Advanced Molecular Diagnostics (AMD)

Despite significant progress made in the treatment of children with cancer, it remains the leading cause of disease related death in children, with significant short and long term morbidities due to treatment toxicity. Assessment of minimal residual disease in these cases can profoundly refine risk-directed therapy to guide treatment decisions. Identifying non-responders to current therapy, subsequently switching regimens, could save precious time as well as spare adverse side-effects resulting from a non-effective therapy. Similarly, the ability to identify early disease recurrence would enable earlier intervention and superior outcome. Our approaches include techniques to identify any cancer cell DNA circulating in the body (liquid biopsy), resulting in cheaper, less invasive and more sensitive monitoring of cancer occurrence, response to therapy and recurrence leading to improved patient survival.

The research team

> Dr Jonathan Karpelowsky, Advanced Molecular Diagnostics team leader, email: Jonathan.Karpelowsky@health.nsw.gov.au

Jonathan is a Paediatric Surgical Oncologist at the Children’s Hospital at Westmead and Conjoint Associate Professor at the University of Sydney. He dedicates his clinical career to improving the outcomes of children and adolescents with solid tumours. Understanding the clinical challenges in treating cancer enables him to ask translational questions in order to improve the care of these patients. Through his basic science work on liquid biopsies he is hoping to translate this exciting novel technology to impact on treatment paradigms in children with solid tumours.

More information can be found on Jonathan's University of Sydney profile page.

> Other research team members:

• Dr Bopesh Bollu, Masters Student

• Dr Smadar Kahana-Edwin, post-doctoral researcher

Key publications

Elevated Preoperative Neutrophil Lymphocyte Ratio is Predictive of a Poorer Prognosis for Pediatric Patients with Solid Tumors. Nayak, A., McDowell, D., Kellie, S., Karpelowsky, J. (2017).  Annals of Surgical Oncology, 24(11), 3456-3462.

Five lessons in uncomplicated appendicitis: Can we remove the surgery?  Read, A., Xu, J., Adams, S., Karpelowsky, J. (2017). Journal of Paediatrics and Child Health, 53(11), 1127-1130.

Hirschsprung disease.  King, S., Karpelowsky, J. (2017).  ANZ Journal of Surgery, 87(10), 754.

Management for intussusception in children.  Gluckman, S., Karpelowsky, J., Webster, A., McGee, R. (2017).  Cochrane Database of Systematic Reviews, 2017 (6), 1-54.

Nonoperative management in children with early acute appendicitis: A systematic review.  Xu, J., Adams, S., Liu, Y., Karpelowsky, J. (2017).  Journal of Pediatric Surgery, 52(9), 1409-1415.

Papillary thyroid cancer in childhood: is parental screening helpful? Stephenson, C., Norlen, O., Shun, A., Karpelowsky, J., Robinson, B., Delbridge, L. (2017).  ANZ Journal of Surgery, 87(7-8), 615-618.

Patterns of reflux in gastroesophageal reflux disease in pediatric population of New South Wales.  Narayanan, S., Cohen, R., Karpelowsky, J. (2017).  Diseases of the Esophagus, 30(2), 1-8.

Pediatric transplantation: An international perspective. Collin, M., Karpelowsky, J., Thomas, G. (2017).  Seminars in Pediatric Surgery, 26(4), 272-277.

Reducing the incidence of hepatic artery thrombosis in pediatric liver transplantation: Effect of microvascular techniques and a customized anticoagulation protocol.  Ziaziaris, W., Darani, A., Holland, A., Alexander, A., Karpelowsky, J., Barbaro, P., Stormon, M., O Loughlin, E., Shun, A., Thomas, G. (2017). Pediatric Transplantation, 21(4), 1-7.

A full list of publications can be found here.