In the December issue of the Journal of Clinical Oncology , the International Neuroblastoma Risk Group (INRG) presents three sets of papers outlining a: standard classification system; pre-treatment staging system; and an analysis of a rare group of patients.
The INRG studies provide for a unified system of clinical trials that will enable quicker identification of optimal treatments for neuroblastoma.
Neuroblastoma is the most common solid cancer that occurs outside the cranium during childhood. For some young children, it disappears with minimal treatment. In other children, it can be relentlessly aggressive, with a high likelihood of death. Predicting the behavior of this tumor is crucial in planning appropriate treatment.
The INRG task force is co-chaired by Susan Cohn, professor and director of clinical sciences at the University of Chicago Comer Children's Hospital, and Andrew Pearson, chairman of paediatric oncology at the Institute of Cancer Research at Royal Marsden Hospital in the UK.
Cohn says that in the past, criteria used to predict tumor behavior and stratify treatment have not been uniform throughout the world, which makes it impossible to directly compare clinical trial results. The INRG classification system is designed to create consistency of risk group assignment around the globe, and will facilitate clinical research.
"We strongly recommend that cooperative groups begin using this classification system now," Cohn says.
"The system will allow the direct comparison of results from clinical trials conducted in different regions of the world and will help us determine the best treatment strategies for patients with neuroblastoma," she adds. "By working together, physicians will be able to ask questions about treatment approaches that would otherwise not be possible to ask in a single cooperative group or country because of the small numbers of patients. We plan to continue to expand this database, and as new molecular tools are developed to test cancer genetics, the INRG Classification System will be refined."
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The conference also included presentations of fresh insights into the critical symbiotic relationships between bacteria and plants. Some plants rely on bacteria to fix the nitrogen they need for the manufacture of critical compounds, primarily proteins, from the air, rather than from nitrates they obtain in the soil. One talk by Eva Kondorosi from the Institut des Sciences du V?©g?©tal in Gif sur Yvette in France, showed that the process by which the Rhizobium bacteria in legume root nodules adapt to their nitrogen fixing role is induced, at least in part, by small peptides (proteins) made by the plant which target the bacteria in the nodule.
The ESF conference also highlighted the benefits of cross fertilisation with disciplines such as mathematics, physics and computation, that are now increasingly involved in microbiology. For example Michael Elowitz, an applied physicist from the California Institute of Technology (Caltech), showed that frequency modulation, a technique better known for its role in transmission of FM radio signals or digital data, was actually used in micro-organisms such as yeast and bacteria to orchestrate expression of many genes simultaneously involved in a particular process or pathway. Essentially the frequency of movement of a single factor initiating coordinated expression of multiple genes in turn determines the level of expression within a wide range, enabling a flexible response to different situations.
Apart from bringing together experts from different fields to reveal new insights like the role of frequency modulation in gene expression, the ESF conference also achieved its other major objective of sustaining momentum in the field by establishing BacNet as an ongoing biannual series of meetings in Europe with a similar status and quality to the Gordon conferences on microbiology in the USA. The next BACNET meeting is in planning and is likely to be held at the same location in September 2010.
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