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Genetic Differences Increase Risk for Painful Nerve Damage in Children Receiving Common Anti-Cancer Medication

INTRO:Acute lymphoblastic leukemia (A-L-L) has a cure rate of more than 85 percent. However, one of the main medications used to treat this cancer can cause painful and sometimes debilitating nerve damage. These side effects can persist long after treatment has stopped. A new study examined whether differences in an inherited gene is associated with an increased risk of developing these side effects. Catherine Dolf explains in this week’s JAMA Report.

VIDEO
B-ROLL
Chemotherapy drug being transported from pharmacy, graphic of A-L-L

AUDIO
VO
Inside this plastic pouch, is a lifesaving chemotherapy drug on its way to a young patient diagnosed with acute lymphoblastic Leukemia or A-L-L.

AUDIO
SOT/FULL Super@:11 Kristine R. Crews, Pharm.D., – St. Jude Children’s Research Hospital Runs:10
“Vincristine is a very powerful chemotherapy agent but it has a terrible toxicity that’s called neuropathy.
Some children get very weak in their ankles and their feet and need support to walk.”

(Video covering middle of bite: physical therapist working on Hannah’s feet)

NATSO/FULL
Runs:04    “…as best you can get that heel out ok…”

VIDEO
B-ROLL
Hannah walking with physical therapist

AUDIO
VO
18 year-old Hannah Tate developed this debilitating side effect after being treated with vincristine for another type of cancer.

AUDIO
SOT/FULL Super@:37 Hannah Tate – Cancer Patient Runs:05
“First I noticed it in my feet. They were just weak, they kind a dropped, like I couldn’t pull my feet up, it’s really hard.”

(Video covering 1st half of bite: Hannah walking)

AUDIO
SOT/FULL Super@:42 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:05
“We had some hints that there could be a genetic component to the risk of developing this toxicity.”

VIDEO
B-ROLL
Dr. Evans and Dr. Crews walking down hospital hallway, talking with co-authors, doctor looking into microscope, slides, cu of hand on microscope, pan of doctors talking

AUDIO
VO
Doctors William Evans and Kristine Crews from St. Jude Children’s Research Hospital and co-authors examined a large panel of genes in more than 300 children with A-L-L. They all received multiple courses of the anti-cancer drug, vincristine, over an extended period of time.

AUDIO
SOT/FULL Super@1:03 Kristine R. Crews, Pharm.D., – St. Jude Children’s Research Hospital Runs:08
“We found that a change in this gene, CEP72, made patients more at risk for developing the side effect to vincristine.”

GXF FULL
JAMA COVER

AUDIO
VO
The study appears in JAMA, Journal of the American Medical Association.

AUDIO
SOT/FULLSuper@1:15 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:14
“They have over a three times greater risk of developing this side effect of vincristine and it’s more severe when they do develop it, over twice as severe. Not only are their neurons more sensitive, therefore they get more toxicity, but their leukemia cells are more sensitive.”

(Video covering middle of bite: doctor looking into microscope)

VIDEO
B-ROLL
Doctors talking in lab

AUDIO
VO
Researchers are hoping to use this information to help reduce those side effects. Future studies are planned.

AUDIO
SOT/FULL Super@1:35 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:09
“To see if we can lower the dose of vincristine in those children, reduce their toxicity without compromising the success of their leukemia therapy.”

VIDEO
B-ROLL
Hannah working with physical therapist, braces on legs

AUDIO
VO
Hannah’s doctors say she is making great progress. She now has braces for her legs, making it easier for her to walk and she is looking forward to graduating high school this year.

AUDIO
SOT/FULL Super@1:53 Hannah Tate – Cancer Patient Runs:08
“I’m really excited about being finished with all of this. Hopefully next I’ll figure out what I want to do in college.”

(Video covering bite: Hannah working with therapist)

VIDEO
B-ROLL
Hannah doing exercises

AUDIO
Catherine Dolf, the JAMA Report.

TAG: This gene variant is present in about 16 percent of patients diagnosed and treated for A-L-L.

INTRO:Acute lymphoblastic leukemia (A-L-L) has a cure rate of more than 85 percent. However, one of the main medications used to treat this cancer can cause painful and sometimes debilitating nerve damage. These side effects can persist long after treatment has stopped. A new study examined whether differences in an inherited gene is associated with an increased risk of developing these side effects. Catherine Dolf explains in this week’s JAMA Report.

VIDEO
B-ROLL
Chemotherapy drug being transported from pharmacy, graphic of A-L-L

AUDIO
VO
Inside this plastic pouch, is a lifesaving chemotherapy drug on its way to a young patient diagnosed with acute lymphoblastic Leukemia or A-L-L.

AUDIO
SOT/FULL Super@:11 Kristine R. Crews, Pharm.D., – St. Jude Children’s Research Hospital Runs:10
“Vincristine is a very powerful chemotherapy agent but it has a terrible toxicity that’s called neuropathy.
Some children get very weak in their ankles and their feet and need support to walk.”

(Video covering middle of bite: physical therapist working on Hannah’s feet)

NATSO/FULL
Runs:04    “…as best you can get that heel out ok…”

VIDEO
B-ROLL
Hannah walking with physical therapist

AUDIO
VO
18 year-old Hannah Tate developed this debilitating side effect after being treated with vincristine for another type of cancer.

AUDIO
SOT/FULL Super@:37 Hannah Tate – Cancer Patient Runs:05
“First I noticed it in my feet. They were just weak, they kind a dropped, like I couldn’t pull my feet up, it’s really hard.”

(Video covering 1st half of bite: Hannah walking)

AUDIO
SOT/FULL Super@:42 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:05
“We had some hints that there could be a genetic component to the risk of developing this toxicity.”

VIDEO
B-ROLL
Dr. Evans and Dr. Crews walking down hospital hallway, talking with co-authors, doctor looking into microscope, slides, cu of hand on microscope, pan of doctors talking

AUDIO
VO
Doctors William Evans and Kristine Crews from St. Jude Children’s Research Hospital and co-authors examined a large panel of genes in more than 300 children with A-L-L. They all received multiple courses of the anti-cancer drug, vincristine, over an extended period of time.

AUDIO
SOT/FULL Super@1:03 Kristine R. Crews, Pharm.D., – St. Jude Children’s Research Hospital Runs:08
“We found that a change in this gene, CEP72, made patients more at risk for developing the side effect to vincristine.”

GXF FULL
JAMA COVER

AUDIO
VO
The study appears in JAMA, Journal of the American Medical Association.

AUDIO
SOT/FULLSuper@1:15 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:14
“They have over a three times greater risk of developing this side effect of vincristine and it’s more severe when they do develop it, over twice as severe. Not only are their neurons more sensitive, therefore they get more toxicity, but their leukemia cells are more sensitive.”

(Video covering middle of bite: doctor looking into microscope)

VIDEO
B-ROLL
Doctors talking in lab

AUDIO
VO
Researchers are hoping to use this information to help reduce those side effects. Future studies are planned.

AUDIO
SOT/FULL Super@1:35 William E. Evans, Pharm.D., – St. Jude Children’s Research Hospital Runs:09
“To see if we can lower the dose of vincristine in those children, reduce their toxicity without compromising the success of their leukemia therapy.”

VIDEO
B-ROLL
Hannah working with physical therapist, braces on legs

AUDIO
VO
Hannah’s doctors say she is making great progress. She now has braces for her legs, making it easier for her to walk and she is looking forward to graduating high school this year.

AUDIO
SOT/FULL Super@1:53 Hannah Tate – Cancer Patient Runs:08
“I’m really excited about being finished with all of this. Hopefully next I’ll figure out what I want to do in college.”

(Video covering bite: Hannah working with therapist)

VIDEO
B-ROLL
Hannah doing exercises

AUDIO
Catherine Dolf, the JAMA Report.

TAG: This gene variant is present in about 16 percent of patients diagnosed and treated for A-L-L.

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