Vivian Weiss, MD, PhD, assistant professor of Pathology, Microbiology and Immunology, has been named a 2020 V Scholar and will receive $200,000 from the V Foundation for Cancer Research.
The grant will support her research to improve the diagnosis of thyroid cancer in pediatric patients and to identify potential treatment targets.
“Pediatric thyroid cancer is not well studied and not well funded despite it being one of the most common solid tumors in children,” Weiss said.
“One of the reasons is children get a very similar treatment regimen to adults. The treatments are highly effective, but they may not be tailored to minimize long-term side effects. We think that pediatric thyroid cancer is different from adult. The mutations seem to be somewhat different.”
The treatment regimen, typically surgery followed by radioactive iodine therapy, has a high cure rate but can have lingering effects on children as they develop, impacting growth, weight and energy levels. Children are more likely to have metastatic disease at diagnosis than adults, Weiss said.
In other instances, a suspicious nodule may be detected incidentally in a child’s thyroid during imaging for some other medical reason, such as an injury. Follow-up needle biopsies of the nodule fail to provide a definitive benign or malignant diagnosis in up to 30% of cases.
“With an atypical biopsy where we can’t tell if it is benign or malignant, the children go to surgery,” Weiss said. “They lose at least half their thyroid in order to get a diagnosis. What that means is even for kids who don’t end up having cancer, they must live with having only half a thyroid, which sometimes is fine, but sometimes they will need thyroid hormone replacement.”
Weiss will do molecular profiling of pediatric thyroid tissue samples from a Vanderbilt biobank.
It’s a cohort of deidentified samples from about 100 patients. Besides doing genomic sequencing on those samples, Weiss will also use 3-D organoids to simulate how the tumor cells grow and to study the tumor cells in mouse models as well.
“In adults, the most common type of thyroid cancer is papillary thyroid carcinoma, and the majority have a BRAF mutation, but in children the BRAF mutation is a lot less common,” she said.
“We don’t even understand the molecular drivers of pediatric thyroid cancer.”
In addition to potentially identifying mutations that may improve the diagnosis of pediatric thyroid cancer, the research may additionally reveal pathways for targeted therapies.
Weiss’s work is also supported by a $100,000 grant from the Children’s Cancer Research Fund that will focus on children age 10 and younger. The V Scholar award supports research in older children.
“Not only is pediatric thyroid cancer different from adult thyroid cancer, the cancer is probably different in younger and older children,” Weiss said.
“For instance, hormones, such as estrogen, may not drive thyroid cancer growth in a 5-year-old or a 6-year-old, whereas they might drive it in a 16-year-old or an 18-year-old.”
The V Foundation for Cancer Research was founded by ESPN and college basketball coach and broadcaster Jim Valvano. Since its formation in 1993, the V Foundation has awarded more than $225 million in cancer research grants nationwide.
