Every child diagnosed with cancer to have access to a revolutionary new treatment program

More than 1000 Australian children diagnosed with cancer each year will be granted access to lifesaving care, thanks to a new nationwide program.

Kristian Kozul (Centre) is one of thousands of children who will now have access to revolutionary cancer treatment. Picture: Tony Gough

Every child diagnosed with cancer will now have access to a revolutionary treatment program being rolled out across the country in a world first.

The pioneering scheme, expected to cure or prolong the lives of more than 1000 children a year, will be fully operational across Australia within months.

Previously only the sickest and most vulnerable children with cancer had access to the exciting therapy, but now every person aged 18 and under will be eligible.

No other country in the world offers this treatment program for every child, regardless of where they are, and for all cancer types.

The Zero Childhood Cancer Program sees each patient undergo a sophisticated genetic sequencing test that looks for alterations that may be driving the cancer’s growth.

Kristian Kozul was diagnosed with a type of brain cancer at one year of age. Picture: Supplied

Through the Zero Childhood Cancer program, Kristian was given an experimental drug, which has stabilised the cancer.

Laboratory scientists then search a database of more than 120 drugs that can specifically target that unique alteration.

A scheme run by the Children’s Cancer Institute and the Kids Cancer Centre at Sydney’s Children’s Hospital in Randwick, Sydney, saw Australian children with the highest-risk cancers – those who faced less than a 30 per cent chance of survival – have a “remarkable” 70 per cent success rate.

ZERO will now be rolled out to all nine of Australia’s children’s hospitals by the end of the year thanks to $67 million in new funding from the federal government and Minderoo Foundation, a philanthropic organisation.

“The expansion of ZERO to be available to all Australian children with cancer is something we’ve all been working towards for a long time, so it’s extremely exciting to now see it unfolding,” Professor Michelle Haber, executive director at Children’s Cancer Institute, said.

Kristian and his brother, Tomislav. Picture: Supplied

Kristian is now able to attend school and play with his brother, Tomislav.

“Analysing each child’s cancer at a genomic level is providing totally unprecedented and extremely valuable insights into childhood cancer.

“Finding out which genetic changes drive these cancers will allow us to develop new targeted therapies matched to these changes.”

She added: “Genomic analysis will occur from the time of diagnosis, allowing us to track the way each child’s cancer changes in response to treatment.

“Analysing the cancer journey of up to 1000 young Australians each year in this way will add volumes to our understanding of childhood cancer, for the benefit of all children diagnosed with cancer in the future.

“The more children who participate in ZERO, the more we learn. So children being treated for cancer today are actually helping the children of tomorrow.”

Professor David Eisenstat, director of the Children’s Cancer Centre at the Royal Children’s Hospital in Melbourne, said the scheme was a gamechanger that had untold possibilities.

Kristian with his mum, Marie.

“It’s really unprecedented because it’s going to give us population level understanding, which very few countries can do because other countries are too big. The US, Canada and UK have to focus on the kids who are the most difficult to treat. We will have 1000 kids a year going through – roughly 300 from the RCH and Monash – so we are going to get tremendous, tremendous data.

“It’s going to find kids potentially genetically predisposed to developing cancer, it’s going to identify new at risk groups that we didn’t know about before – so it really is an unprecedented opportunity.

“I think Australia should be very proud that we are going to be international leaders in children’s cancer research of this kind.”

Professor David Ziegler, chair of clinical trials for ZERO, said the program was a fundamental change in the way cancer is treated and was literally saving lives.

“In ZERO’s first national precision medicine trial, we saw some very promising results in children with the highest risk cancers,” Prof Ziegler said.

“Some children are alive today who would have died had they not been enrolled, while some others had precious months added to their life by changing their treatments.”

The expansion of the program will be done in stages, starting with all children diagnosed with brain cancer, then rolling out to all other types of childhood cancers as the year progresses.

ZERO childhood cancer program

What is childhood cancer?

Childhood cancer is not simply adult cancer in a child. Cancers in children are often different in their causes, the way theygrow and spread, and how they respond to treatment.

Almost all cancer treatments used in children today were developed for adults.

Most of these treatments target all rapidly growing cells, not only cancer cells, and this leads to unwanted side-effects, some of which can be severe.

Two thirds of survivors of childhood cancer go on to suffer significant long-term health problems as a result of their treatment, including organ dysfunction, cognitive deficits, impaired fertility and secondary cancers.

How prevalent is childhood cancer?

In Australia, more than a thousand children and adolescents are diagnosed with cancer every year. Close to three children die each week from cancer in Australia.

What is Zero Childhood Cancer?

The Zero Childhood Cancer Program (ZERO) is Australia’s first-ever precision medicine program for children and young people with cancer.

How does ZERO work?

When a child joins ZERO, samples from the child and their cancer are sent to Children’s Cancer Institute and ZERO partner organisations where scientists carry out comprehensive analysis and testing to find out as much as possible about the cancer.

A rapid report is issued to the doctor looking after each patient, highlighting the critical genetic features of the tumour that may influence diagnosis, prognosis and treatment strategies.

What has ZERO achieved so far?

ZERO’s first national precision medicine trial began in 2017 and focused on identifying new treatment options for childrenwith high-risk cancers.

Some children are alive today who almost certainly would not be without ZERO, while other childrenhave had precious months added to their lives.

Data from the first 250 children to take part in ZERO’s first national precision medicine trial show that a treatment recommendation was able to be provided in more than 70 per cent of cases, and that 70 per cent of children who received the recommended treatment had a complete or partial response, or their disease stabilised.

These results are remarkable given that those children taking part in the trial had the highest-risk cancers, with the lowest chance of survival, and many had already failed standard treatment.

How will ZERO be expanded?

ZERO will now become available to all young Australians with cancer, regardless of their risk profile, stage or cancer type.

Over the coming months, increasing numbers of patients will become eligible to join ZERO’s national clinical trial, beginning with all those diagnosed with brain cancer.

By the end of 2023, all Australians aged 18 and under with cancer will be able to be enrolled in ZERO by their treating clinician at the time of their diagnosis.

This means that the results from their genomic analysis will be available to help inform theircare right from the beginning, potentially leading to a more specific diagnosis, prognosis and in some cases, a refined treatment approach.

Over time, it is hoped the program will help answer important research questions, such as what makes some children susceptible to developing cancer, which genetic changes drive childhood cancers, and how to develop new treatments that effectively target these genetic changes.

Can ZERO help my child?

ZERO has been able to help many children with cancer. However, every case is unique and there is no guarantee that ZERO can help every child who is enrolled.

When genomic analyses are done on a child’s cancer, the ZERO team provides that child’s oncologist with any clinically valuable information that is generated, with a view to helping guide patient management. However, not every analysis yields clinically useful information, nor will it necessarily lead to a change in treatment for that child.

The aim of ZERO is not only to help provide potential clinical solutions to clinicians treating children enrolled in the program, but also to improve our understanding of childhood cancer overall.

Identifying the specific genetic changes that drive childhoodcancers is leading to the development of new targeted therapies.

In this way, children enrolled on ZERO today are helpingthe children of tomorrow.

How can my child join ZERO?

If you are interested in ZERO for your child, please consult with your child’s treating oncologist.