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The Gordian Knot of Precision Medicine: Ethical Dilemmas and Psychosocial Impacts

Posted on September 19, 2019 by Jamie Irvine


Presentation Description:
Targeted drug therapies show promise for treating certain types of pediatric cancers. Yet, they also come with serious ethical and psychosocial implications that can have far-reaching impacts on patients, families and health professionals. Using a case-based approach with examples from Canada, Australia and the United States, this workshop will explore ethical and psychosocial implications of tumour sequencing, somatic and germline testing, and other aspects of precision medicine, and discuss potential strategies to address and mitigate them.

Speakers:
Conrad Fernandez, MD, FRCPC
Professor and Head, Pediatric Hematology/Oncology
IWK Health Centre
Senior Scientist, Beatrice Hunter Cancer Research Institute
Dalhousie University

Dr. Conrad Fernandez is Professor and Head of the Division of Pediatric Hematology Oncology at the IWK Health Centre and Dalhousie University. He is the founding Co-Chair of the Children’s Oncology Group (COG) Return of Research Results Committee and Vice Chair of the COG Bioethics Committee. He is the lead of the Ethics Node of the Terry Fox Research Institute PROFYLE Project. He is a member of the Panel on Research Ethics, which informs the research ethics policy of Canada, called the TriCouncil Policy Statement on Ethical Conduct for Research Involving Humans. He is a Senior Scientist and a Chair of the Research Committee for the Beatrice Hunter Cancer Research Institute at Dalhousie University. He is Chair of the COG Renal Tumors Committee and a member of the COG Voting Body Steering Committee.

Dr. Fernandez’s two research passions are the development of clinical trials for children with renal tumours and exploring the many ethical challenges encountered in considering the return of summary or individual research results to participants.

Steven Joffe, MD, MPH
University of Pennsylvania Perelman School of Medicine
Emanuel and Robert Hart Professor of Medical Ethics and Health Policy

Dr. Steven Joffe is the Emanuel and Robert Hart Professor of Medical Ethics and Health Policy at the University of Pennsylvania Perelman School of Medicine. He serves as Chief of the Division of Medical Ethics and directs two post-doctoral fellowships in bioethics and in the ethical, legal and social implications of genomics. He is also Professor of Pediatrics at Children’s Hospital of Philadelphia.

Dr. Joffe attended Harvard College, received his MD from the University of California at San Francisco (UCSF), and received his MPH from UC Berkeley. He trained in pediatrics at UCSF and in hematology/oncology at the Dana-Farber Cancer Institute and Boston Children’s Hospital.

Dr. Joffe’s clinical work is in pediatric stem cell transplantation. His research addresses the ethical challenges that arise in the conduct of clinical and translational investigation. He has been principal investigator of National Institutes of Health, Patient-Centred Outcomes Research Institute (NIH, PCORI) and foundation-funded studies that examine the roles and responsibilities of principal investigators in multi-centre trials, governance in learning healthcare systems, return of genetic results to research participants, and the integration of genomic sequencing technologies into cancer care. He is a member of the U.S. FDA’s Pediatrics Ethics Subcommittee and of the National Human Genome Research Institute’s Genomics and Society Working Group.

Claire Wakefield, BPsych(hons), MPH, PhD
Director Behavioural Sciences Unit
Sydney Children’s Hospital

Professor Claire Wakefield, registered psychologist, is Director of the Behavioural Sciences Unit at Sydney Children’s Hospital, Australia. She is a chief investigator on grants worth >$26M and has published >140 peer-reviewed articles. Professor Wakefield holds a prestigious NHMRC Career Development Fellowship, and a $2.7M program grant, and is Co-Director of the SPHERE Kids to Adults (K2A): Creating Healthy Futures Clinical Academic Group. She chairs the pediatrics committee for the International Psycho-Oncology Society and founded the first international early career group for professionals working in pediatric psycho-oncology. Professor Wakefield’s team has created and implemented evidence-based resources for bereaved families, parents of children with cancer, and adolescents and young adults with cancer, including 10 clinical decision aids, many of which are now endorsed and disseminated by NSW Health. With increased use of genetic testing and personalized medicine in pediatrics, her team is assessing the psychological impact of new genetic technologies on children and families and is exploring the ethical questions arising in this novel area of medicine. Her team leads the patient-reported outcomes study in the PRISM clinical trial, one of the largest personalized medicine trials for childhood cancer patients worldwide.

Posted in 2018 Symposium, Education for Health Professionals | Tagged 2018 symposium, ethics, psychosocial

Beneath the Surface: The Psychosocial Impacts of Precision Medicine

Posted on September 19, 2019 by Jamie Irvine


VIEW THE PRESENTATION

Presentation Description:
Precision medicine represents arguably the most exciting advance in pediatric oncology in recent decades. Despite great hope for this new approach to making individualized treatment recommendations for children with cancer, there will likely be associated psychosocial challenges for all stakeholders involved, including patients, parents, clinicians and scientists. Precision medicine trials are very complex, meaning that patients’/parents’ understanding about their treatment options might be limited. Healthcare professionals might also find it difficult to manage the psychosocial impacts of precision medicine for their patients. This presentation summarises the key potential impacts of precision medicine for children with cancer, their families and the professionals who care for them. Professor Wakefield will present data from recent systematic reviews, a large-scale acceptability study, plus emerging prospective data from the first 100 families enrolled in the Australian PRISM precision medicine trial for children with high-risk cancer.

Speaker:
Claire Wakefield, BPsych(hons), MPH, PhD
Director, Behavioural Sciences Unit
Sydney Children’s Hospital

Professor Claire Wakefield, registered psychologist, is Director of the Behavioural Sciences Unit at Sydney Children’s Hospital, Australia. She is a chief investigator on grants worth >$26M and has published >140 peer-reviewed articles. Professor Wakefield holds a prestigious NHMRC Career Development Fellowship, and a $2.7M program grant, and is Co-Director of the SPHERE Kids to Adults (K2A): Creating Healthy Futures Clinical Academic Group. She chairs the pediatrics committee for the International Psycho-Oncology Society and founded the first international early career group for professionals working in pediatric psycho-oncology. Professor Wakefield’s team has created and implemented evidence-based resources for bereaved families, parents of children with cancer, and adolescents and young adults with cancer, including 10 clinical decision aids, many of which are now endorsed and disseminated by NSW Health. With increased use of genetic testing and personalized medicine in pediatrics, her team is assessing the psychological impact of new genetic technologies on children and families and is exploring the ethical questions arising in this novel area of medicine. Her team leads the patient-reported outcomes study in the PRISM clinical trial, one of the largest personalized medicine trials for childhood cancer patients worldwide.

Posted in 2018 Symposium | Tagged 2018 symposium, psychosocial

2018 POGO Pre-Symposium Nursing Seminar

Posted on November 22, 2018 by Jamie Irvine


On November 1, 2018 POGO hosted a one-day nursing seminar the day before the 2018 Multi-Disciplinary Symposium on Childhood Cancer. Topics covered included: Practical strategies to improve Patient/Family Education; CAR-T and other Immunotherapies; Survivorship in the Age of Precision Medicine; and Strategies to Maintain Optimism and Build Resilience for Pediatric Oncology Nurses. 

Over 90 nurses and other health care professionals from across Ontario and beyond attended the conference.

VIEW THE PROGRAM

PLENARY SESSIONS

Closing the Gap, Bridging the Divide: How to Effectively Teach Patients and Families
Stephanie Cox, RN(EC), MN, NP-Pediatrics
Angela Filice, RN

Avoiding Information Overload: What do Families Actually Need to Know?
Jen Sullivan, MSN, RN, CPON

Managing Stress and Cultivating Optimism: Enhancing Resiliency in Pediatric Oncology Nurses
Teresa Conte, PhD, CPNP

QUICK-HIT SESSIONS

Management of Fatigue in Children and Adolescents with Cancer and Pediatric Recipients of Hematopoietic Stem Cell Transplants: A Clinical Practice Guideline
Lillian Sung, MD, PhD

CAR-T Cell Therapy: Patient Eligibility, Management, and Nursing Considerations
Colleen Callahan, RN, MSN, CRNP

Stopping Cancer Cell Evasion with Immune Therapies
Sue Zupanec, MN, NP Pediatrics

New Therapies, New Late Effects – Survivorship in the Age of Precision Medicine
Eleanor Hendershot, RN(EC), MN, BScN, NP Pediatrics

BRAF Inhibition and Fusion in Low Grade Glioma
Tara McKeown, MN NP Pediatrics

Posted in 2018 Pre-Symposium Nursing Seminar, Education for Health Professionals | Tagged 2018 symposium, CAR-T, fatigue, immune, new therapies, Nurses, stress

2018 POGO Symposium on Childhood Cancer

Posted on November 22, 2018 by Jamie Irvine


The 2018 POGO Multi-Disciplinary Symposium on Childhood Cancer – Precision Medicine in Pediatric Oncology – examined clinical and scientific advances in precision medicine and explored how those advances are impacting the diagnosis and treatment of cancer in children.

Over 250 delegates representing a variety of disciplines attended the conference.

VIEW THE PROGRAM

Click on the session titles below to view presentations that POGO has permission to share. 

PLENARY SESSIONS

Precision Medicine in the Pediatric Oncology Clinic: From Feasibility to Clinical Impact
Katherine Janeway, MDMD, MMSc

Precision Medicine – A Paradigm Shift?
Ian F. Tannock, CM, MD, PhD, DSc
Uri Tabori, MD

Thinking Practically: Delivery of Care Considerations for New Agents
Karen Fung, MSW, RSW
Tara McKeown, RN MN NP-Paediatrics

Ethics and Consent in the Age of Precision Medicine – Forging a Path Forward
Steven Joffe, MD, MPH

Select Poster Presentations
Alexandra Zorzi, MD, FRCPC
Andrew Shuen, PhD Candidate, MD, FRCPC
Lauren Mulrooney
, Nursing Student (3rd year)
Valli Subasri, MSc candidate (Medical Biophysics)
Nicole Espinosa, BScH Candidate (Life Sciences)
Mohammad R. Alqudimat, PhD Student (Nursing)
Marta Wilejto, Assistant Professor Paediatric Hematology/Oncology
Sarah Naraine, Fourth Year Nursing Student
Ceilidh Eaton Russell, PhD
Jill Furzer, PhD candidate (health economics)

Targeted and Traditional Agents: Can We Reduce Side Effects Using Pharmacogenomic and Endogenous Biomarkers?
Richard B. Kim, MD, FRCPC

The Future of Immunotherapy, CAR-T and Beyond
Shannon L. Maude, MD, PhD

WORKSHOPS

The Evolution of Clinical Trials in Canada
Rebecca Deyell, MD, MSc, FRCPC
Josh Silvertown, PhD, MBA, MSM
Patrick Sullivan

PROFYLE/KiCS: The ABCs of Precision Medicine in Canada
Alexandra Zorzi, MD
Anita Villani, MD, MSc, FRCPC
Andrea Cote, RN, BScN

CAR-T Cell Therapy in Ontario: Opportunities and Challenges
Joerg Krueger, MD
Stacey Marjerrison, MD, MSc, FRCPC
Colleen Callahan, RN, MSN, CRN

Posted in 2018 Symposium, Education for Health Professionals | Tagged 2018 symposium, CAR-T, Clinical Trials, consent, diagnos, ethics, genetics, pharmacology, precision therapy, psychosocial, side effects

Precision Medicine in the Pediatric Oncology Clinic: From Feasibility to Clinical Impact

Posted on November 22, 2018 by Jamie Irvine


VIEW THE PRESENTATION

Speaker:
Katherine Janeway
, MD, MSc
Associate Professor of Pediatrics
Harvard Medical School Director Clinical Genomics,Dana-Farber Cancer Institute
Senior Physician and Director Solid Tumor Service, Pediatric Oncology
Dana-Farber/Boston Children’s Cancer and Blood Disorders Center

Dr. Janeway is Associate Professor of Pediatrics at Harvard Medical School, and is the Director of Clinical Genomics and of the Pediatric Solid Tumor Program at Dana Farber Cancer Institute. Her research focus is applying cancer genomics to the pediatric oncology clinic and identifying central oncogenic mechanisms, novel drug targets and new therapeutics for sarcomas, malignancies in particular need of scientific and clinical advances. As Vice Chair of the Children’s Oncology Group Bone Tumor Committee, Dr. Janeway helps set priorities for clinical investigation and guides protocol development for collaborative trials in Ewing sarcoma and osteosarcoma. She sits on national committees charged with bringing the power of genomic characterization to patient care, e.g., she co-chairs the target and agent prioritization committee for the National Cancer Institute Pediatric MATCH study. Dr. Janeway received her MD from Harvard Medical School in 2000 and a Master of Medical Science from Harvard Medical School in 2008. She completed her residency in pediatrics at Boston Children’s Hospital where she later served as chief resident. Dr. Janeway then completed her fellowship in pediatric hematology-oncology at Dana-Farber Cancer Institute/Boston Children’s Hospital where she was also chief fellow before joining the staff in 2007.

Posted in 2018 Symposium | Tagged 2018 symposium, precision therapy

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