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Current research by Dr. Brenda Gallie and Dr. Helen Chan at The Hospital for Sick Children (SickKids) has resulted in
Preliminary results show that early diagnosis, combined with this new chemotherapy protocol and focal therapy directed to the eye tumours, offers the most effective means of saving affected eyes and retaining vision. This outcome is especially true in the more serious and complex cases that are found when the cancer occurs in both eyes.
The new protocol is also proving to be effective in advanced cases that result from later diagnosis.
The Toronto team has initiated a Worldwide Trial to increase the number of participants and compare these findings across various countries and populations. This is the world's first organized clinical trial in retinoblastoma.
The Daisy’s Eye Cancer Fund is supporting the Worldwide Trial through financial support for families of children who would otherwise be unable to access such specialized care.
The "Toronto Protocol" for treatment of advanced retinoblastoma.
The Toronto Protocol for chemotherapy of retinoblastoma, both inside the eye and for spread outside the eye, was developed through basic research by Dr. Helen Chan.
Dr. Chan showed that retinoblastoma tumor cells are "protected" from chemotherapy by a protein (P-glycoprotein) that removes the drugs from the cell. The Toronto Protocol uses a common drug, cyclosporine, in an unusual way, to block P-glycoprotein while the chemotherapy is given.
All intraocular tumors also receive laser and cryotherapy.
All extraocular tumors also may receive combinations of radiation, chemotherapy in the fluid bathing the brain, and stem cell (bone marrow) transplant.
The Toronto Protocol is being further tested in a Worldwide Trial, comparing outcome to children around the world who received chemotherapy without cyclosporine.
Molecular testing for RB1 gene mutation improves quality of care.
Retinoblastoma Solutions, a Canadian non-profit charity with 92% sensitivity to find the mutation within 4 weeks for each family, developed from our translational research studies.
Basic cancer research in retinoblastoma in the Toronto lab has revealed fundamental concepts broadly important in cancer biology.
The RB1 gene is an important "tumor suppressor gene".
A series of cancer genes promote retinoblastoma in the developing retina after both copies of RB1 are lost.
The World Survey brings 26 Retinoblastoma Centers in 5 continents together.
Analysis of 2000 eyes of 1500 children shows important world trends
The new International Retinoblastoma Classification better predicts outcome of current chemotherapy/focal therapy treatments than the 40 year-old classification.
The National Retinoblastoma Strategy (Canada) is underway to develop national standards of care.
A novel retinoblastoma patient and treatment protocol database supports delivery of best-practice care.
Complex treatment histories are made clear and simple.
Impact of the database on the quality and efficiency of clinical care for retinoblastoma families is underway.
At Sick Kids, ophthalmologists from around the world are trained in best practices for retinoblastoma and in global collaborative research.
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