Liquid biopsies to detect Neuroblastoma relapse of childhood cancer early

Neuroblastoma mainly affects toddlers and young children - in the EU region there are 1500 new cases per year. Neuroblastoma is a malignant tumor of the peripheral nervous system and around 50% of patients are high-risk cases. Recurrences occur frequently, and conventional therapies are no longer effective for these children. With liquid biopsies it is possible to monitor therapy success and to predict the recurrence of the tumor in time to take medical countermeasures.

Scientists from leading European research institutions in paediatric oncology are testing this promising diagnostic tool under the coordination of the European Society for Pediatric Oncology (SIOPE) and scientific lead of the Princess Máxima Center for pediatric oncology and St. Anna Children's Cancer Research Institute. The framework is a five-year Horizon Europe project.

Liquid biopsies are a promise for the future of personalized cancer medicine: Many children with high-risk neuroblastoma, i.e. 50 percent of all neuroblastoma cases, are at risk of not responding to therapy and developing a recurrence. Until now, the success of the therapy has been monitored with medical imaging procedures and bone marrow examinations.

These examinations are expensive, invasive, and stressful for children who need anesthesia. Liquid biopsies are small blood samples, so the procedure is minimally invasive, and comparatively simple. In the laboratory, the sample can be used to determine whether children have responded to therapies. Finally, an impending recurrence can be detected early.

Genetic tumor markers in the blood plasma, small pieces of DNA and messenger RNA (mRNA), which are released by tumor cells and provide information about the genetic changes in the tumor, are examined. In the event of a relapse, these can help to find targeted therapies for children with neuroblastoma. For example, the enzyme anaplastic lymphoma kinase (ALK) plays a decisive role in cancer development. If a child’s tumor has a fault in the ALK-gene, it could be targeted with ALK inhibiting drugs.

Dr. Lieve Tytgat, pediatric oncologist specialized in neuroblastoma at the Princess Máxima Center for pediatric oncology, and scientific co-lead of the MONALISA project, says: ‘This research is a real breakthrough in the world of non-invasive diagnostics. Liquid biopsies are increasingly commonly used in adults with cancer. With this study we aim to catch up with research in adults; an important development for children with cancer.’

Reference: Neuroblastoma: Liquid biopsies to detect relapse of childhood cancer early