One of VIVA’s foremost aims is to improve cure rates for childhood cancers by encouraging research and enabling novel therapies through the strategic setting up of critical facilities and strategic research programs. Through our local expert doctors and researchers, we seek to quickly translate and replicate new discoveries from St. Jude and other top centres into therapies for Asian children.
In Singapore, our small families limit the chances of finding a matched donor for stem cell transplantation. Thus, VIVA looks at new forms of treatment so more children who lack a matching donor can be offered a chance of cure. The development of cures for childhood cancer is a priority for VIVA Foundation. Through research studies supported by VIVA, cancer cure rates have been increasing. Here is an elaboration of the key clinical research programs and the progress so far.
Malaysia-Singapore ALL 2003 Study
Through the above study, which focuses on treatment for children with acute lymphoblastic leukaemia (ALL), doctors were able to develop a personalized cancer treatment protocol which improves childhood cancer cure rate and decreases mortality by reducing the side effects of chemotherapy. As a result, patients suffer lesser damage to their organs and overall quality of life post-treatment is improved.
More than 550 children under 18 years of age received treatment as part of this study and the 10-year overall survival rate is 88.1%.
Infant Malaysia-Singapore ALL 2003 Study
Focusing on treating acute lymphoblastic leukaemia (ALL) in infants, the overall 10-year survival rate for infants treated under their program is 50%. This is comparable to the European Interfant ALL 1999 protocol which ran from 1999 to 2008.
Malaysia-Singapore ALL 2010 Study
This is the successor trial of the Ma-Spore ALL 2003 Study for children with acute lymphoblastic leukaemia (ALL). It is a multi-centre study involving the National University Hospital (NUH) and KK Women and Children’s Hospital in Singapore, and the University Malaya and Sime Darby Medical Centre in Malaysia. The Ma-Spore ALL 2010 study uses minimal residual disease (MRD)* levels to risk stratify patients. So far, based on December 2013 evaluation, with 185 patients enrolled in the treatment program, the overall 5-year survival rate is 86.5%.
Malaysia-Spore AML 2006 Study
This multi-centre study for children with acute myeloid leukaemia (AML) involves the same institutions participating to Ma-Spore ALL 2010. It uses a modification of previous treatment methods in efforts to avert cardio-toxicity. It relies on MRD* quantitation and newly-identified markers to assess response and select treatment intensity. 162 patients are enrolled on this treatment program. As of February 2014, the 8-year overall survival rate is 64.9%.
St Jude AML 2008 Study
NUH was the first international site which enrolled patients in leukaemia protocols based on St Jude Children’s Research Hospital acute myeloid leukaemia (AML) protocols. The AML08 study for children with AML monitors treatment response by measuring MRD* levels. Standard risk patients receive infusions of haploidentical natural killer (NK) cells to eradicate residual leukaemia cells. As of end 2013, 4 patients have been enrolled and are receiving treatment in Singapore based on this specially-designed trial from St Jude.
*Minimal Residual Disease (MRD): New equipment and facilities will allow VIVA to establish state-of-art trials in treating childhood acute leukaemia through molecular and flow-based MRD which will allow the doctors to accurately predict the risk of relapse in almost every child with leukaemia.