Precision in Pediatric Sequencing (PIPseq) Program

Our Precision in Pediatric Sequencing (PIPseq) program is a customized treatment approach that has the potential to propel pediatric cancer care to new levels of success. PIPseq will identify the molecular drivers of each patient’s cancer and use this information to personalize his or her treatment using new, biologically targeted investigational agents.

What Makes Our Program Different

We Are Committed to Finding Answers

While tremendous progress has been made in the treatment of pediatric cancers, oncologists are still challenged by cancers that fail to respond to treatment or develop resistance to treatment and come back. The key to our success in the battle against these cancers lies in the biology of each child’s cancer. What mutations are driving its growth, or rendering it invulnerable to the standard therapies we try to use?

We Bring the Technology of Tomorrow to Today’s Patients

The mission of PIPseq clearly sets forth a path for using the most innovative technology to find real-world treatment solutions to each patient. Our mission includes:

  • Connecting patients with innovative laboratory-based technologies
  • Using the technology to create a comprehensive picture of a patient’s molecular makeup for every pediatric oncology patient we treat
  • Making clinical decisions for our patients based on the precise PIPseq results
  • Foster collaboration by experts throughout Columbia University Medical Center, The Herbert Irving Comprehensive Cancer Center and New York Presbyterian/ Morgan Stanley Children’s Hospital

Our Approach to Care

We Follow a Proven Process From Observation to Treatment

Our process for using PIPseq to find the appropriate therapy for a patient, based on their specific molecular profile, is simple but effective:

  1. Surgeons remove cancerous tissue for analysis
  2. Pathologists prepare biopsy samples
  3. Scientists perform the whole-genome sequencing, a process that looks at a patient’s body at a molecular and DNA level to find clues about what makes that patient different from others and what specific factors are driving their disease, and use those findings to pinpoint potential new therapies
  4. Geneticists help interpret the results
  5. Oncologists and pediatric oncology nurses administer personalized treatments

Avatars Are Our Pathway to the Future

A promising way to test the effectiveness of potential new drug treatments involves the creation of “avatar” laboratory models, in which a tumor from a patient grown in mice for evaluation. As part of the PIPseq program, our investigators are creating patient-derived xenograft models (human tumors grown in mice) using tissue samples from young patients with solid and hematologic (blood) cancers.

The avatar models can then be used to determine whether the gene mutations identified by PIPseq contribute to the cancer’s development. Avatars allow our researchers: 

  • To evaluate new drugs, with each avatar acting as its own miniature “clinical trial” of a single drug or drug combination, including investigational agents.
  • To pinpoint changes in the body that cause cancer development
  • To tailor therapies to target those changes

New York Presbyterian/Morgan Stanley Children’s is the only center in New York City routinely applying this technology to pediatric cancers.

Our Success Is in Our Stories

As an example of one of the PIPseq program’s successes, the Columbia researchers created an avatar for a toddler with an aggressive form of a cancer called infantile fibrosarcoma. The child did not have the genetic changes commonly known to be associated with this disease, so the researches set out to find out what was at the bottom of this cancer.

As a result of sequencing efforts through the PIPseq program, they identified and cloned a gene that had not before been associated with the tumor’s aggressive behavior. Insight offered by molecular and DNA information and creation of an avatar model of this tumor have allowed the clinicians to choose and test an effective chemotherapy regimen.

We are one of the only programs in the United States and the only one in New York to prospectively sequence cancers, create personalized avatars, and use the results to make clinical decisions for our patients. Our efforts to bring the technologies of tomorrow to our patients today have extraordinary implications for defining the way we will all care for children with solid tumors and hematologic malignancies in the future.