A group of drugs that transformed survival rates for children with liver cancer have been found to cause genetic mutations in healthy liver tissue that speed up how fast the organ ages. The drugs are platinum-based chemotherapy agents, a class that uses platinum compounds to damage the DNA inside tumor cells and stop them from dividing. A study published Thursday in Science examined two agents from that class, cisplatin and carboplatin, and their effects on children treated for hepatoblastoma, a rare liver cancer.
Hepatoblastoma is the most commonly diagnosed liver cancer in childhood. Before platinum-based chemotherapy became standard, the five-year survival rate for the disease sat at around 20%. For localized tumors, that figure has since climbed above 80%. Cisplatin and carboplatin drove that change.
The drugs work by damaging DNA inside cancer cells, which stops those cells from reproducing. Healthy cells absorb the same treatment. In healthy tissue, that damage does not simply clear; it becomes permanent mutations. Research has established the concern that those mutations may raise the risk of secondary cancers forming years after treatment ends. That picture was documented in adult patients. The Science study was built to examine whether the same holds in children.
Children receive these drugs during development, when cells are dividing rapidly. A mutation introduced then has more time to accumulate and progress than one introduced in an adult. The study found what its title says: the mutations alter liver tissue in ways that age it.
That finding raises the question of what health monitoring these survivors may need as they get older. The survival rate for localized hepatoblastoma stands above 80% because of cisplatin and carboplatin. Any longer-term risk has to be read against that number.