To mark International Clinical Trials Day this year we speak to Dr Meriel Jenney, Chair of the NCRI Children’s Cancer & Leukaemia (CCL) Clinical Studies Group (CSG), and ask her about the importance of clinical research for childhood cancers and how partnership working and collaborations (both across the UK and internationally) are vital to ensure high-quality research.
How did you get into clinical cancer research?
As a paediatric oncologist, clinical cancer research has always been part of my day-to-day work. Children’s cancers are rare and therefore paediatric oncologists need to work together to answer clinical research questions and try to improve treatments.
How has collaborative working progressed during your career?
As the speciality of children’s cancer developed there were early trials with colleagues collaborating across the UK, exploring different treatment approaches for a variety of childhood leukaemias and other solid tumours. More recently research partnerships have widened and we regularly work with colleagues across Europe – and the world – to answer difficult questions in the treatment of a number of children’s cancer.
What made you want to be a part of the NCRI CSGs?
Working in partnership with colleagues is essential in the treatment of rare cancers. The NCRI CSGs are a hub for these collaborations and they bring together a wide range of experts to develop clinical studies and provide advice and support which helps to improve the quality of studies overall. The CSG also provides an opportunity for patients and carers representatives to directly influence the development of clinical studies.
What does the CCL CSG do and how does it advance research into childhood cancers?
The primary aim of the Children’s Cancer and Leukaemia CSG is to improve the quality of clinical studies and make sure they address unmet need in a robust and reliable way. This is achieved by providing expert and timely review of clinical studies, from the emergence of new ideas through to the implementation, conduct and conclusion of the study.
In children’s cancer we have a particular challenge because of the relatively small patient population and wide variety of different cancers. The CSG and its subgroups work directly with colleagues from Europe and the United States to bring together expertise, improve study design and maximise the number of patients that could be recruited – so that questions can be answered in rare patient groups. For example, the CSG has supported the International Study for High Risk Neuroblastoma (SIOPEN HR Nbl) – this recruited the highest number of patients in a clinical study in neuroblastoma worldwide and has identified the high dose therapy regimen which delivers best survival outcomes (now standard of care). The study also has an infrastructure though which tumour samples are sent to an expert reference group in Newcastle. This has improved the molecular diagnosis of neuroblastoma.
What do you see as being the most exciting development in childhood cancer research at the moment?
The development of precision medicine – I think that exploring the molecular profile of children’s cancers could lead to new targets for treatment and hopefully new targeted anti-cancer therapies.
Whilst there has been extraordinary progress over the past 30 years and I have seen the survival rates in many children’s cancers (for example leukaemia and lymphoma) improve very significantly, the prognosis for several tumours still remains poor and there is an urgent need for new drugs and other approaches to treat these. The development of new programmes for stratified medicine and the strengthening of the infrastructure within paediatric cancer services and the national children’s tumour banks will be essential in advancing molecular diagnostic techniques and improve outcomes for children with these very rare, treatment- resistant cancers.