June 11, 2018 6:00 AM

Probing Why Cancer Outcomes Are Worse for Minority Kids

A new multi-institutional project is studying cancer biology and care to identify why minority children have worse cancer outcomes compared to their white peers.

New research will focus on finding better treatments for minority children with high-risk cancer malignancies — a group whose outcomes and survival rates are worse than other pediatric patients.

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The multi-institutional project, led by University of Michigan C.S. Mott Children’s Hospital, will include clinical sequencing of a multi-ethnic cohort of pediatric cancer patients from Ann Arbor, Detroit and Flint. The research will focus on further understanding cancer biology in minority children as well as other factors — including socioeconomic background and access to care — which may contribute to disparities in outcomes.

The Children’s Hospital of Michigan Foundation recently awarded a $592,100 grant for the project, which is a collaboration between Mott and Children’s Hospital of Michigan along with support from the Chad Carr Pediatric Brain Tumor Center and Michigan Medicine.

“We have seen tremendous improvement in outcomes of children with cancer, but survival for those with recurrent or metastatic disease remains dismal — and outcomes are even worse for minority children,” says lead researcher and Mott pediatric oncologist Rajen Mody, M.D.

“This research will provide critical insights into the tumor biology of minority children, which will be key to developing innovative therapies. We will also be identifying barriers that prevent minority and underprivileged patients in Detroit and Flint from accessing cutting-edge technology in the cancer field.”

Researchers plan to study tumor DNA and RNA along with normal DNA in a diverse population of child and adolescent cancer patients with relapsed or resistant rare tumors. The cohort will comprise 40 percent African-American patients, 10 percent Middle Eastern and 50 percent Caucasian. Patients are being treated in a variety of health care settings, including urban academic (Children’s Hospital of Michigan in Detroit), suburban academic (U-M) and an urban community center (Hurley Medical Center in Flint).

“We will be comparing the biological differences between malignant tumors of majority and minority populations in order to better understand the disparities in outcomes,” Mody says.

"Studying genetic differences that may contribute to outcomes, along with other factors including socioeconomic status and delays in diagnosis, will lay the groundwork for tailoring better treatments for this population."
Rajen Mody, M.D.

‘All of the potential causes’

Gene sequencing has shown promise in improving understanding of why certain cancers spread and resist treatment. Researchers will analyze patients’ tumor DNA/RNA as well as normal DNA to determine personalized cancer drivers, potential novel treatment options, reasons for treatment resistance and metastasis, and individual drug metabolism.

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To identify new drug targets, researchers will also study patients’ tumor immune composition to predict responses to immunotherapy.   

Over the past several decades, overall five-year pediatric cancer survival rates have increased significantly (from 63 percent between 1975 and 1979 to 79 percent between 1995 and 1999). But current data show Hispanic and black children and adolescents have poorer five-year survival rates than their white peers (73-74 percent versus 81 percent).

“We need to look at all of the potential causes of disparities that lead to one group of pediatric patients faring worse than other children,” Mody says. “Studying genetic differences that may contribute to outcomes, along with other factors including socioeconomic status and delays in diagnosis, will lay the groundwork for tailoring better treatments for this population."