Friday, September 14

Therapeutic and Supportive Care Protocols Paving the Way to a Brighter Future for Children with AML: Children’s Oncology Group Experience (C217)

coglogo1CNE  Acute leukemia is the most common malignancy in childhood and acute myeloid leukemia (AML) accounts for 15% of childhood leukemias. Survival for children with AML has improved, but overall survival is limited to 65%–70%. Improvement in survival for children with AML has been achieved by advances in knowledge contributed by various international cooperative group clinical trials. The majority of children newly diagnosed with AML in North America receive treatment on a Children’s Oncology Group (COG) clinical trial. The COG clinical trials for AML have investigated the role of risk stratification and intensification of therapy including the use of hematopoietic stem cell transplant. With the increase in intensity of chemotherapy, the COG recognized the limitations in delivering this therapy due to infection. Bacterial sepsis and invasive fungal infections are the leading cause of morbidity and treatment-related mortality in children receiving treatment for AML. To address this challenge, attempts to improve supportive care through COG’s Cancer Control trials have focused on prophylactic antibacterial and antifungal therapies.

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11:00 am – Noon Friday, September 14

Improving Access to Hematopoietic Cell Transplantation Clinical Trials for Patients with Sickle Cell Disease (214)

1CNE  Sickle cell disease (SCD), the most common inherited hemoglobin disorder in the U.S., affects nearly 100,000 people. Yet progress for advancing curative treatments such as hematopoietic cell transplantation (HCT) has been limited in part due to the shortage of clinical trial (CT) participation by individuals most affected. How to improve clinical trial participation for patients is the $1 million dollar question for many healthcare providers. Participants attending this session will be able to identify evidence-based strategies to enhance patients’ trust and increase HCT CT participation.

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3:30 – 4:30 pm Thursday, September 13

Are Your Patients with Advanced Cancer Suffering? A Nurse-Led Study Utilizing Technology to Measure Symptoms (C205)

coglogo1CNE  Nurses and nurse practitioners have the opportunity to be at the forefront of supportive care research using current technology. Through collaboration between the COG Nursing Research Subcommittee and Alex’s Lemonade Stand Foundation, a mentored nursing grant funded a multisite study investigating how children with advanced cancer experience symptoms. Minimizing suffering, including effective symptom management, in children with advanced cancer is a central value for pediatric oncology clinicians (Nuss et al., 2005). Patient-reported outcomes have been used in pediatric oncology symptom-related research (Baggot et al., 2012); however the majority of literature specific to symptoms during palliative or end-of-life care for children with advanced cancer is based upon medical record reviews and to a lesser extent, patient self–report (Hinds et al., 2007; Wolfe et al, 2015). The study purpose was to prospectively describe symptom frequency, severity, and distress level in children and adolescents with advanced cancer using patient self-report and parent proxy.

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3:30 – 3:50 pm Thursday, September 13

Paper Presentation: Supporting Parents Across the Treatment Continuum — Reasons, Hopes, Risks, Expectations: Qualitative Interviews of Parents Consenting to Genomic Sequencing for their Child (204-1)

1CNE  Basis of inquiry: Genomic sequencing is rapidly being incorporated into care for patients diagnosed with cancer. Little is known about why parents of children with cancer consent to sequencing and how they understand and weigh the risks, benefits, and uncertainty inherent in testing.

Purpose/Objectives: This qualitative inquiry was part of the Genomes 4 Kids study which included somatic and germline sequencing in a cohort of 301 prospectively identified pediatric oncology patients with leukemias, central nervous system (CNS), or non-CNS solid tumors treated at St. Jude Children’s Research Hospital. The aims of this aspect of the study were to identify reasons for participation given by parents enrolled in the larger study and perceived risks, benefits, expectations, and hopes.

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3:30 – 4:30 pm Thursday, September 13

Going Viral: Review of Viral Illness and Antiviral Therapy in Hematopoietic Stem Cell Transplant Pediatric Patients (200)

1CNE  Hematopoietic stem cell transplant (HSCT) recipients are at significant risk for developing serious and sometimes fatal infectious complications. Common viral infections post-transplant occur from reactivation of a dormant virus, including herpes simplex (HSV), Varicella (VZV), cytomegalovirus (CMV), BK virus and Ebstein Barr Virus (EBV). Immunocompromised patients may also experience significant morbidity and mortality from common respiratory viruses, such as influenza, parainfluenza, adenovirus, and respiratory syncytial virus (RSV). Interventions vary greatly and can include prophylaxis, preemptive therapy or treatment of active infection. A variety of antiviral agents are now used including cellular immune therapy. A pharmacologic review will show that antiviral agents often have different dosage schemes, complex side effect profiles, and the need for supportive care.

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Consulting, Arranging and Referring: How to Create the Connections Needed for a Successful CAR T Patient Experience (004)

3.25CNE  Leukemia is the number one cause of pediatric cancer mortality. In addition, there are poor outcomes for second and greater relapses of ALL, so there is a need for new novel therapies (Novartis, 2015). Chimeric antigen receptor-engineered T cells (CAR T cells) have yielded unprecedented efficacy in B cell malignancies, most remarkably in anti-CD19 CAR T cells for B cell acute lymphoblastic leukemia (B-ALL) with up to a 90% complete remission rate. (Wang, Wu Han, 2017). Because CAR-T therapy success can be contingent on factors such as disease burden and previous therapy, communication between referring and referral centers to facilitate rapid consultation is essential.

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