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Chemotherapy More Effective at Causing Programmed Cell Death in Young Tissues

GregoryAuneby Gregory Aune, MD, PhD, CKN Editor


Childhood Cancer Survivors have their own unique set of issues that often go unaddressed by health care professionals once treatment has ended and the child enters adulthood.  Although the last 20 years have seen growth in survivorship research, this research is rarely filtered down to the people who need it most – the survivors and their families.  Dr. Gregory Aune, Pediatric Oncologist, researcher, childhood cancer survivor and advocate, has taken on the position of CKN Editor, Knowledge Translation – Childhood Cancer Survivorship.  His goal is simple:  to help empower childhood cancer survivors to start a dialogue with their doctors by publishing short, easy-to-read research study summaries, like this one.


THE HEADLINE:  Tissues from Young Mice and Patients are Primed for Apoptosis

THE RESEARCH:  Cancer Cell:  Developmental Regulation of Mitochondrial Apoptosis by c-Myc Governs Age- and Tissue-Specific Sensitivity to Cancer Therapeutics.  Programmed cell death or apoptosis has been extensively studied in cancerous tissues and is a common mechanism by which tumor cells are killed by radiation and chemotherapy.  In contrast, apoptotic response to chemotherapeutic regimens has not been systematically studied in normal tissues such as the brain or heart.  Moreover, although children exposed to chemotherapy earlier in life are more susceptible to the development of long-term organ toxicities, there is no scientific basis for these clinical observations.  Lab investigators at Dana-Farber Cancer Institute in Boston, Massachusetts exposed mice of different ages to chemotherapy and measured the propensity of cells in different normal tissues to undergo apoptosis.

KEY FINDINGS:  In adults, cells from the brain, heart, and kidneys are refractory to apoptosis.  In contrast, in early life, brain, heart, and kidney are primed to undergo apoptosis.  In the case of the heart, investigators showed that the level of apoptosis correlated with heart dysfunction caused by the commonly used chemotherapy agent, doxorubicin.  Importantly, investigators also identified some of the key molecular pathways that drive these responses, thereby laying the foundation for the development of novel protective strategies.

WHAT THIS MEANS FOR CHILDHOOD CANCER SURVIVORS:   The association between younger age of treatment exposures and elevated risk of late health complications has been known for quite some time.  These laboratory studies in mice reiterate the importance of screening for late effects in childhood cancer survivors that received their cancer treatment under the age of five.  It is particularly important that this subgroup of childhood cancer survivors receive annual monitoring for late effects in a comprehensive survivorship program.

WHAT THIS MEANS FOR CHILDHOOD CANCER SURVIVORSHIP RESEARCH: This work highlights the utility of preclinical models in evaluating the effects early chemotherapy and radiation have on normal tissues.  Going forward, application of similar models to our existing treatments and for new anticancer agents is vital to improve long-term quality of life for all childhood cancer survivors.



Medical Disclaimer:  The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this web site is for general information purposes only.  If you feel the research summarized applies to you or someone you know, talk to your doctor about your concerns.



Videos with Dr. Aune

Presentation on YouTube (Jan 2015):  Eliminating Long-term Health Effects in Cancer Survivors – Gregory Aune, MD, PhD

Interview for the National Coalition for Cancer Survivorship (June 2015):  Hodgkin’s Lymphoma Survivor Dr. Greg Aune Discusses Issues in Long-Term Survivorship Care

Interview with the Washington Post Live Summit (Dec 2016): How cancer lives on in young adults after treatment ends



Dr. Gregory J. Aune is the Stephanie Edlund Distinguished Professor of Pediatric Cancer Research and a St. Baldrick’s Foundation Scholar.  His experience in pediatric cancer spans over 27 years and encompasses his own patient experiences, research in experimental therapeutics, clinical care of pediatric oncology patients, and childhood cancer advocacy.  His interest in pediatric oncology began at age 16, when he was diagnosed with Hodgkin’s lymphoma.  While fortunate to survive, the experiences he encountered as a patient initiated a path towards a research and clinical career aimed at developing less toxic chemotherapy regimens.  His experience as a long-term survivor included open-heart surgery at age 35 to replace his aortic valve and bypass three blocked coronary arteries that were damaged by his teenage cancer therapies.  This life-changing event initiated his research interest in cardiac disease.  His training to become a successful physician scientist and pediatric oncologist has included time spent at some of the most well-respected oncology institutions in the United States including, M.D. Anderson Cancer Center, the National Cancer Institute, and Johns Hopkins Hospital.

Dr. Aune is a national leader in childhood cancer advocacy efforts.  In San Antonio, he has been a leader in local fundraising and awareness efforts.   Since 2010, he has spearheaded efforts by the St. Baldrick’s Foundation and For the Kids Dance Marathon at the University of Texas San Antonio that have raised over $830,000 for childhood cancer patients and research efforts.  In September 2014, his appointment to the National Cancer Institute Council of Research Advocates (NCRA) was announced by NCI Director Dr. Harold Varmus at a White House briefing on childhood cancer.

In addition, Dr. Aune is a policy advisor for the National Coalition for Cancer Survivorship, serves on the Board of Directors of the American Childhood Cancer Organization, is a member of the St. Baldrick’s Foundation National Advocacy Committee, and serves on the scientific advisory board for the Canines-N-Kids foundation.

In May 2015, Dr. Aune addressed the 68th World Health Assembly in Geneva, Switzerland and called on the World Health Organization to make childhood cancer a top global health priority.



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