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The Paediatric Hepatic International Tumour Trial is recruiting patients diagnosed with hepatoblastoma and hepatocellular carcinoma.

The Paediatric Hepatic International Tumour Trial (PHITT), which opened in August 2017, is continuing to recruitment patients, with eight registered to date. PHITT, which is being coordinated by the University of Birmingham’s Cancer Research UK Clinical Trials Unit, will be operating in 13 European countries and aims to recruit 300 patients.   

Hepatoblastoma (HB) and hepatocellular carcinoma (HCC) are very rare liver cancers that account for 1% of paediatric cancers. Around two children in every million are diagnosed every year. The prognosis for children with liver cancer depends on the nature of their disease with survival rates ranging from approximately 50% to 100%.

Current treatment regimens can expose children and young adults to significant toxicities, for example cisplatin-induced hearing loss, kidney problems, heart problems, and secondary leukaemia.

PHITT, which underpins the Children’s Liver Tumour European Research Network (ChiLTERN), will examine whether reductions in therapy can reduce the risk of toxicities without compromising the outcome in good risk patients. It will also evaluate the efficacy of new regimens for patients where the prognosis is poor.

Professor Keith Wheatley, the ChiLTERN Project Coordinator from the University of Birmingham, said: “PHITT is the core part of the ChiLTERN project, which will be the most comprehensive research project ever undertaken in childhood liver cancer. There are experts from many specialities collaborating, including oncologists, surgeons, laboratory scientists, clinical trialists and lay people.”

PHITT is the largest HB and HCC clinical trial ever undertaken among the paediatric population recruiting patients from Europe, the USA and Japan. Within the UK, patients will be recruited from 19 hospitals, including the West Midlands’s Birmingham Women’s and Children’s NHS Foundation Trust and University Hospitals Birmingham NHS Foundation Trust.

Professor Bruce Morland from Birmingham Children's Hospital, Chief Investigator for PHITT, said: “PHITT is an amazing achievement built on a strong international collaborative effort. To be able to undertake such a trial in a very rare population of patients is impressive. We will establish new gold standards for treatment in the process as well as collecting a large volume of biological material which will guide our understanding of these tumours to new levels.”

ChiLTERN is funded by the European Union’s Horizon 2020 research and innovation programme and was awarded €7.9m awarded in 2015. It aims to cure more children with liver cancer, expose fewer children to toxic chemotherapy and ensure their surgery is both effective and safe.

Global collaboration is critical to ChiLTERN’s success. During the course of the project it will bring together over 20 collaborators from across the world, including the Children’s Oncology Group in the United States, the Japanese Children’s Cancer Group in Japan and International Society of Paediatric Oncology in Europe.