While tremendous progress has been made in the treatment of pediatric cancers, oncologists are still challenged by cancers that fail to respond or develop resistance to treatment. The key to our success in the battle against these cancers lies in the biology of each child’s cancer. What mutations are driving its growth, or rendering it invulnerable to the standard therapies we try to use?

The answers to those questions will increasingly come from our Precision in Pediatric Sequencing (PIPseq) program. “Through this initiative, we’re aiming to identify the molecular drivers of each patient’s cancer and use this information to personalize his or her treatment using novel, biologically targeted investigational agents,” explains Julia Glade Bender, MD, Medical Director of PIPseq. “With next generation sequencing, we can delve deeper into the genetic basis of cancer to pinpoint novel therapeutic targets.” This customized treatment approach is gaining speed across the spectrum of cancer care, including adult cancers, and has the potential to propel pediatric cancer care to new levels of success.

Development of the PIPseq program was initiated by former division director Andrew Kung, MD, PhD, with the intent of translating laboratory-based technologies to the patients cared for in the Division. The effort now brings together experts from throughout both Columbia University Medical Center and NYP/Morgan Stanley Children’s: the surgeons who remove cancerous tissue for analysis, the pathologists who prepare those biopsy samples and who perform the sequencing, laboratory scientists who use those findings to pinpoint potential new therapies, the geneticists who help interpret the results, and the oncologists and pediatric oncology nurses who administer those treatments.

In January 2014, we began performing whole-genome sequencing of patients with high-risk or relapsed cancers. We are now able to offer comprehensive molecular characterization to every pediatric oncology patient we treat, with results returned to clinicians and patients within three weeks. “No other pediatric cancer program is applying precision medicine to the problem of childhood cancers the way we are,” says Maria Luisa Sulis, MD, head of hematologic malignancies in PIPseq. “We are one of the only programs prospectively sequencing cancers and using the results to make clinical decisions for our patients. Our efforts to bring the technologies of tomorrow to our patients today have extraordinary implications for defining the way we will all care for children with solid tumors and hematologic malignancies in the future.”