Presentation Description: The use of ultrasound and other diagnostic modalities have permitted the diagnosis of many fetal conditions, including fetal tumours. This presentation will review the options for managing prenatally-diagnosed surgical conditions, including the use of a variety of fetal surgical interventions.
Speaker: Jacob C. Langer, MD
Professor of Surgery
University of Toronto, Toronto, ON
Attending Pediatric Surgeon
The Hospital for Sick Children, Toronto, ON
Dr. Jacob C. Langer was educated and trained at the University of Toronto and The Hospital for Sick Children in Toronto. He did research fellowships at the University of California, San Francisco, and McMaster University, funded by the Ontario Ministry of Health, the Medical Research Council of Canada and the McLaughlin Foundation
Dr. Langer was assistant professor of surgery and pediatrics at McMaster University and a pediatric surgeon at the Children’s Hospital at Chedoke-McMaster from 1989 to 1992. He then moved to St. Louis and became associate professor of surgery and pediatrics at Washington University and a pediatric surgeon at St. Louis Children’s Hospital from 1992 to 1999. He came back to Canada in 1999 to become professor of surgery at the University of Toronto, and chief of the division of general and thoracic surgery at The Hospital for Sick Children, a position he held until 2012. He was also the inaugural holder of the Robert M. Filler Chair in Pediatric Surgery. Dr. Langer has travelled widely to operate, and to lecture on a variety of topics in pediatric surgery. He has received many prestigious honours, is widely published in peer-reviewed journals, and has authored many book chapters on a variety of subjects.
Presentation Description: Regardless of whether an anti-cancer drug is in development or has been used in the clinic for over 50 years, the current approaches used to select a drug dosage for infants often lead to increased risk of morbidity and poor tumour control. This current dosing paradigm, which has grown out of an absence of data, normalizes adult dosages according to age, body weight or body surface area. However, the continued use of such practices in infants is contrary to current knowledge that maturation and development affect drug disposition and exposure-response relationships. This is particularly pertinent to infants with brain tumours. Contemporary treatment for infants with brain tumours has used craniospinal irradiation (CSI) to substitute or delay intensive chemotherapy to avoid the long-term morbidity associated with CSI. For many of the drugs used in these studies, the evaluation of the PK and PD has been inadequate, suffering from low numbers of subjects and heterogeneous populations. Therefore, it is crucial that comprehensive PK and PD studies are conducted of drugs used to treat infants with brain tumours as well as to study the pharmacologic response (e.g., toxicity, efficacy and long-term effects) to these drugs in a large controlled population.
Speaker:
Clinton Stewart, PharmD
Clinical Pharmacologist
Member, Pharmaceutical Department
St. Jude Children’s Research Hospital, Memphis, TN
Dr. Clinton Stewart completed his Doctor of Pharmacy at the University of Tennessee Health Science Center, Memphis. After completing a postdoctoral fellowship at St. Jude under the mentorship of Dr. William E. Evans, Dr. Stewart joined the University of Tennessee College of Pharmacy faculty as an assistant professor and was promoted to associate professor. In 1991, he joined the St. Jude faculty as an assistant member (equivalent of assistant professor) and has moved through the ranks to full member (equivalent of full professor).
He is an active member of the American Society of Clinical Oncology and the American Association of Cancer Research. His research efforts are focused in the area of pediatric clinical pharmacology, addressing clinically relevant problems of cancer therapeutics in infants and children. Current research efforts include the use of preclinical models to enhance design of clinical trials of new agents in children with cancer, and the use of pharmacokinetics (PK) and pharmacodynamics (PD) to optimize drug exposure in children with cancer. Dr. Stewart has authored or co-authored more than 275 peer-reviewed articles and book chapters. He is presently the co-chair of the Pharmacology Committee of the National Institutes of Health-funded Pediatric Brain Tumor Consortium.
Presentation Description: The tumours in infants differ from older children in clinical presentation, biological characteristics and response to therapy. The therapy may be impaired by concerns about increased adverse effects due to chemotherapy and radiotherapy. Many of the tumours are related to disruption of normal embryonic development, and as such, embryonal tumours are more common. This presentation will give an overview of rare solid tumours that occur in infancy, and review the use of molecular studies for accurate diagnosis and targeted therapies for their treatment.
Speaker:
Rajkumar Venkatramani, MD, MS, FAAP
Associate Professor Department of Pediatrics
Baylor College of Medicine, Houston, TX
Texas Children’s Cancer Center, Texas Children’s Hospital, Houston, TX
Dr. Venkatramani completed his pediatric training at King’s College in London, and obtained membership in the Royal College of Paediatrics and Child Health. He completed a fellowship in pediatric hematology oncology at Children’s Hospital, Los Angeles. He is currently the director of the Rare Tumors Program and Thyroid Cancer Program at Texas Children’s Hospital in Houston, Texas. He is the author of more than 50 original publications, multiple reviews and book chapters, and is a member of the Pediatric Blood and Cancer editorial board and PREP Hematology/Oncology editorial board.
Laura Collins Presentation Description: Cancer and its therapy can negatively affect nutritional status due to limited intake, increased metabolic needs and poor absorption. Malnutrition has been shown to decrease tolerance to therapy, impair wound healing, decrease quality of life and increase length of stay. Malnutrition in infants and young children is particularly concerning due to periods of rapid growth and limited body reserves. Baseline nutrition assessment, proactive nutrition support and monitoring to improve nutritional status is an essential adjunct to cancer therapy in this patient population. This workshop will review the importance of a multi-disciplinary team, assessment, nutrition interventions and monitoring of an infant with cancer to promote normal growth and development.
Speakers:
Laura Collins, RD
Registered Dietitian in Pediatric Oncology
McMaster Children’s Hospital, Hamilton Health Sciences Centre, Hamilton, ON
Laura Collins graduated with concurrent degrees from the University of Western Ontario with a BSc Human Nutrition and a BA Kinesiology. She successfully completed her dietetic internship at the Hamilton Health Sciences Centre in 2000 and accepted a full-time position in pediatric oncology where she continues to practice as a clinical registered dietitian in the acute care setting. She has a particular interest in nutritional assessment, proactive enteral nutrition and anthropometric measures, resulting in several publications, posters and lectures over the past 17 years. Her most recent publication in 2017 was on anthropometry in long-term survivors of acute lymphoblastic leukemia. Laura has been involved in several COG- and POGO-nutrition related initiatives since 2003, including proactive enteral feeding lectures, CAM investigations and enteral nutrition guideline development. Laura also provides education about the importance of optimizing nutrition during and after cancer therapy to learners, including dietetic interns and medical trainees.
Deborah L. O’Connor, PhD, RD
Professor, Department of Nutritional Sciences
University of Toronto, Toronto, ON
Senior Associate Scientist
Translation Medicine Program, Research Institute
The Hospital for Sick Children, Toronto, ON
Scientific Associate Staff, Department of Pediatrics
Mount Sinai Hospital, Toronto, ON
Dr. Deborah O’Connor (PhD, RD) is a professor in the Department of Nutritional Sciences at the University of Toronto where she holds a Chair in Vitamin Research in Human Milk and Development. She also holds scientific appointments at The Hospital for Sick Children (SickKids) and Mount Sinai Hospital. Dr. O’Connor served as the Director of Clinical Dietetics and Breastfeeding Support at SickKids from 2000 to 2012 and then as associate chief of academic and professional practice until 2013. Dr. O’Connor’s research career has focused on maternal and infant nutrition and she has published extensively in the area of the nutritional requirements of pregnant and lactating women, children, and strategies to support the provision of human milk to vulnerable infants. Dr. O’Connor has received numerous awards including the 2015 Khursheed Jeejeebhoy Award for best application of research to clinical practice from the Canadian Nutrition Society. She currently serves as co-chair of the Advisory Committee for the Rogers Hixon Ontario Human Donor Milk Bank, and was co-chair of the Canadian Society of Obstetricians and Gynecologists’ Nutrition Working Group that recently published their first national female nutrition practice guidelines.
Speakers:
Anna Taddio, PhD
Full Professor, Leslie Dan Faculty of Pharmacy
Senior Associate Scientist
The Hospital for Sick Children, Toronto, ON
Anna Taddio is a professor of pharmacy at the University of Toronto, and senior associate scientist at SickKids. Her program of research examines: (1) the short‐term and long‐term effects of pain in children; (2) the effectiveness and safety of pain management interventions; and (3) evidence‐based practice and implementation research. Dr. Taddio currently leads a national inter‐disciplinary team, Help Eliminate Pain in Kids and Adults (HELPinKids&Adults), investigating and promoting evidence based pain management during vaccination. She has authored over 200 scientific papers and book chapters, and is the recipient of numerous awards recognizing her scholarly and advocacy achievements in pediatric pain.
Jason Thomas Maynes, PhD, MD
Wasser Chair in Anesthesia and Pain Medicine
Associate Chief of Perioperative Services, Research
Director of Research, Anesthesia and Pain Medicine
Scientist, Division of Molecular Medicine
The Hospital for Sick Children, Toronto, ON Jason Maynes, PhD, MD, is the associate chief of perioperative services (research), director of research for anesthesia and pain medicine, and an anesthesiologist at The Hospital for Sick Children. He is the holder of the Wasser Chair in Anesthesia and Pain Medicine. He has a doctorate in biophysics and completed clinical training at the University of Alberta, Stanford University, and Washington University in St. Louis, moving to Toronto in 2012. His research primarily involves finding new ways to quantify drug action, both therapeutic and toxic, including how to improve the clinical effect of anesthetics and pain medications. His lab has developed new therapies for heart failure, modelling cardiac function using stem‐cell derived tissue, and has created platform technologies that measure cardiomyocyte function for the purposes of drug discovery. He holds patents and intellectual property around new therapies for heart failure, novel methods for quantifying cardiomyocyte function and for anti‐viral small molecule therapies. He is currently funded by the CIHR, NSERC, Canada Foundation for Innovation, The Ontario Research Fund, and The Labatt Family Heart Centre, in addition to being funded by pharmaceutical and venture capital groups.
