Glasgow Paediatric ECMC

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Overview

Our Centre

Glasgow ECMC Paediatric centre delivers phase I/II trials to children and young adults in Scotland and the North East of England. As the only Paediatric ECMC Centre in Scotland, we pride ourselves in offering pioneering experimental treatment to both our own patients and patients referred to us through our “Northern Network” and beyond. We have worked with over 10 pharmaceutical companies for the safe delivery of early phase experimental medicines. Our team of consultants here in Glasgow have been Principle Investigators (PI) and Chief Investigators (CI) for both national and international Studies. We also accept international referrals for one of our commercial phase I/II studies, facilitated by having a dedicated ECMC Research Nurse supported by our Clinical Research Facility (CRF) Network. In the last 3 years since our ECMC Research Nurse has come into post we have opened 10 Phase I/II Trials to which we are actively recruiting.

The clinical trials service is embedded within the Children and Young Adult Cancer Unit at The Royal Hospital for Children, Glasgow. In 2011 the Scottish Government established a Managed Service Network (MSN) for Children and Young People with Cancer. As a result cancer services for Children and Young people in Scotland are now delivered as a single cohesive service through working of MSN.

Paediatric Haematology is provided by 5 Consultant Haematologists, and there are a further three full time clinical paediatric oncologists caring for children with solid tumours and brain tumours from the West of Scotland and beyond. The Royal Hospital for Children Oncology service also looks after patients from other Principle Treatment Centres who are referred to Glasgow as per agreed pathways of MSN, or as required for consideration for Early Phase trials.

Radiotherapy facilities are available at the nearby Beatson West of Scotland Cancer Centre and two dedicated Consultant Clinical Oncologists support this service.

Our patient population

In 2019 we recruited, 12 children to early phase clinical trials within our unit. This is in addition to all the late phase trials (Phase III) that we participate in. We diagnose 20 malignant haematology patients each year. 60 new patients are diagnosed with malignant solid tumours/ brain tumours in the West of Scotland.

We accept referrals from throughout Scotland, the North of England and Ireland.

International patients are accepted to our Ymabs Neuroblastoma Study facilitated by our ECMC Team here in Glasgow

Organisations affliated with the Glasgow ECMC:

Our location:

We are based in the Royal Hospital for Children, Glasgow. This is part of the Queen Elizabeth University Hospital Campus (QEUH) West of Scotland

We have very good rail/road links. Also the site is very close to Glasgow International airport. The Scottish Government, in partnership with the voluntary sector, (Young Lives Vs Cancer) has addressed the needs of families travelling long distances by providing a brand new, family orientated, “Home from Home” on the campus of the new hospital.

Contact the Centre Manager:

Fiona Conway
fiona.conway@glasgow.ac.uk
+44 (0) 141 330 4890

Address

Royal Hospital for Sick Children
1345 Govan Road
Govan
Glasgow, G51 4TF

Beatson West of Scotland Cancer Centre
1053 Great Western Road
Glasgow

Paul O'Gorman Leukaemia Research Laboratories
1053 Great Wester Road
Glasgow

Wolfson-Wohl Cancer Research Centre
University of Glasgow

Team Members

Milind Ronghe

ECMC Lead Consultant

milind.ronghe@ggc.scot.nhs.uk

Dr Milind Ronghe is our Lead Clinician for paediatric ECMC. With over 20 years experience as a Paediatric Oncologist with a special interest in Liver Tumours, his Clinical Trial knowledge has allowed the Teaching and Development of our Haematology Oncology Clinical Trials Unit Since 2016 he has been ECMC Lead Consultant here in Glasgow.

Emily Blyth

ECMC Research Nurse

Expertise:

Paediatric

In 2018 we were provided funding for an ECMC Research Nurse which has afforded us the opportunity to open and maintain a vast number of Early Phase Trials. Emily attends a variety of MDT Meetings allowing for the early identification of Clinical Trial Patients and the ability to plan care of the Child and their Family.

We do not currently have a Stand Alone Haematology Oncology PPIE Group. However, our ECMC Research Nurse is looking into the benefit of potentially developing this in the future.

Albert Borg

ECMC Clinical Research Fellow

The addition of Dr Albert Borg as our Clinical Research Fellow in 2020 has afforded excellent support to our Unit and has improved our ability to provide the huge amount of Patient and Family centred care required to a Family during a Clinical Trial.

Maria Nygren

Clinical Trials Pharamcist

Expertise:

Paediatric

We are extremely lucky to have a Clinical Trials Pharmacist that works closely with our MDT. Maria Nygren joined our Team in 2019 and has allowed fantastic collaboration of the MDT to provide a smooth running process in the Clinical Trial Environment.

Paediatric Expertise

Cancer Types

We have expertise in both solid tumours and haematological malignancies.

As the only Paediatric ECMC in Scotland, we specialise in early phase clinical trials; however, we also have many years experience treating children on Phase III/IV trials. Any patient diagnosed with a malignancy will be screened for any open clinical trial for their disease group.

Drugs/Treatment Modalities

Combination therapies
Immunotherapy
Small molecules
Surgery
MIBG Therapy

Radiotherapy

We have regular access to photon radiotherapy.

Although we do not have access to protons within our centre, we have excellent collaboration with centres to which we refer to and are so pleased to be able to offer our patients proton therapy here in the UK since the MCR Christie Hospital has opened.

We have research expertise in the following:

Intensity Modulated Radiotherapy (IMRT)
Image Guided Radiotherapy (IGRT)
Stereotactic Radiotherapy (SBRT/SABRT)
Internal Radiotherapy

Molecular Diagnostic Testing

We have the following available on a routine basis to our patients.

Single gene testing

This is available for tumours and for ctDNA (circulating tumour DNA)

We do currently have limited expertise to test for genetic testing but we current access this via SMPaeds trial in Relapsed/ refractory tumours. At the present time, we routinely do not offer NGS testing here in Glasgow. We have a well developed relationship with GOSH centre for NGS. We ensure every Relapsed/Progressed patient has NGS either through SM Paeds or Off Trial NGS Testing by Prof Tom Jacques in GOSH.

We are also 1 of 4 MRD labs in the UK. This allows extensive testing for Disease monitoring and Prognostic Testing. MRD testing is offered for all paediatric haematological malignancies (ALL, AML, CML)

Facilities

Dedicated 24 hour stay facilities (including weekends)
Radiopharmacy
On-site pharmacy
PK testing facility
Dedicated research staff i.e. research nurses, lab technician
Snap freezing facilities i.e. liquid nitrogen
On-site ITU (intensive treatment unit)
On-site central lab

Support serices available through the Paediatric ECMC:

Paediatric National Stem Cell Transplant Unit
Apheresis service provided by the West of Scotland Blood Transfusion Service; this unit is supported by specialist in-house Paediatric Renal, Respiratory, Cardiology, Gastroenterology and Endocrinology Consultants
Radiology Department which has ultrasound, CT and new MRI scanning facilities alongside nuclear medicine; there is also access to interventional radiology
Targeted radio-nucleotide suite for children in the United Kingdom
Histopathology service provided by 5 Paediatric pathologists
Medical Genetics on site with a dedicated cancer genetics service
Paediatric Clinical trials unit staffed by 1 Clinical Trial Co-ordinator, 3 Data Managers and 2 dedicated Research Nurses for early phase trials
Dedicated pharmacist within the centre with lead responsibility for the conduct of early phase trials
A dedicated Teenage Cancer Trust (TCT) unit for teenagers (13 to16 years) & young adults (16 to 25 years) provides a separate, age specific, space both in the Royal Hospital for Children and the Beatson West of Scotland Cancer Centre. Each unit has its own staff trained to look after the specific needs of this group of patients. There is a dedicated TCT support worker who acts as a befriender and information resource for teenagers and their families.
“Home from Home” facilities available on the campus of the Royal Hospital for Children for families travelling long distances for treatment. This service provides brand new, family orientated accommodation which allows whole families to travel and stay while their children are having complex or innovative therapies. Families are housed in a series of apartments which can be configured to their needs and allows them to stay in Glasgow without the expense of dining out, laundry and travel. Within the new house there is also a large social area that allows families to provide informal support to one another.
Prior to discharge follow up arrangements are discussed with the patient their family and additional support is provided the Paediatric Oncology Outreach Nursing service (POON; 3 in Glasgow). Patients and families are also supported by an oncology specific psychology team, Young Lives vs Cancer service and outreach nurses including and end of life palliative care team.

Case Study

Case Studies

Publication List

1: Brock PR, Maibach R, Childs M, Ronghe M, et al. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med. 2018 Jun 21;378(25):2376-2385.

2: Mahamdallie S, Yost S, Ronghe M, et al. Identification of new Wilms tumour predisposition genes: an exome sequencing study. Lancet Child Adolesc Health. 2019 May;3(5):322-331.

3: Zsiros J, Brugieres L, Brock P, Ronghe M, Casanova M, Morland B, et al ; International Childhood Liver Tumours Strategy Group (SIOPEL). Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol. 2013 Aug;14(9):834-42.

4: Murray MJ, Ajithkumar T, Ronghe M et al. Clinical utility of circulating miR-371a-3p for the management of patients with intracranial malignant germ cell tumors. Neurooncol Adv. 2020 Apr 13;2(1):vdaa048.

5: Ronghe MD, Halsey C, Goulden NJ. Anticoagulation therapy in children. Paediatr Drugs. 2003;5(12):803-20.

6: Jackson TJ, Williams RD, Brok J, Ronghe M et al; Children's Cancer and Leukaemia Group (CCLG) Renal Tumours Group. The diagnostic accuracy and clinical utility of pediatric renal tumor biopsy: Report of the UK experience in the SIOP UK WT 2001 trial. Pediatr Blood Cancer. 2019 Jun;66(6):e27627.

7: Milner TD, Ronghe M, Shaikh MG, MacGregor FB, Reed N. Vandetanib tumor shrinkage in metastatic medullary thyroid cancer Allowing Surgical Resection of the Primary Site: A Case Report. J Pediatr Hematol Oncol. 2019 Jul;41(5):e329-e332.

8: Ronghe MD, Moss TH, Lowis SP. Treatment of CNS malignant rhabdoid tumors. Pediatr Blood Cancer. 2004 Mar;42(3):254-60.

9: Estlin EJ, Ronghe M, Burke GA, Yule SM. The clinical and cellular pharmacology of vincristine, corticosteroids, L-asparaginase, anthracyclines and cyclophosphamide in relation to childhood acute lymphoblastic leukaemia. Br J Haematol. 2000 Sep;110(4):780-90.

10: Ronghe M, Burke GA, Lowis SP, Estlin EJ. Remission induction therapy for childhood acute lymphoblastic leukaemia: clinical and cellular pharmacology of vincristine, corticosteroids, L-asparaginase and anthracyclines. Cancer Treat Rev. 2001;27(6):327-37.

11: Turnbull C, Perdeaux ER, Morland B, Ronghe M, Pritchard-Jones K et al. A genome-wide association study identifies susceptibility loci for Wilms tumor. Nat Genet. 2012 Apr 29;44(6):681-4.. Erratum in: Nat Genet. 2013 Aug;45(8):962.

12: Scott RH, Murray A,Pizer B, Ronghe MD et al. Stratification of Wilms tumor by genetic and epigenetic analysis. Oncotarget. 2012 Mar;3(3):327-35.

13: Chisholm JC, Merks JHM, Casanova M, Ronghe M,et al ; European paediatric Soft tissue sarcoma Study Group (EpSSG) and the European Innovative Therapies for Children with Cancer (ITCC) Consortium. Open-label, multicentre, randomised, phase II study of the EpSSG and the ITCC evaluating the addition of bevacizumab to chemotherapy in childhood and adolescent patients with metastatic soft tissue sarcoma (the BERNIE study). Eur J Cancer. 2017 Sep;83:177-184

14: Narayanan VK, Ronghe M, MacGregor FB et al. Use of Vandetanib in Metastatic Medullary Carcinoma of Thyroid in a Pediatric Patient With Multiple Endocrine Neoplasia 2B. J Pediatr Hematol Oncol. 2016 Mar;38(2):155-7.

15: Ronghe M, Hargrave D, Bartels U, et al. Vincristine and carboplatin chemotherapy for unresectable and/or recurrent low-grade astrocytoma of the brainstem. Pediatr Blood Cancer. 2010 Sep;55(3):471-7.

16: Zsíros J, Brugières L, Brock P, Morland B,Casanova M, Ronghe M et al. Efficacy of irinotecan single drug treatment in children with refractory or recurrent hepatoblastoma--a phase II trial of the childhood liver tumour strategy group (SIOPEL). Eur J Cancer. 2012 Dec;48(18):3456-64.

17: Scott RH, Douglas J, Baskcomb L, Ronghe MD, et al; Factors Associated with Childhood Tumours (FACT) Collaboration. Constitutional 11p15 abnormalities, including heritable imprinting center mutations, cause nonsyndromic Wilms tumor. Nat Genet. 2008 Nov;40(11):1329-34.

18: Ronghe MD, Barton J, Jardine PE et al. The importance of testing for adrenoleucodystrophy in males with idiopathic Addison's disease. Arch Dis Child. 2002 Mar;86(3):185-9.

19: Ronghe MD, Foot AB, Martin R et al. Non-Epstein-Barr virus-associated T-cell lymphoma following cardiac transplantation for Barth syndrome. Acta Paediatr. 2001 May;90(5):584-6.

20: Divekar AA, Ali US, Ronghe MD et al Superior sagittal sinus thrombosis in a child with nephrotic syndrome. Pediatr Nephrol. 1996 Apr;10(2):206-7.

21: Tomlinson RJ, Ronghe M, Goodbourne C et al. Once daily ceftriaxone and gentamicin for the treatment of febrile neutropenia. Arch Dis Child. 1999 Feb;80(2):125-31.

22: van den Berg H, Paulussen M, Le Teuff G et al ; Euro-EWING99 Group. Impact of gender on efficacy and acute toxicity of alkylating agent -based chemotherapy in Ewing sarcoma: secondary analysis of the Euro-Ewing99-R1 trial. Eur J Cancer. 2015 Nov;51(16):2453-64.

23: Shewale S, Duncan R, Murphy D, Ronghe M. Axillary fossa tumours in children: rare and easily missed. Acta Orthop Belg. 2009 Feb;75(1):126-8.

24: Pritchard-Jones K, Bergeron C, de Camargo B et al ; SIOP Renal Tumours Study Group. Omission of doxorubicin from the treatment of stage II-III, intermediate-risk Wilms' tumour (SIOP WT 2001): an open-label, non-inferiority, randomised controlledtrial. Lancet. 2015 Sep 19;386(9999):1156-64. Epub 2015 Jul 9.

25: Ronghe MD, Foot AB, Cornish JM, Steward CG et al. The impact of transfusion of leucodepleted platelet concentrates on cytomegalovirus disease after allogeneic stem cell transplantation. Br J Haematol. 2002 Sep;118(4):1124-7.

Text Book Chapters

Chemotherapy and Novel Cancer Targeted Therapies, Chapter 9 in Eds Carachi/Grosfeld: "The Surgery of Childhood Tumors, 3rd Edition" M. Ronghe, D. Murphy (Springer), pp 135-152, 2016
M Ronghe, D Murphy Chapter for Textbook – New Drugs for Children and Adolescents with Cancer in Surgery for childhood tumours. 3^rd edition. Eds Prof Carachi / Jay Grosfeld. 2013
M Ronghe, D Murphy Chapter for Textbook – Chemotherapy & Immunotherapy for Childhood Cancer in Surgery for childhood tumours. 2^nd edition. Eds Prof Carachi / Amir Azmy / Jay Grosfeld. 2008, pages 117-133

Glasgow Paediatric ECMC

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