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How an aquarium pet became a scientific star in childhood cancer research

A Q&A with Seth Corey, the new chief of pediatric hematology and oncology, on the role of zebrafish in medical research and more

Seth Corey, M.D., M.P.H., joined VCU Massey Cancer Center and Children’s Hospital of Richmond at VCU (CHoR) in October 2015 as the chief of the Division of Hematology, Oncology, and Stem Cell Transplantation in the Department of Pediatrics. He is also the inaugural Children’s Hospital Foundation Endowed Chair in Pediatric Cancer Research, which is funded by a large grant from Children’s Hospital Foundation and a gift from Connor’s Heroes. Additionally, he is the co-leader of Massey’s Cancer Molecular Genetics research program and a professor of pediatrics and microbiology/immunology at the VCU School of Medicine. A board-certified pediatric oncologist and cancer researcher, Corey specializes in leukemias, bone marrow failure, and stem cell transplantation. He leads a research lab that studies myeloid malignancies ranging from pre-leukemic states such as inherited bone marrow failure to myelodysplastic and/or myeloproliferative neoplasms like acute myeloid leukemia. He is currently studying zebrafish to identify genetic factors in patients with Shwachman-Diamond Syndrome, an inherited bone marrow failure disorder. His work has been published in a wide variety of peer-reviewed journals, including Blood, Cancer Research and Immunity, and his research has been funded by multiple organizations, including the National Institutes of Health, the Leukemia and Lymphoma Society and the Department of Defense.

Corey came to VCU from Northwestern University in Chicago, where he was a professor in pediatrics and cell and molecular biology and the Sharon Murphy-Steven Rosen Professor of Cancer Biology and Chemotherapy at the Feinberg School of Medicine. Also, he was previously the director of oncology research at Children’s Memorial Hospital and the Robert H. Lurie Comprehensive Cancer Center, Departments of Pediatrics and Cellular and Molecular Biology. Corey earned a bachelor’s degree at Yale University and both his M.D. and M.P.H. degrees from Tulane University. He served his residency at the St. Louis Children’s Hospital and Washington University School of Medicine and completed his fellowship at Boston Children’s Hospital/Dana-Farber Cancer Institute.

How common is childhood cancer, and are there genetic factors that predispose children to the disease?
One in 3,000 children will get cancer in the U.S., and there are approximately 15,000 new cases of pediatric cancer each year. When cancer develops in a child, it is unlikely due to environmental factors. Through genetic sequencing of 500 different genes, we’re beginning to understand more and more that there is a genetic predisposition to cancer, although it is not the predominant reason. Because of the growing power of genetic information, we started a Bone Marrow Failure and Cancer Susceptibility Clinic at CHoR this summer.

What initially interested you in treating and researching childhood cancer?
As a medical intern, I cared for a 6-year-old girl with aplastic anemia. Her bone marrow failure stimulated my interest in blood production, which led me to focus on myeloid leukemias and related diseases.

What attracted you to VCU?
I was attracted to the opportunity to make an impact on pediatric hematology, oncology and stem cell transplantation by helping a clinically excellent division rise to the next level of national recognition as a program of excellence for children and adolescents with pediatric cancer and blood disorders.

What plans do you have for the pediatric hematology-oncology division? 
I plan to bring innovative services and therapies to our patients; establish a more academically productive group; build larger research and clinical bridges with our adult oncology colleagues; and mentor the fellows and junior faculty to become the next generation of pediatric physician-scientists and clinical investigators in hematology, oncology and stem cell transplantation.

What should parents know about what to expect regarding the care your team will provide to their child? 
We will treat your child as the most important person in the world, providing our full attention and offering the very best and latest therapies. 

What exciting advances are on the horizon for pediatric cancer?
While we have been able to make cancer a curable disease for the majority of our patients, our goal is to cure every child. Important advances are in identifying the mutational landscapes of pediatric tumors, developing and applying molecular targeted therapies, using next generation sequencing to predict disease progression and to intervene more effectively, and to incorporate immunotherapy in front-line treatment.

How are your studies contributing to the medical community’s understanding of the causes of and treatments for pediatric cancer?
A focus of my research interest is inherited bone marrow failure syndromes such as Shwachman-Diamond Syndrome and Severe Congenital Neutropenia. Children with these syndromes have a greatly increased risk of developing leukemia. My research team wants to know why, to better understand biology and better develop diagnostic tests or chemo-preventative measures to prevent cancer from forming at all.

By manipulating the zebrafish system using a new technique called CRISPR genome editing, we can zero in on a certain component of the gene and mutate it. Using this method, we created fish that display the features of Shwachman-Diamond Syndrome. We are trying to figure out if these fish will be more likely to develop cancer. We also are treating fish with chemical carcinogens to see if they develop cancer. If so, we can sequence the genes to determine which ones cause leukemia. Then we can do surveillance on these genes in children and practice preventive medicine.

Why conduct research with zebrafish?
To speed up discovery and innovation that will impact children’s health, we study animal models of human disease. We can genetically or chemically manipulate them. Zebrafish are being used more and more to study a variety of human conditions and diseases, including cancer, cardiac and vascular defects, brain development and even infections like tuberculosis. Zebrafish lay hundreds of eggs at a time, develop in four days and are easy to genetically manipulate. They also are vertebrates (backbones) and have gene sequences that may be as much as 90 percent similar to humans.

Without laboratory-based research, there is no progress. Without research, our quality of life would not be as good as it is today. Without research, we wouldn’t have cancers that are being cured and with less side effects.

How is philanthropic support allowing you to advance the work of your division?
When I write a grant, it may take a year to get the funds, which is a year without progress. If you’re a parent of a child with cancer, you can’t wait a year. The time is now. Philanthropic support is allowing me to advance research more quickly.

I think we have the best, strongest and broadest academic pediatric oncology program in Virginia. We will offer leading advances in pediatric cancers and blood disorders, and philanthropic support will be critical to allowing us to recruit the best physicians, develop cutting-edge therapies to find and eradicate cancer cells and tailor therapies to be more effective and less toxic. Philanthropy is critical to research. It drives most of scientific discovery.

What do you like to do in your spare time? 
I enjoy traveling, theatre and music. And now that I am in Richmond, I may buy a bike and ride along the river. 

Written by: Jenny Owen

Posted on: July 7, 2016

Category: Research