MIB Agents OsteoBites

September marks Childhood Cancer Awareness Month and Back-to-School season. Mackenzie, Sloane, and Penelope join osTEAo host Sammy to discuss the challenges and feelings that can accompany going back to school. They share their personal stories about how their diagnoses interrupted their school and extracurricular activities, accessibility issues on campus, and resulting FOMO. Based on their own experiences, they share advice and tips for newly diagnosed AYA patients on managing school during and post-treatment. Listen in to hear these OsteoWarriors discuss how to be the best advocate for yourself and why FOMO is less about being at the club, and more about what comes next.

For decades, academic clinical trials consortia have collaborated to optimize outcomes for childhood cancers through evaluating incremental improvements in conventional multi modality treatment regimes. There are now increasing opportunities to partner with industry to test new medicines in academic-sponsored trials, but these collaborative studies rarely contribute to marketing authorizations. Under the auspices of the multistakeholder platform ACCELERATE, a working group of representatives was convened from clinical academia, the pharmaceutical industry, the European Medicines Agency, US Food and Drug Administration, and patient advocacy to explore why this is the case and to seek solutions to enable academic-sponsored trials to directly contribute to the licensing of new medicines. This presentation summarizes the group's findings and provides an industry perspective on how to move forward.Dr. Barry is a board-certified pediatrician and pediatric hematologist/oncologist with over 15 years of experience in drug development. Prior to joining Day One in 2021, she was the Global Clinical Lead for Pediatric Oncology at Pfizer, as well as Head of Pfizer’s Pediatric Oncology Leadership Team where she oversaw more than 10 pediatric oncology clinical programs. She has also held previous roles at Genzyme and Millenium/Takeda focused on the development of oncology therapeutics in adults. Dr. Barry serves on the Industry Advisory Council for CureSearch and is a member of the ACCELERATE Platform Steering Committee. She is also a co-chair of the Children’s Oncology Group Industry Relations Council. Dr. Barry is a graduate of the pediatric hematology/oncology fellowship program at the Dana Farber Cancer Institute and Children’s Hospital Boston, and the pediatric residency program at Tufts. She received her M.D. at Yale University School of Medicine and also obtained a Masters in Medical Science degree from Harvard Medical School.

Brigitte Brisson, DMV, DVSc, DACVS from the Ontario Veterinary College at the University of Guelph joined us on OsteoBites to introduce Magnetic Resonance guided High Intensity Focused Ultrasound as a treatment modality for osteosarcoma and describe preliminary results in canine patients.High Intensity focused ultrasound (HIFU) is a non-invasive percutaneous thermal ablation technique that allows deep tissue treatment with precise control over the shape and location of energy deposition. It causes minimal collateral damage and can be used to treat primary and metastatic tumours. In addition to its role in tumour ablation, HIFU has attracted attention for its potential to stimulate the immune system and possibly mount a response against metastasis. In humans, HIFU has been used for ablation of a variety of soft tissue tumours and most recently, it has been used in bone applications, specifically for the treatment of osteoid osteoma (OO) lesions in pediatric patients. Other reported bone applications include bone metastasis and osteosarcoma.Dr. Brigitte Brisson is a professor of soft tissue surgery in the Department of Clinical Studies at the Ontario Veterinary College (OVC). She graduated from the Faculté de Médecine Vétérinaire at the University of Montreal in 1996. She performed a small animal rotating internship at the OVC followed by a Surgery residency with concurrent Doctor of Veterinary Science (DVSc) in small animal surgery. She became board certified in small animal surgery (ACVS) in 2001 and has since been on faculty at the Ontario Veterinary College. She is an ACVS Founding Fellow in Minimally Invasive Surgery and a Founding Member of Veterinary Neurosurgical Society.

This month osTEAo co-hosts Mia and Sammy are joined by OsteoWarrior Kara to tackle the ambivalent mix of emotions from good scan results. Good scans equal good vibes, right? Not necessarily. Mia, Sammy, and Kara get real about their reluctance to celebrate, the complications of sharing good news with their friends and family, and the guilt that can accompany good scan results. Like other long-term effects of cancer and treatment, the ambivalence and guilt are normal, and may never go away, but Mia, Sammy, and Kara share their personal experiences and tips for coping with the guilt, managing their loved one's expectations about scans, and balancing all the mixed emotions, which may include putting yourself out there and taking some chances, having a shot with your care team (for patients 21+ of course!), and getting a cat.

Diana Azzam, PhD joined us on OsteoBites to discuss her lab's work on functional precision medicine for the treatment of pediatric and adult cancers. This presentation describes the foundational principles of functional precision medicine as applied to pediatric cancers and how major technological improvements as well as an explosive broadening of the cancer pharmacopeia has enabled the bridging of genomics with functional drug testing as clinical decision support tools to impact patient care.Diana Azzam, PhD, is an Assistant Professor and Research Director of the Center for Advancing Personalized Cancer Treatments at Florida International University. She has a Masters in Biochemistry from the American University of Beirut, Lebanon and a PhD in Biochemistry & Molecular Biology from the University of Miami, Florida. Her lab focuses on implementing functional precision medicine (FPM) approaches in adult and pediatric cancer patients that have run out of treatment options. Working with local hospitals including Nicklaus Children’s Hospital and Cleveland Clinic Florida, her lab delivers individualized treatment plans based on a patient’s cancer genomic profile and ex vivo drug response. She is currently engaged in two clinical studies to assess feasibility and clinical utility of FPM in relapsed/refractory patients with childhood cancer (ClinicalTrials.gov registration: NCT05857969) and adult cancer (ClinicalTrials.gov registration: NCT06024603). Dr. Azzam is working on setting up the first CLIA-certified lab in the State of Florida dedicated for functional cancer drug testing. Her goal is to launch large-scale prospective multi-center randomized clinical trials to better assess efficacy of FPM approaches in the treatment of refractory/relapsed cancers. In parallel, she is working on utilizing FPM as a tool to reduce health disparities in childhood cancer patients from minority populations. She is also integrating a novel machine learning approach to identify specific biomarkers among minority populations that can be targeted using FDA-approved drugs. Her lab also investigates cancer stem cells and how they may result from chronic environmental exposures to toxic metals such as arsenic.After a short presentation on this research, she will take questions from attendees. Share your questions in advance with us at [email protected].

Sabina Kaczanowska’s research focus is to understand the role of the immune system in shaping the microenvironment of metastasis during cancer progression. Specifically, she is investigating how myeloid cells orchestrate the immunosuppressive program in the pre-metastatic niche and how we can apply this knowledge of myeloid biology to design new immunotherapeutic strategies for the treatment of solid tumors. She joined us on OsteoBites to discuss her recently published paper on Immune determinants of CAR-T cell expansion in solid tumor patients receiving GD2 CAR-T cell therapy.https://pubmed.ncbi.nlm.nih.gov/38134936/Chimeric antigen receptor T cells (CAR-Ts) have remarkable efficacy in liquid tumors, but limited responses in solid tumors. The NCI conducted a Phase I trial (NCT02107963) of GD2 CAR-Ts (GD2-CAR.OX40.28.z.iC9), demonstrating feasibility and safety of administration in children and young adults with osteosarcoma and neuroblastoma. Patient samples were evaluated by multi-dimensional proteomic, transcriptomic, and epigenetic analyses. The data uncover mediators of CAR-T biology and correlates of expansion that could be utilized to advance immunotherapies for solid tumor patients.https://clinicaltrials.gov/study/NCT02107963Dr. Sabina Kaczanowska received her Ph.D. in Molecular Microbiology and Immunology from the University of Maryland, Baltimore for her dissertation work on T-cell immunotherapy at the UM Marlene and Stewart Greenebaum Comprehensive Cancer Center. She joined the Tumor Microenvironment and Metastasis Section of the Pediatric Oncology Branch at the National Cancer Institute as a postdoctoral fellow in 2017 with Dr. Rosandra Kaplan. Dr. Kaczanowska was appointed as a Staff Scientist in the Pediatric Oncology Branch in 2022 to continue her work evaluating the responses of solid tumor patients to immunotherapy and translating new immuno-oncology approaches into the clinic.

Dr. Bhuvana Setty will join us on OsteoBites to discuss the role of adapting the immune system in the fight against cancer. She will discuss the ongoing study utilizing natural killer (NK) cells in combination with a chemotherapy backbone for patients with relapsed osteosarcoma and other sarcomas. She will discuss preclinical data supporting the utilization of NK cells in this patient population and discuss the goals of the clinical trial.Bhuvana Setty, MD, is a Pediatric Hematologist/Oncologist at Nationwide Children's Hospital. Her clinical interests include treating pediatric and young adult patients with bone and soft tissue sarcomas, and patients with vascular anomalies. She is the Director of the Clinical Sarcoma Team. She is the Site Principal investigator for the Sunshine Project supported by the National Pediatric Cancer Foundation and serves as the lead for the Ewing sarcoma Task Force at the Sunshine Project. In addition, she is the Site Principal Investigator for CaNVAS, the Consortium of iNvestigators for Vascular Anomalies. Her research interests include developing translational and therapeutic clinical trials with novel agents for patients with aggressive bone and soft tissue sarcomas. She leads as National PI for the TINKS trial as well as the upcoming metastatic Ewing sarcoma trial at the Children's Oncology Group.https://clinicaltrials.gov/study/NCT05634369

In this episode of osTEAo, Mia is joined by Dr. Christopher Kuo, Matt, and Valerie to discuss the often forgotten and overlooked children in an AYA cancer diagnosis - the siblings. Dr. Kuo is a physician-scientist, and pediatric oncologist at Children's Hospital Los Angeles/USC Keck School of Medicine and he has lost two brothers, one to osteosarcoma (Stanley), during his AYA years. He recently published an article that highlights the impact of a cancer diagnosis on siblings "The unfulfilled promise from a forgotten child" which gives voice to the impact of a cancer diagnosis on siblings. Dr. Kuo, Matt, and Valerie discuss how their siblings' osteosarcoma diagnosis and ultimate passing have impacted and shaped their lives and how they manage their grief and loss and strive to maintain a sense of self. Our guests share how music, journaling, and breakdancing have helped them process their trauma and offer advice on how to best support siblings of an AYA cancer patient.Inspired by Banksy's quote - "[T]hey say you die twice. One time when you stop breathing and a second time, a bit later on, when somebody says your name for the last time," we continue to honor our OsteoAngels and dedicate this episode to Cecilia Nguyen, Mason Allen, Stanley Kuo, Sammy Kuo, and all the siblings and loved ones we have lost to osteosarcoma.Read Dr. Christopher Kuo's article: "The unfulfilled promise from a forgotten child"AYA Cancer Dedicated Siblings CampsArizona: Alex's Lemonade Stand Arizona Camp SidekicksCalifornia: Oncology and Kids Sibling Camp Reach for the SkyCalifornia: Camp Okizu California: Camp Ronald McDonald For Good TimesIdaho: Camp Rainbow GoldIowa: Children’s Cancer Connection - Camp Heart ConnectionKentucky: Kids Cancer Alliance (Sibling Camp)Maryland: Camp Sunrise—Sun Sibs ProgramMaryland: Special Love Inc. (BRASS Camp)Montana: Camp Mak-A-Dream Siblings CampNew Mexico: Camp Enchantment; Super Stars Sibling RetreatNorth Caroline: Camp CarefreePennsylvania: Camp Can DoTexas: Camp BravoList of summer camps for AYA cancer patients and their families