Dr Tal Zaks at Moderna, the innovative pharmaceutical company, describes how their process takes this information about a patient’s normal genes and information from his/her mutated genes found in his/her cancer and pushes both to the cloud. A bioinformatics algorithmic process in the cloud predicts up to 34 mutations that will help our immune system to be much more effective and launch an attack on cancer. Moderna’s process creates a vaccine that encodes for each of these mutations and loads them onto a single mRNA molecule. Once a cancer vaccine is injected it tells the body to express portions of the mutations so that the immune system will recognize the cancer and not attack normal cells which chemotherapy does. Each personalized vaccine is produced on a just in time basis and usually within a few weeks. The combination of personalized m-RNA cancer vaccines plus immunotherapy with checkpoint inhibitors, such as Keytruda, is a powerful way to destroy cancer cells by activating the immune system.

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Recently, I spent an hour on a zoom call hosted by Zurich Children’s Hospital. What they have accomplished is world class.  

The Zurich Children’s Hospital has great clarity and focus plus the committed and competent leadership to implement the mission which is to find a cure for pediatric brain tumours. 

They have created a global network of the top researchers in pediatric brain tumours.

The network is a working community of highly collaborative researchers. They share. They inform. They work separately and together. This community is working with the mission of finding a cure for pediatric brain tumours. They are not concerned about fame or fortune. 

The researchers were present on the zoom call lead by the key researchers at Zurich Children’s Hospital. Drs Javad Nazarian from the DIPG/MG Center Zurich and Sabine Mueller from UCSF/ the Pacific Pediatric Neuro-Oncology Consortium were the clear leaders of the entire community. PNOC brings 225 clinicians and researchers together to push for breakthrough.  Without effective leadership this could not be accomplished. 

The other key participants were the executive directors of family foundations with an interest in pediatric brain tumours. Most had had a personal experience in having lost a child to this lethal disease. 

Zurich Children’s Hospital had created a distributed centre of excellence of the top research centres in pediatric brain tumours and the funding sources able to fund the community and the research machine which has over 30 different approaches to curing pediatric brain tumours. 

Some of these approaches include using novel agents that disrupt mitochondria in the cancer cells and sono-sensitization which uses a drug to sensitize the cancer cell to high intensity focused ultrasound. 

The other dimension of Zurich Children’s Hospital is their clinical outreach. Pediatric brain tumours are rare. To gain the critical mass of patients, the ZCH has a global clinical outreach service which provides clinical assessments and virtual expert opinions for children with brain tumours irrespective of where they live.  This allow the ZCH to have the cumulative experience with patients necessary to deeply understand the disease and to have enough patients for the many clinical trials that are organized at and by ZCH. 

So the combination of the top researchers in pediatric brain tumours, the biggest database of patients with pediatric brain tumours and a vast inventory of clinical trials with novel agents and technologies plus the committed funding sources presents the highest probability of finding a cure for pediatric brain tumours. Well done Zurich Children’s Hospital.

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These tests are different from genetic tests for inherited cancer risk. The genetic tests for inherited cancer risk are known as germline profiling of the whole person.

As cells become cancerous, they develop many gene mutations that cause abnormal growth.

These gene changes, which occur after you are born and throughout your life—are known as acquired or “somatic” mutations. 

Acquired or somatic mutations are different than inherited mutations, which are passed on from parent to child and are present at birth in every cell. 

The findings of a study published in Jama Online suggested that germline analysis (inherited genes producing cancer risk) following tumor sequencing will produce findings that may impact patient care by influencing systemic therapy choices, surgical decisions, additional cancer screening, and genetic counseling in families.

A recent case which we managed at RCM Health Consultancy involved a review of the client’s genes to understand how this client would metabolize chemotherapy agents. By looking at the genes, the consultant was able to inform the client about dosing of appropriate chemotherapy agents. This was very valuable for this client and his/her oncologists. This field of expertise is called oncogenomics.

Current guidelines and tumor testing approaches appear to provide evidence of many of these germline findings, reinforcing the use of both expanded germline follow-up testing as well as germline analysis independent of tumor sequencing in appropriate patients.

The combination of germline testing ( for inherited cancer risk) and the analysis of cancer DNA ( through molecular profiling) is a powerful set of tools for the cancer patient.

Raymond Rupert patient advocate and healthcare consultant.

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