Melanoma drug gives hope to Sydney toddler with brain tumour
At eight months of age, Montana Jackson’s future was uncertain because her brain tumour was not responding to standard treatment like chemotherapy. Then she was given a drug used to treat melanoma — and her life turned around.
NSW
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Looking at little Montana Jackson’s smile and rosy, chubby cheeks, you would never guess she has spent most of her life locked in an extraordinary battle with a brain tumour.
Her recovery is a tribute to new developments in genetic testing and new drugs that can target certain types of tumours.
But her Blue Mountains family’s nightmare began early.
Montana was born a healthy 4.9kg but at 12 weeks of age she stopped putting on weight, despite feeding well. She was also throwing up every day, and by four months of age, she still weighed the same as a newborn.
Mum Angie insisted her baby not leave Nepean Hospital until an answer was found.
“I noticed a very slight eye movement that the nurses could not see, but the paediatrician said let’s do an MRI and that is when she was diagnosed with a brain tumour. It was quite big at 5cm,” Ms Jackson said.
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Montana had surgery at The Children’s Hospital at Westmead to remove most of the tumour and then started three months of gruelling chemotherapy for the glioma.
“She seemed happier in herself after the surgery and we were so hopeful but the vomiting started again and she stopped gaining weight,” she said.
“Three months after, an MRI showed the tumour had grown back and it was devastating to hear that.
“My worst fear was that we would lose her.”
CHW senior paediatric oncologist, Dr Geoff McCowage, was also very concerned.
“We gave our usual chemotherapy for three months, but the tumour just kept on growing and Montana continued to deteriorate,” Dr McCowage said.
But in this brave new world of genetic testing, tumours can now be mapped and analysed for weaknesses that can be targeted.
“We then did a special DNA molecular test and found an abnormality in the tumour cells in a gene called the BRAF gene. BRAF abnormalities are found in a lot of cases of adult melanoma,” he said.
“So then we started treatment with the melanoma drug Trametinib … the tumour not only stopped growing, but it got smaller, and continues to shrink,” Dr McCowage said.
“If this drug did not exist, I don’t think she would have survived.”
While Trametinib is expensive, McCowage managed to get makers Novartis to supply the drug to Montana on compassionate grounds.
Montana’s turnaround was remarkable.
“We saw a difference in three months and now she is trying to talk and she is scooting around on her bottom. She is now 8.5kg, she is still little for her age, but she is a happy little girl. No one would guess what she has been through,” Ms Jackson said.
Montana still has a feeding tube to help her put on weight.
“We just feel lots of love and feel so proud when we look at her. We are lucky to be her parents and she has taught us a lot. Her strength and resilience just continues to amaze us,” Ms Jackson said.
An upcoming trial of the drug will include children with gliomas.
“Montana is a much healthier girl, gets almost no side-effects of this drug compared to the terrible side-effects of her earlier chemotherapy,” Dr McCowage said.
“This drug is giving us a whole new option for treatment.”