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Discussing Long-Term Health Outcomes for Childhood Cancer Survivors With Melissa Hudson, MD

At the recent American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois, Dr. Melissa Hudson of St. Jude Research Hospital, spoke with Oncology Data Advisor about the phase II trial of dabrafenib/trametinib for BRAF V600–mutant pediatric low-grade glioma, which was presented at the meeting by Dr. Eric Bouffet of the University of Toronto's Hospital for Sick Children. Dr. Hudson provides commentary on the study's results and shares additional insights into her research regarding long-term health outcomes for survivors of childhood cancer.

Oncology Data Advisor: Would you like to tell us a little bit about your work at St. Jude and your research interests?

Melissa Hudson, MD: I am the Director of the Cancer Survivorship Division. My research broadly focuses on characterizing health outcomes in long-term childhood cancer survivors and using that information to help us understand who are high risk to have an adverse outcome and what we can do to monitor for that risk—well, first of all, to prevent it, especially if there's a way to modify the frontline therapy to avoid exposure at all. That's the ideal. But if we know that those treatments are required for optimizing cancer cure, then we know that we need to be surveilling those survivors in a different way, and we know that we need to be mindful of interventions that can help them preserve health.

A lot of our efforts focus on translating this observational data that we collect about survivorship, characterizing the risk groups, and funneling that into care for survivors and health surveillance recommendations back to the individuals or investigators who are developing new trials. The goal is to understand how to stratify those exposures in the trials based on the child's presentation, their clinical characteristics, maybe their age, their sex, but also the characteristics of the tumor. Increasingly you'll see that pediatric oncology trials are very much focused on giving as little as possible as safely as possible to assure that we not only cure the cancer, but we have a healthy kid at the end, who's going to potentially live hopefully 60, 70, 80 years after this cancer experience.

Oncology Data Advisor: Would you like to give us an overview of the study on dabrafenib/trametinib for pediatric low-grade glioma, presented by Dr. Eric Bouffet?

Dr. Hudson: This is a study of oral targeted combination therapy for the most common pediatric brain tumor, large low-grade gliomas. The study tested this combination of targeted therapy to the standard chemotherapy combination. That standard combination requires visits to the hospital or the clinic for delivery of the agents and is also associated with health problems later in life. The oral targeted combination showed significantly improved outcomes overall, compared with the standard chemotherapy. This is really, really exciting, because you're now able to target a treatment that's focused on the genetic features of the tumor.The hope is that targeted therapy will be associated with fewer adverse effects on normal tissues during long-term survival.

Oncology Data Advisor: Anything else you'd like to add about the presentations here that are focusing on childhood cancer survivorship?

Dr. Hudson: Many of the presentations present results of novel and targeted therapy combinations that aim to improve cancer control with fewer long-term adverse effects compared to standardly used cytotoxic cancer treatments. Other presentations highlight inequities in access to childhood cancer therapies and outcomes. The survivorship research presented aims to characterize health after the cancer experience, identify survivors at risk for poor outcomes, and describe challenges and inequities survivors experience in accessing resources to support good quality of survival. When evaluating equity and cancer care, we need to look across the cancer survivorship spectrum and really consider not only the child, the specific cancer, and its characteristics, but also the environment where that child is and what we can do to ensure that they're getting access to the resources and services they need during their cancer experience and during long-term follow-up as well.

About Dr. Hudson

Melissa Hudson, MD, is the Director of the Cancer Survivorship Division at St. Jude Research Hospital. She takes special interest in researching and advocating for adolescent and young adults with cancer, specifically in the areas of disease burden after childhood cancer, health status and quality of life after childhood cancer, and pediatric cancer survivorship care guideline development. In 2020, Dr. Hudson was awarded the Northwestern Mutual Award for Excellence in Childhood Cancer Survivorship by the American Society of Pediatric Hematology/Oncology.

For More Information

Bouffet E, Hansford J, Garré ML, et al (2022). Primary analysis of a phase II trial of dabrafenib plus trametinib (dab + tram) in BRAF V600–mutant pediatric low-grade glioma (pLGG). J Clin Oncol (ASCO Annual Meeting Abstracts), 40(suppl_17). Abstract LBA2002. DOI:10.1200/JCO.2022.40.17_suppl.LBA2002

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor. 


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