The changing landscape of children’s cancer treatment
A unique clinical trial
“ESMART is one of the first trials where biopsies are mandatory. It’s very innovative,” says Chesler.
Smart by name, smart by nature, the clever design of ESMART means that it’s testing the benefits of not one, but multiple new treatments, including immunotherapy drugs, and often in novel combinations, all at the same time.
ESMART was designed collaboratively within the Innovative Therapies for Children with Cancer (ITCC) European paediatric early phase clinical trial consortium, which UK centres and investigators play a key role in. The trial started in France in the summer of 2017, with the first UK arm opening in December 2019, with Dr Lynley Marshall at the helm.
“It’s now grown into a 15-arm study. Some arms have already met their recruitment criteria and closed, while others have expanded to include additional patients because of good activity,” says Marshall. “Then, as the science develops and a new compound or new combinations become available, we have the ability to test them as a part of ESMART.”
The Royal Marsden was the first to open as an ESMART centre in the UK, Manchester Children’s Hospital has recently opened, and a further 3 centres will be opening up across the country imminently.
And while ESMART and Stratified Medicine Paediatrics were developed separately, they are intimately linked, with clinicians from each of the UK ESMART sites dialling into the Stratified Medicine Paediatrics’ expert tumour boards.
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