App detects predispositions to cancer in children

Researchers at the Montreal Children's Hospital of the McGill University Health Centre and SickKids hospital in Toronto have developed an app that identifies which patients with first-time cancer should have a genetic evaluation. The relevance of their tool and its clinical utility have just been highlighted by a study published by JAMA Oncology . Free, available on the App Store or Google Play, bilingual and easy to use, the MIPOGG application (for McGill Interactive Pediatric OncoGenetic Guidelines) is already used by nearly 1,000 physicians in some 50 countries around the world. Using a cascade questionnaire to which practitioners respond with a yes or no, the tool helps identify patients who may have cancer predisposition syndrome (CPS) and who should undergo a genetic evaluation for check whether they actually present a higher risk. Almost 150 different cancer predisposition syndromes have been identified to date and children with cancer who exhibit such a predisposition have an increased risk of developing other cancers later in life. “Making a diagnosis of CPS requires the expertise of a clinician, access to genetic tests and to professionals to interpret the results,” said Dr. Catherine Goudie, pediatric hematologist-oncologist at the Montreal Children’s Hospital. “The reality,” continued the junior researcher at the Research Institute of the McGill University Health Centre (RI-MUHC), “is that in Quebec, as in most of the world, we do not have these resources. MIPOGG makes it possible to better target children who must undergo a genetic test and therefore to better allocate available resources.” As part of the study published Oct. 7 in JAMA Oncology, the team of researchers evaluated the performance of MIPOGG on more than 1,000 patients in Canada and the United States who had or had cancer. In 98.6% of the cases, the application correctly identified the children who did not present with CPS and for whom a genetic examination would therefore be superfluous. “It’s major,” said Dr. Goudie. The study also showed that children who tested positive for MIPOGG had a 17.6% chance of having CPS. “There is no rule, but in general, we do a genetic test if there is a 5 to 10% chance of finding something,” said the pediatric hematologist-oncologist. While MIPOGG contributes to better identification of children in need of enhanced follow-up, the tool can also benefit other members of their families. When a predisposition to cancer is detected in a patient, his relatives may also be subject to increased surveillance. Five years of development In another study, published this summer in the Journal of Clinical Oncology , the team of researchers also showed that MIPOGG can help predict which childhood cancer survivors are at risk of developing other cancers later, beyond known risk factors such as chemotherapy and radiation therapy. Born from an idea of Dr. Goudie and Dr. William Foulkes, clinical cancer geneticist and principal scientist at the RI-MUHC, MIPOGG took five years to develop. The application uses 140 decision algorithms, one for each type of pediatric cancer, to analyze patient data as well as their personal and family history. Read: Active surveillance reduces unnecessary treatment in prostate cancer Ultimately, the researchers want to add “a layer of artificial intelligence to facilitate updates and improve the tool’s predictive ability,” said Dr. Goudie, whose ultimate goal would be to prevent most cancers. before they appear. In the meantime, thanks to MIPOGG, “we will be able to put resources in the right place and offer specific follow-up to those who need it most.”

App detects predispositions to cancer in children

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