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Clinical research project in pharmacogenomics on acute myeloid leukemia in children

« MyeChild »

Pharmacogenomics is the science that examines variations in the genes that can dictate the response to drugs. It explores methods that can predict whether a patient will have a positive, negative, or no reaction after taking medication. By establishing an association between genotype (genetic variations) and drug reactions, personalized medicine can be used to reduce toxicity and improve the effectiveness of a treatment in terms of reducing relapses allowing the improvement of the child's survival rate. Indeed, the therapeutic agents used in the context of chemotherapy related to childhood cancers are often very toxic and cause different reactions depending on the patients and too often result in serious side effects.

Acute myeloid leukemia is a rare disease in children and adolescents, but with a high mortality rate. In general, children with acute myeloid leukemia have a cure rate within 5 years of 65-75%, unlike acute lymphoblastic leukemia for which there is about a 80-90% cure rate. With this in mind, we must still find solutions to improve this prognosis, especially for acute myeloid leukemia.

The "MyeChild" project, centralized and coordinated in Geneva for its pharmacogenomic part, consists of an international collaboration, i.e. a recruitment, as early as 2018, particularly in France, Great Britain and probably also in Australia, of DNA samples of approximately 500 patients under 18, who have recently been diagnosed with acute myeloid leukemia. The goal is to test a number of therapeutic strategies against various chemotherapeutic agents to improve outcomes based on pharmacogenomics.

By identifying the genetic markers that will be used to adjust the doses of the treatments, maximum secondary toxicity and thus undesirable effects can be avoided as much as possible, as well as reducing the relapses of this cancer and thus directly increasing the survival of each child. Indeed, by analyzing the DNA samples of these young patients, the goal is to identify the genes responsible for variations in the response to certain chemotherapeutic agents, and therefore the people at risk. The study should last about 5-6 years. It is run in parallel with another ongoing study in 18 countries, acute lymphoblastic leukemia (FORUM), from which some data may also be used in this project. With this in mind and to supervise other research projects, a biobank is continuously being developed within the University Hospitals of Geneva allowing the storage of the different samples.