City of Hope to lead national research aimed at improving testing/treatment for devastating cancer-causing syndrome

Letisia Marquez
National Institutes of Health has awarded the comprehensive cancer center with $8.5 million to study Li-Fraumeni Syndrome
DUARTE, Calif. — Persons who inherit Li-Fraumeni syndrome (LFS) have an extremely increased risk of developing cancer. For instance, females with the syndrome have a 50% chance of developing cancer by the age of 30 and a 90% chance over their lifetime; males with the syndrome have a 70% chance of cancer over their lifetime.
LFS was first described 50 years ago, and 30 years ago the syndrome was linked to inheriting a mutation in the TP53 gene. City of Hope scientists and others worldwide have made advances in identifying and treating people with the syndrome, but more work remains to be done.
A new $8.5 million, five-year grant from the National Institutes of Health seeks to advance research and treatment for this serious syndrome, which can cause multiple cancers, including sarcomas, brain and breast tumors, and adrenocortical cancers.
“This is a devastating syndrome to have – we’ve cared for families with babies who had brain tumors at 18 months,” said Jeffrey Weitzel, M.D., director of City of Hope’s Division of Clinical Cancer Genomics, the Dr. Norman & Melinda Payson Professor in Medical Oncology and the grant’s co-principal investigator. “City of Hope and our partner institutions are determined to develop a better understanding of the cancer risks associated with different TP53 mutations so we can better tailor screening, prevention and treatment for these patients. We are seeing the light at the end of the tunnel but more research is needed.”
The project, termed LiFTUP (Li Fraumeni and TP53 Understanding and Progress), which is co-led by Judy E. Garber, M.D., M.P.H., of Dana-Farber Cancer Institute and Christopher I. Amos, Ph.D., of Baylor College of Medicine, will provide the largest and most comprehensive examination of TP53-associated cancer risk.
Traditionally, clinical TP53 testing was limited to individuals and families who met specific criteria (typically multiple cancers at very young ages). With the introduction of next-generation-based multigene panel testing, which sequences a person’s genome faster and is less costly than previous genetic tests, TP53 testing is now performed on large numbers of people who do not meet the syndrome’s criteria. However, the testing has also raised concerns about false positives, or a test result that incorrectly indicates the syndrome is present.
That’s because blood samples are often used for genetic testing and people may develop TP53 gene mutations in rapidly growing blood cells as they age. Researchers will also examine this group of people to find out why some people in this group develop blood cancers while others do not.
The inherited syndrome is rare. Only about 1,000 children and adults nationwide are included in the Li-Fraumeni Exploration Consortium, and researchers working on this project will also recruit TP53 carriers identified through broader, more agnostic approaches to testing, including commercial genetic testing laboratories, the Geisinger MyCode project, the PROMPT study of individuals with germline mutations and the ORIEN tumor/germline sequencing project.
“Carriers of true germline TP53 mutations may bear the psychological, medical and financial costs of striking personal and family cancer risks, the burden of intensive surveillance, the high risks of cancer deaths at disproportionately young ages and the weight of possibly passing TP53 variants to offspring,” according to the team.
Consequently, a crucial question researchers want to answer is why some people with a TP53 mutation develop cancer while others do not.
“We’re looking at thousands of markers across the whole genome to find out if there are patterns that influence why two TP53 carriers with the same mutation have different outcomes,” Weitzel added. “We will do a clinical and molecular interrogation of the factors that influence the development of cancer.”
“Our hope is that by focusing more research on children and adults with the TP53 mutation, we will be able to take better care of these individuals,” Weitzel said.
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About City of Hope
City of Hope is an independent biomedical research and treatment center for cancer, diabetes and other life-threatening diseases. Founded in 1913, City of Hope is a leader in bone marrow transplantation and immunotherapy such as CAR T cell therapy. City of Hope’s translational research and personalized treatment protocols advance care throughout the world. Human synthetic insulin and numerous breakthrough cancer drugs are based on technology developed at the institution. A National Cancer Institute-designated comprehensive cancer center and a founding member of the National Comprehensive Cancer Network, City of Hope is the highest ranked cancer hospital in the West, according to U.S. News & World Report’s Best Hospitals: Specialty Ranking. Its main campus is located near Los Angeles, with additional locations throughout Southern California. For more information about City of Hope, follow us on FacebookTwitterYouTube or Instagram.