Cancer survivorship research highlighted at ASCO Annual Meeting

Investigators from St. Jude Children's Research Hospital will present new findings at the five-day Chicago event, including study results focused on late and long-term effects of cancer treatment.

Select Onsite Experts

Cancer Survivorship

Global Pediatric Oncology

Solid Tumors

When: Saturday, June 3 at 1:15 p.m. CST
Location: S504
Title: Temporal trends in chronic disease among survivors of childhood cancer diagnosed across three decades:  A report from the Childhood Cancer Survivor Study (CCSS).
Abstract: LBA10500 (Read the Press Release)

Childhood Cancer Survivor Study releases data on chronic disease in survivors

Todd M. Gibson, PhD, an assistant member of the St. Jude Department of Epidemiology and Cancer Control, will report findings from the Childhood Cancer Survivor Study (CCSS). The CCSS is a National Cancer Institute-funded study that includes 35,923 childhood cancer survivors diagnosed between 1970 and 1999. It also includes over 5,000 siblings of survivors who serve as the comparison group for the study. CCSS is a component of the Long Term Follow Up Study, which began in 1994 and is a collaborative, multi-institutional study. Gibson will present data on chronic diseases in long-term survivors of pediatric cancer. 

When: Saturday, June 3 at 1:39 p.m. CST
Location: S504
Title: A high-risk genetic profile for premature menopause (PM) in childhood cancer survivors (CCS) exposed to gonadotoxic therapy: A report from the St. Jude Lifetime Cohort (SJLIFE) and Childhood Cancer Survivor Study (CCSS).
Abstract: 10502

Genetic factors linked to premature menopause in childhood cancer survivors

Researchers led by St. Jude scientists have discovered inherited gene variations that are associated with a dramatically increased risk of premature menopause in a high-risk treatment group of childhood cancer survivors. The findings may help identify patients who are candidates for fertility preservation measures.

“While radiation and chemotherapy are known to put childhood cancer survivors at increased risk for premature menopause, until this study the genetic contribution to risk was unknown,” said Russell John Brooke, PhD, a postdoctoral fellow in Epidemiology and Cancer Control and the lead author of the study. The study included 799 long-term female childhood cancer survivors whose DNA was screened for inherited genetic variations that may predict their risk for premature menopause. The group included 30 women with clinical diagnoses of premature menopause, defined as menopause prior to their 40th birthdays.

The survivors were all enrolled in the St. Jude Lifetime Cohort study (St. Jude LIFE). The study brings long-term St. Jude cancer survivors back to campus for health screenings and other tests in an effort to improve life for childhood cancer survivors now and in the future. The analysis included more than 800,000 genetic variants and marks the first time the genome-wide approach was used to study premature menopause in childhood cancer survivors. Researchers focused on survivors whose cancer treatment included irradiation to the ovaries, a known risk factor for premature menopause. The scientists found that, within this high-risk group, survivors were more than 10 times more likely to experience premature menopause if they carried two copies of a genetic haplotype (pattern) in the regulatory region of the NPY2R gene. The gene plays a role in metabolism and ovulation.

Fifty-three percent of the St. Jude LIFE survivors diagnosed with premature menopause carried two copies of the high-risk haplotype.  Researchers confirmed the association between premature menopause and the high-risk haplotype in 1,624 long-term female childhood cancer survivors enrolled in the multi-center Childhood Cancer Survivor Study.

Yutaka Yasui, PhD, of Epidemiology and Cancer Control, is the senior author.

When: Monday, June 5 at 10:24 a.m. CST
Location: S504
Title: Subcortical brain volumes and neurocognitive function in survivors of childhood acute lymphoblastic leukemia (ALL) treated with chemotherapy-only.
Abstract: 10517

Volume of key brain regions reduced in leukemia survivors treated with chemotherapy alone

Brain regions involved in memory, attention and other cognitive skills were smaller in childhood leukemia survivors treated with chemotherapy alone compared to a similar group of healthy volunteers. The reductions were associated with lower scores on neurocognitive tests.

Brain MRIs of 176 St. Jude acute lymphoblastic leukemia (ALL) survivors and 82 community volunteers showed that glucocorticoid receptor-rich regions, such as the hippocampus and thalamus, were smaller in survivors than in community controls. Dexamethasone, a steroid, is a key component of ALL therapy and is suspected to target these regions.

“While there was strong evidence that the hippocampus was sensitive to radiation exposure, this study is the first to show sensitivity to steroids as well in this population,” said first author Nicholas Phillips, MD, PhD, a clinical fellow in Oncology. “The brain volume differences correlated to age at diagnosis and gender and were greatest for females and younger patients.”

The findings come almost 10 years after St. Jude demonstrated that pediatric ALL, the most common childhood cancer, could be cured without cranial irradiation. But survivors treated with chemotherapy alone still face life-long challenges related to impaired neurocognitive functioning that impacts success at school and on the job.

Phillips said efforts are underway to identify drugs and other strategies to reduce the impact of chemotherapy on neurocognitive functioning while preserving high pediatric ALL cure rates.

Kevin Krull, PhD, of Epidemiology and Cancer Control, is the senior author.

When: Monday, June 5 at 12:10 p.m. CST
Location: S504
Title: Genomics in Medulloblastoma and Ependymoma (Education session)

Experts offer insight into using histology, genomics to guide treatment decisions for CNS tumors

Amar J. Gajjar, MD, director of the Neuro-Oncology Division at St. Jude, along with experts from M.D. Anderson Cancer Center and Massachusetts General Hospital, will share insights into the clinical utility of genomics to guide treatment decisions for central nervous system tumors, including medulloblastoma and ependymoma. 

When: Monday, June 5 at 4:45 p.m. CST
Location: E253ab
Title: Global Health in Pediatric Oncology: Challenges in Building International Pediatric Oncology Programs (Meet the Professor session - ticketed)

Rodriguez-Galindo leads discussion on developing international pediatric oncology programs

Carlos Rodriguez-Galindo, MD, chair of the St. Jude Department of Global Pediatric Medicine, will lead an interactive discussion on pediatric global medicine with session attendees. This ticketed session requires pre-registration through ASCO.