Platinum-based chemotherapy in childhood causes mutations that age the liver — SkimNews
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- Hepatoblastoma survival jumped from roughly 20% to over 80% for localized tumors thanks to platinum-based drugs like cisplatin and carboplatin, making the long-term safety of these treatments a growing concern.
- A study published Thursday in Science found children treated with platinum agents carried an average of 2,200 mutations per liver sample — a burden normally seen in adult livers, effectively aging the children's liver cells.
- Mutation load scaled with platinum exposure: children who received both cisplatin and carboplatin showed more mutations than those given cisplatin alone, and the mutations appeared in both cancer-related genes and genes tied to liver metabolism.
- Liver cells accumulated far more mutations than blood cells from the same systemic treatment, and lead author Foad Rouhani of King's College London said researchers don't yet know whether the liver metabolizes or repairs platinum differently.
- Rouhani stressed the findings show only "potential for these cells to eventually cause problems" and do not guarantee future cancer, but called for closer lifetime monitoring of survivors.
- In a perspective article, Baylor College of Medicine's Sanjeev Vasudevan and Donald Williams Parsons wrote that the findings "provide strong evidence for conducting survivorship studies" of treated children beyond their third decade of life.
Why it matters: For the majority of hepatoblastoma patients who now survive because of platinum chemo, the study provides the first concrete mutation count in their healthy liver tissue, prompting two Baylor researchers to call for survivorship tracking past age 30 — and hinting that future drug design could aim to spare healthy cells while still killing tumors.
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