A Pediatric Cancer Research Program and a Data Management Unit were also established during 2012.
The data management unit is formally evaluating the treatment and outcome of all children with cancer. It assures quality improvement by periodic assessment of quality and outcome measures in pediatric cancer care.
The cancer research program aims to study the specifics of childhood cancer and its treatment in Lebanon and the region. The goal is to better understand and fight pediatric cancer with demographic specific considerations.
Below are a number of important studies that were published in 2012:
1. A large study led by Dr. Samar Muwakkit and Dr. Miguel Abboud, showed that children with Acute Lymphoblastic Leukemia (ALL)
who are treated at the CCCL with a treatment protocol developed by SJCRH, have excellent outcomes similar to those in the USA
are Europe, with overall cure rates approaching 80% (see Pub#1 below).
2. A study led by Dr. Hajj-Fuleihan at AUBMC and Dr. Miguel Abboud showed that Lebanese children with ALL have some loss of bone
mass during treatment, and identified some factors that may be associated with this chemotherapy side effect (see Pub#2 below).
3. Future work will now aim to better characterize these features, and to improve overall bone health in Lebanese children, in order
to minimize such side effects whenever possible.
4. One study led by Dr. Raya Saab showed that, for children with a type of tumor called Ewing Sarcoma, a two-drug treatment that
has been used in USA and in Europe can indeed help some children whose tumor came back after standard treatment
(see Pub#3 below).
5. Another study led by Dr. Raya Saab showed that, children with a muscle tumor called Rhabdomyosarcoma have as good survival
as those in the USA and in Europe, and are treated with the same drugs/protocols (see Pub#4 below). Interestingly, this
study showed that our children can have more tumors returning after the same radiation treatment, as given in the USA,
suggesting that the biology of our tumors may be different. Studies are now being done to better understand the biology of
children in our region who develop this tumor, to better predict who will benefit from radiation treatment.
6. A biologic study performed by Dr. Raya Saab’s laboratory (Pub#5) showed that, for a type of brain tumors called pineoblastoma,
new treatments may be useful if they target a specific protein called CDK2. This work is very early, and more work is being done
in Dr. Saab’s laboratory to confirm this finding and better understand how such a drug may work.
7. Another biologic study done in Dr. Saab’s laboratory (Pub#6) investigated the usefulness of the drug Retinoic Acid in the
muscle tumor Rhabdomyosarcoma.
Although thought to be promising in previous limited laboratory studies published in the USA and Europe, Dr. Saab’s laboratory found that this drug indeed seemed useful to slow down tumor cell division, but alone is not strong enough to stop tumor growth in living animals.
Work is now being focused to find stronger drugs and retinoic derivatives that may better stop Rhabdomyosarcoma tumor growth
- Pub#1: Muwakkit S, Al-Aridi C, Samra A, Saab R, Mahfouz RA, Farra C, Jeha S, Abboud MR.
Implementation of an Intensive Risk Stratified Treatment Protocol for Children and Adolescents with Acute Lymphoblastic
Leukemia in Lebanon. Am J Hematol. 2012.
- Pub#2: Hajj Fuleihan G, Muwakkit S, Arabi A, Daouk LE, Ghalayini T, Chaiban J, Abboud M. Predictors of bone
loss in childhood hematologic malignancies: a prospective study. Osteoporos. Int. 2012.
- Pub#3: Farhat R, Raad R, Khoury NJ, Feghaly J, Eid T, Muwakkit S, Abboud M, El-Solh H, Saab
R. Cyclophosphamide and Topotecan as first-line salvage therapy in patients with relapsed Ewing sarcoma at a single
institution. J Pediatr Hematol Oncol. 2012
- Pub#4: Salman M, Tamim H, Medlej F, El-Ariss T, Saad F, Boulos F, Karam D, Eid T, Geara F, Muwakkit S,
Khoury N, Abboud M, Saab R. Rhabdomyosarcoma treatment and outcome at a multidisciplinary pediatric cancer center in Lebanon.
Pediatr Hematol Oncol. 2012.
- Pub#5: Zalzali H, Harajly M, Abdul-Latif L, El-Chaar N, Dbaibo G, Skapek SX, Saab R. Temporally distinct
roles for tumor suppressor pathways in cell cycle arrest and cellular senescence in Cyclin D1-driven tumor. Mol Cancer. 2012.
- Pub#6: Al-Tahan A, Sarkis O, Harajly M, Kebbe Baghdadi O, Zibara K, Boulos F, Dighe D, Kregel S,
Bazarbachi A, El-Sabban M, Skapek SX, Saab R. Retinoic acid fails to coordinate cell cycle arrest with myogenic differentiation
in rhabdomyosarcoma: implications for therapeutic use. Pediatr Blood Cancer. 2012.