8 | New Scientist | 19 February 2022
AN AMBITIOUS Australian
programme to use personalised
medicine to reduce the number
of children who die of cancer to
zero has already kept alive more
than 150 children with aggressive
cancers who would have otherwise
died. The success of the scheme –
the Zero Childhood Cancer
Program, or Zero – means it will be
made available to all Australian
children with cancer from 2023.
One of Zero’s participants
is Jack Burai in Sydney, who was
diagnosed with a brain tumour
in 2017, when he was 9 years old.
His cancer was surgically removed,
but came back aggressively a year
later and spread through his brain
and spine, leaving him unable to
walk, eat or see out of his right eye.
“It was an end-of-life situation,”
recalls his father Alex. “When
his mum was out of the hospital
room, he would turn to me and
say, ‘Dad, am I going to die?’.”
Now, Jack is a healthy, seemingly
cancer-free 14-year-old who runs
marathons and rides his BMX bike
daily thanks to the personalised
care he received through Zero.
The idea of the programme
is to move away from giving
standardised treatments and
to view every child’s cancer as
unique, says Chelsea Mayoh at
the Children’s Cancer Institute
in Sydney, where Zero is based.
The first step is to try to work
out more about each child’s
cancer. To do this, Mayoh and her
colleagues genetically sequence
a child’s tumours and run other
tests. Once the possible drivers
are identified, the team searches
medical literature and talks to
colleagues to determine what
sort of treatment might work best.
The team also tries a scattergun
approach by testing more than
100 different cancer drugs on
tumour cells taken from the child
and grown in Petri dishes. DrugsMedicineTE
K^ IMAGE/SCIENCE^ PHOTOLIBRARYThe dream of ending child cancer
Is it possible to prevent all children dying from cancer? Alice Klein reports
DNA sequencing helps
offer a personalised
approach to cancerJack Burai was diagnosed
with a brain tumour when
he was 9 years oldNews
700
Number of children who have
joined the Zero cancer programme72%
Proportion of those children
recommended a targeted therapy31%
Proportion of those treated whose
cancers shrunk or were stabilisedpersonalised medicine scheme.
“They told me I was nuts, but they
agreed to give it a go,” she says.
After securing A$20 million
(US$14 million) of funding from
the Australian government, the
team started by enrolling children
with cancers that give people a
less than a 30 per cent chance of
survival, like Jack’s. “These are the
children whose parents are told,
‘Go spend some quality time
together’,” says Mayoh.
Since 2015, 700 children
have joined Zero from children’s
cancer hospitals in Australia.
Individual cancer drivers have
been identified for 94 per cent
of them and targeted treatments
have been recommended
for 72 per cent.
Of the children who have had
targeted treatments, 31 per cent
have responded, meaning their
cancers have partially or
completely disappeared or
stabilised, says Mayoh, who will
present the results at the annual
scientific meeting of the Royal
College of Pathologists of
Australasia next month.
With standard care, these
children would have died, says
Mayoh. “We always said that
helping just one patient would
be amazing, so we think it’s been
a huge success.” Because the
treatments in Zero are targeted,
they also tend to have fewer
side effects than conventional
therapies, says Mayoh.A faster approach
Zero hasn’t been able to save
every child, often because they
succumb to their disease before
a personalised treatment can be
VIV found. The team has managedIANROSATIthat seem most active against
the cells are then tested in mice
that have been injected with
the child’s tumour cells to check
their safety and efficacy before
they are given to the child.
In Jack’s case, genetic
sequencing showed that a
mutation called V600E in a gene
called BRAF was driving his cancer.
The Zero team knew that cancers
with this mutation often respond
to drugs called dabrafenib and
trametinib and recommended
them to his oncologists.
Within a week of taking these
drugs, Jack was walking again, and
after four weeks, he was playing
tennis. Scans showed the tumours
in his brain and spine rapidly
shrinking, before disappearing
altogether. “It was truly miraculous
because he had been slipping
away in front of our eyes, and
then he was suddenly back to his
normal self,” says his mother Viv.
Zero is the brainchild of
Michelle Haber, the executive
director of the Children’s Cancer
Institute. In 2013, she convened
several cancer experts and
explained her idea for the