Grants Search Results

A growing number of childhood cancer survivors have been treated with high-dose chemotherapy. This high-dose chemotherapy places the survivors at risk for cognitive problems, affecting their thinking skills, processing speed, attention, and memory. Downstream effects of cognitive impairment include difficulties with independent living as they transition into adulthood. Currently, there is limited information as to whether cognitive remediation interventions can improve cognitive functioning in childhood cancer survivors. Cognitive remediation is important for teaching effective decision-making and reasoning skills to enhance self-management and self-advocacy, which in turn could result in improvement in other areas, such as employment and independent living. In particular, given the barriers to accessing medical care (e.g., distance to medical center, reliable transportation), Dr. Murdaugh will use telemedicine to deliver this intervention. This study aims to assess the efficacy of a 4-week intervention delivered via telemedicine that teaches strategies to improve decision-making and reasoning skills in cancer survivors between the ages of 10 and 18 years old.

Children with acute lymphoblastic leukemia (ALL), a cancer of the blood, who receive modern therapy have a high likelihood of being cured. A side effect of treatment in some survivors of ALL is lifelong troubles with learning and memory. One part of therapy that may increase the chance of having learning and memory problems is many exposures to anesthesia. Treatment for ALL includes painful procedures for which children routinely receive anesthesia. Understanding the connections between specific anesthesia medicines, their doses, and the length of time they are given and the chances of having learning problems later on will be important for patients, families and clinical teams in making the best choices for anesthesia use.

Most children diagnosed with cancer today will survive but will develop late complications of their cancer treatment. Childhood cancer survivors have almost twice the risk of diabetes compared to other adults. Diabetes is known to increase the risk of heart disease among survivors, and heart disease is the leading cause of non-cancer death among survivors. Prediabetes is easily diagnosed and begins months to years before diabetes. However, little is known about prediabetes risk-factors and prevention in survivors, despite reports that up to 1 in 3 survivors have prediabetes. Using treatment information and recent assessment of over 3,500 adult survivors of childhood cancer, this research will identify the extent of prediabetes among survivors, characterize what cancer-treatments increase risk, and determine how quickly these survivors develop diabetes. Research will then establish if a medication and lifestyle intervention to prevent diabetes in prediabetic survivors is safe and achievable. This will inform a future diabetes intervention trial with the goal of improving long-term survival and quality of life for childhood cancer survivors.

This grant funds two students to complete work in pediatric oncology research for the summer. The experience may encourage them to choose childhood cancer research as a specialty. Project 1: Neuroblastomas are an enigmatic cancer of childhood with subtypes that have extremely good or poor survival. Poor prognosis neuroblastomas contain normal immune cells that help tumors grow. Important questions are 1) what is the repertoire of immune cells in neuroblastomas at time of diagnosis, 2) how the interplay between normal and tumor cells changes when tumors recur. The Summer Fellow will analyze images of tumors at recurrence and compare to the diagnosis images. These findings will provide insights into the types of immune cells that cancer cells rely on and may allow identification of new targets of therapy. Project 2: Decline in brain function may happen after irradiation to the brain in children. It is hard to predict the extent and speed by which it happens. There is suggestion that more rapid injury happens in areas with iron deposition. Using a novel MRI method that allows chemical identification and quantification of iron in the brain, the Summer Fellow will characterize the imaging changes in white matter of the brain in children who have been treated with radiation for their brain tumors. This will allow to then correlate the changes with future outcome of their cognitive function.

Young adulthood is a time filled with exciting possibilities and also difficult challenges. People at this stage of life may be deciding on or attending school, selecting a career or working hard at their jobs, dating or in a relationship, and may be planning for or raising children. A cancer diagnosis does not fit into these plans and goals. Researchers are finding that the biology of the cancers in people of this age group are different, and increasing data indicates that adult patients with some cancers would benefit by being treated on what are traditionally pediatric therapies. Ochsner's Adolescent and Young Adult (AYA) Cancer and Survivor program is the first and only one of its kind in the region. The team is made up of professionals from pediatric and adult medicine. This program is designed for people between the ages of 15 and 39 years of age with cancer -newly diagnosed, actively in therapy and or cancer survivors. This grant supports a Nurse Coordinator who works with new patients in the combined AYA Cancer and Survivor Clinic, to ensure they have access to the best clinical trials for their cancer.

This grant supports the Childhood Cancer Survivorship Program at Valley Children's Hospital, providing critical patient data for survivorship researchers.

Thanks to remarkable scientific advances, over 80% of children with cancer will become long-term survivors, but most survivors experience long-term side effects of treatment. Our research has found that parents want early information about long-term side effects of treatment starting at diagnosis, but unfortunately most parents do not receive the information they need. In this project, Dr. Greenzang and colleagues are building a website to help parents understand the long-term effects of their treatment choices. They will then use the website with parents who are making new treatment decisions to evaluate whether parents find the website clear and useful, and to assess if using it can improve parents' understanding of medical information, help parents make decisions about treatment, and help prepare parents for their children's long-term care.

Surviving cancer is an achievement of immeasurable magnitude, however for most survivors this achievement does not signify the end of cancer related health issues. The cardiovascular system is commonly affected by cancer treatment and cardiovascular disease is the second leading cause of death in childhood cancer survivors. As the To-morrow's Research Fund St. Baldrick's Scholar, Dr. Bottinor is helping childhood cancer survivors live healthier lives by using advanced cardiac imaging techniques to identify survivors with subclinical cardiovascular dysfunction before they develop overt heart disease. She plans to use echocardiographic imaging to detect cardiovascular disease at its earliest stages, when treatment is most likely to be efficacious. Dr. Bottinor is analyzing cardiac screening studies collected in routine care to determine if subclinical abnormalities can predict which survivors are at risk for subsequent cardiovascular disease and therefore the most likely to benefit from early medical intervention. She believes these techniques will be helpful in childhood cancer survivors because previous work in adult patients has suggested that advanced cardiac imaging techniques can predict which patients with cancer on active treatment are at higher risk for developing subsequent cardiovascular disease. This grant is named for To-morrow's Research Fund, a Hero Fund created to honor Becky Morrow who is a childhood cancer survivor. Becky was diagnosed with acute lyphoblastic leukemia when she was 12 and endured grueling treatments and its side effects. Today she is cancer free, a wife and a mom but suffers late effects. This fund supports survivorship research for safer treatments that help kids not only survive but thrive. Awarded at Vanderbilt University and transferred to Virginia Commonwealth University.

Children and adolescents everywhere in the world get cancer and both the type of cancer, and perhaps more importantly, where they live in the world, factor into whether they live or die. This is due to major disparities between countries in access to optimal treatment, early abandonment of therapy despite the potential for cure, and availability of quality supportive care. Acute lymphoblastic leukemia (ALL), the most common childhood cancer, is mostly curable in countries with strong health systems, like the United States. However, we do not know the exact number of children and adolescents who develop and die from ALL worldwide, because many countries with limited resources also lack quality health registration systems. Identification of context-appropriate strategies to prevent future deaths in children with ALL are necessary, and when combined with improved burden estimates, can guide policy decisions more effectively. Knowing that the majority of countries in the world have limited resources, this project will determine what the best interventions are to improve outcomes for children and adolescents with ALL now, while testing ways to improve estimates of the number of children with ALL who are currently not correctly diagnosed or do not reach healthcare. Awarded at St. Jude Children's Research Hospital and transferred to University of Washington.

Survivors of cancer have a higher risk of health problems because of the severity of the chemotherapy and radiation treatments they received. As survivors of childhood cancer age, they increasingly succumb to the "late effects" of their cancer treatment (such as second cancers and heart and lung disease). After 10-15 years, these late effects become the leading causes of death in this population. Adolescents and young adults (AYAs, aged 15-39) are a subgroup of cancer patients that are defined as high risk because they: more commonly suffer from toxicities and side effects of their cancer treatment; have unique barriers to accessing health care; and suffer specific psychosocial concerns because of their life stage transitioning into adulthood. To date, little research has been done on the factors that influence long-term health outcomes in the population of survivors of AYA cancer. Dr. Moke is working to explore how cancer and its treatments affect health later on in life in survivors of AYA cancer, identify the causes of death in this population, and determine what factors and cancer treatments are associated with these specific life threatening health problems. This study will provide the baseline data needed to design ways to decrease the severity of and death from these late effects, and thus be an important step in promoting long and healthy lives in survivors of AYA cancer.

Based on progress to date, Dr. Ou was awarded a new grant in 2022 and 2023 to fund an additional year of this Scholar grant. Due to the tumor and treatment damaging the developing brain, 60-80% of pediatric brain tumor survivors experience long-term neurocognitive impairment. There are two possible paths to improve outcomes: intervene the adverse brain development after treatment, or further optimize radiotherapy dose distribution in the brain before treatment. For the former, the question is to find at-risk patients to intervene after treatment. For the latter, the question is to find target brain regions, where changing radiation doses can potentially change outcomes. Both questions have been studied on the population-level, not on the individual level. This project aims to push our knowledge in these two fronts to the individual level. Dr. Ou is using data from 3 just finished clinical trials to find target patients and find target brain regions for radiation dose optimization. Compared to studies that consider one risk factor a time, Dr. Ou will consider a comprehensive set of risk factors to improve precision to the individual level. The results will allow him to design future larger-scale, multi-site retrospective replicative and eventually prospective clinical trials, to improve neurocognitive outcomes in this vulnerable population before and after treatment. This grant is generously supported by the Grace for Good Fund, established in honor of Grace Carey and celebrates her survivorship from medulloblastoma. Her cancer journey began in 2007 when she was diagnosed at age 5 with a treatment regime that entailed surgery, proton beam therapy and chemotherapy. While Grace handled it all with minor setbacks, she now faces the physical, emotional and cognitive challenges wrought by the very medications and procedures that saved her life. This fund was inspired by Grace’s desire to help other kids with cancer and supports research of brain tumors and the multitude of challenges facing survivors post treatment.

Thanks to advanced diagnosis and treatment, many children now can be treated from cancer and stay alive for a long time; they are called survivors. Some anticancer drugs are harmful to the heart and may cause heart failure in these survivors. High blood pressure increases the risk of heart failure in survivors, but no one knows how this happens. Dr. Zordoky has developed a new model to answer this question. He thinks that anticancer drugs make the hearts age faster leading to a worse response to increased blood pressure. He is looking at a natural compound and a new group of drugs which prevent aging to see if they will protect the hearts from the bad effects of anticancer drugs and make the hearts stronger when hit by high blood pressure. The findings of this research will open the door for testing these compounds in the clinic in order to prevent late side effects of anticancer drugs in survivors.

Retinoblastoma, a highly curable cancer of the eye, is associated with many long term difficulties due to the effects of therapy. Carboplatin is an important drug for this disease but its effects on hearing loss have not been studied in depth. Certainly, children already compromised in vision will be substantially impacted if in fact they acquire hearing impairment. Recently, a consortium of thirteen retinoblastoma treatment centers have been assembled to study the health problems of hundreds of patients with this condition. This consortium investigates the long term toxicity experienced by these patients from their cancer condition, and also examines how the long term side effects impact both the intellectual function of these children, and their quality of life. Dr. Hayashi is working to clearly define the nature and scope of hearing loss in this patient population and the impact of this hearing loss on the overall well-being of the child. With this information, he hopes to advance efforts to minimize the long term hearing loss of these children, but also to provide interventions in the future to optimize the health and well-being of those patients already impacted by their therapy.

With increased survival for children with cancer, efforts that prevent long-term health problems are important for improving the quality of life and life expectancy of these children. Diet and fitness are two critical factors for healthy survivorship, but interventions for survivors of childhood cancer have had limited impact, focus almost exclusively on physical activity, and often exclude caregivers, the primary nutrition gatekeepers in the home. Although research supports a key role for the gastrointestinal (GI) microbiome in regulating weight and health outcomes, no studies have examined the “obesogenic” microbiome in the context of interventions for these survivors. Harvesting Hope for Kids (HH4K) is a unique, biobehavioral lifestyle intervention delivered over 8 weeks during the summer in a university-based, cancer survivor garden. It was adapted from a successful intervention for survivors of adult-onset cancer, with pilot data supporting its feasibility in children. In line with St. Baldrick’s mission to improve outcomes for children with cancer, this randomized controlled trial is evaluating the efficacy of HH4K to improve dietary and physical activity patterns in 40 survivors of pediatric cancer (i.e., ages 8-12; < 2 years off treatment). Results will support a larger, multi-institutional trial and improve survivorship care to prevent costly, long-term morbidity.

Today, over 80% of children diagnosed with cancer in high income countries like the United States will survive. Considered a miracle of modern science, these gains are unfortunately not reflective of outcomes for the 90% of children with cancer who live in low- and middle-income countries (LMIC). Yet, as many LMIC continue their epidemiological transition away from overwhelming infectious disease to a greater non-communicable disease burden, cancer care has recently become a major global focus. As policy-makers now begin the cancer control and prioritization planning process to meet this challenge, estimates of global and national cancer-related disease burden are a critical piece of data required when making decisions. However, current efforts meant to generate global pediatric cancer burden data such as incidence, mortality and long-term morbidity measures are not ideally suited for this purpose as they are optimized to measure adult cancer burden and do not incorporate key pediatric-specific data sources. Instead, a pediatric cancer specific analysis is needed since children are sufficiently different from adult cancers such that new methods, which account for small numbers of cases, the lack of etiologic risk factors, histology-based classification codes, and the long-term effects of treatment, are required. As the Friends for Hope Fund St. Baldrick's Scholar, Dr. Bhakta will address this critical gap by producing comprehensive pediatric cancer-related burden estimates using the most current data sources and rigorous statistical estimation methods. It is anticipated the results of this study (to be published and made publicly available) will provide global stakeholders and policymakers key outcomes data to cure more children with cancer globally. This grant is named for the Friends for Hope Fund created to honor Morgan Loudon and celebrates her strength and determination as a cancer survivor. Diagnosed when she was 9 with a rhabdoid tumor, today she has no evidence of disease. Through this fund, Morgan's family and friends hope to 'battle on' in the search for cures and better treatments.

In the U.S., children with a blood cancer called Hodgkin lymphoma (HL) are usually treated successfully. Some of these children will suffer health problems several years later because of the treatment they received. Because of this, doctors use powerful imaging tools to identify patients who are likely to do well or not. Those who are likely to do well require less treatment and those who are less likely to do well can receive more treatment. But in low-income countries like Malawi, these tools are unavailable, and the children there often receive treatment that may be unnecessary. Scientists have found unique abnormalities in adults with HL that can tell us who is less likely to do well. Here, Dr. Ozuah is testing whether these abnormalities are present in children and could be used to decide how best to treat children with HL in low-middle income countries

Despite cure after cancer, the majority of childhood cancer survivors are diagnosed with chronic health problems such as diabetes, hypertension, or heart disease within 30 years of cancer diagnosis and treatment. Hypertension and diabetes are important health problems associated with heart disease and result in early death compared to survivors without heart disease. Compared to siblings, childhood cancer survivors treated with radiation have a higher risk of developing diabetes at a young age. Even though important, the reasons for developing diabetes in cancer survivors are poorly understood. Insulin is an important hormone and affected by cancer treatment. Dr. Mostoufi-Moab is for the first time examining cancer treatment effects (radiation vs. chemotherapy) on making insulin and breaking down blood sugar in childhood cancer survivors, age 15-30 years. She will use tests to measure glucose breakdown, insulin secretion, and mathematical modeling to evaluate the body's handling of fat, all important steps for understanding the why cancer therapy causes diabetes in CCS. Understanding the steps leading to diabetes will help doctors chose the correct treatments for diabetes and for scientists to test options to prevent diabetes in cancer survivors. Achieving these goals will improve quality of life and avoid early death due to cancer treatment-related conditions in childhood cancer survivors.

This grant funds a Nurse Practitioner for the the Childhood Cancer Survivorship Program. The program also provides critical patient data for survivorship researchers.

Women who are diagnosed with cancer before 40 are often concerned about whether they will be able to have children in the future. Women can freeze their eggs or embryos (called fertility preservation) to help protect their fertility, but these services may not be widely available. Dr. Nichols has looked at how often women in North Carolina have children after cancer treatment and whether the health of their babies is different from women without cancer. She is further examining the use of fertility preservation after diagnosis and its association with birth rates and outcomes. This research will provide information to improve the long-term health of AYAs with cancer.

Dr. Deatrick is developing family support and education materials for maternal caregivers of young adult survivors of childhood brain tumors to improve their quality of life and quality of life of the survivors. Training in Problem Solving (TIPS) for Caregivers, leverages past research, eHealth, and Bright IDEAS family problem-solving intervention (an evidence-based intervention for caregivers of children newly diagnosed with cancer) to target challenges identified by maternal caregivers to their family management. TIPS is targeted to caregivers with “condition-focused FM” (family life organized around the special needs of the survivor). Using the prototype session developed in partnership with maternal caregivers, Dr. Deatrick will work with them to design the web-based intervention. She will develop other sessions of TIPS and adapt them to technology, which will be used “live” online with a health care provider and online with interactive homework sheets, videos, and other resources. Future research will involve fathers and other caregivers, survivors, and other family members.