Finding answers, faster 

“Providing an earlier diagnosis has several advantages,” says Peet.  

First, it could support surgeons to conduct more precise surgeries to remove tumours. “It might be possible to conserve more brain tissue in lower-risk tumours,” explains Peet. “These are important considerations, particularly because we’re dealing with developing brains.” 

Second, it could support doctors to pick the best treatment plan for their patients. “Medulloblastoma often needs complicated, multimodal treatment,” he says. “It’s important to match patients to the right treatment as quickly as possible.” 

And third, it could give families valuable information at a time when uncertainty can be difficult to manage.  

“Working with families who are in the midst of intolerable uncertainty has shown me how important it is to share early, accurate information about prognosis and next steps,” says Peet. “Providing clinicians with tools to have those discussions would be immensely beneficial.” 

Jack’s story  

This sort of information could be transformative for children like Jack, who was diagnosed with medulloblastoma in March 2023, when he was six.   

Jack had surgery within 24 hours of doctors noticing his tumour and a sample was sent to the lab for analysis.  

But it took a month to determine what treatment he should have. Jack received chemotherapy while waiting, before switching to the radiotherapy that would work best for his cancer.   

While waiting for the results, “it was such a worrying time,” says Jack’s mum, Suzanna. “If this new research can help other families, it would make a huge difference.”

Now, Jack is doing well. He still needs to use a wheelchair as he gets tired and has difficulties with balance but is back at school full time now. He has scans every four months, medication to help his energy and hormone injections that he will take for life.   

“He could barely take steps a year ago and now he’s running,” says Jack’s dad, Tom. “He does fall sometimes but he picks himself up every time – usually with a smile. It’s amazing when you think where he was.”   

He also loves Minecraft, Lego and going to the trampoline park. “He is his cheeky old self, says Suzanna. “He’s doing all he can to be a normal eight-year-old.” 

Personalising treatment for patients  

Clifford, Peet and the team are now fine-tuning their scanning technique so that it captures as much information as possible. They’re also working on a prototype computer system that could support doctors to understand MRS data and help them reach an accurate diagnosis.  

And they continue to unlock new information about the different types of medulloblastoma.  

“We’ve made some major discoveries, including identifying a number of additional subgroups with specific features and behaviours that could be treated differently,” says Clifford.  

For example, one subtype of SHH medulloblastoma gives a much higher risk for patients. There also seem to be subtypes within the SHH, Group 3 and Group 4, which may need less intense treatment to achieve the same positive outcomes.  

The team’s findings are forming the basis of their next European clinical trial, where they’ll test personalised medicines based on these discoveries – with patients in “lower risk” groups receiving a lower intensity of chemotherapy and radiotherapy. 

This could be key to matching patients to the most appropriate treatment, ensuring patients who need intense treatment receive it, while minimising long-term side effects for others who might not benefit.  

Looking ahead to future breakthroughs  

Talking with Clifford and Peet, it’s clear that there are so many avenues to this research. They’re all central to understanding children’s and young people’s cancers as early as possible, so they can be precisely matched to the most appropriate treatment.  

As Peet reflects on how far we’ve come since the start of his career and where the coming decades could take us, he’s particularly interested in what the different subtypes are telling us.  

Could they lead us to new, targeted treatments? 

“We’ve discovered these patterns in medulloblastoma – they’ve got to be telling us something about the underlying chemical pathways,” he says. “Surely if these pathways are needed for the tumour to grow, we’ve also got the opportunity to develop targeted drugs that disrupt them.” 

Peet's vision is that, one day, we could use imaging technique like MRS to understand a patient’s tumour chemistry, give them a targeted drug to treat it, and then use follow up imaging to see that the treatment is working – all without the need for invasive brain surgery.  

“Because at the end of the day, it’s great to have these breakthroughs in the lab,” says Peet, “but using them to make a difference to children and their families is what really matters.” 

Professor Andrew Peet has now retired from clinical practice.