Her parents, Josiane and Sgessiel, took her to the hospital and over the subsequent weeks Giovanna, who is known affectionately as Gio, underwent several scans and blood tests. A cloudy mass was discovered near her right lung and after a biopsy, it was confirmed as neuroblastoma, a childhood cancer that is usually seen in younger children. The disease originates from developing nerve cells.
鈥淭hroughout all the tests, the doctors were open with us that it could be cancer,鈥 Gio bravely explains. 鈥淲e knew it was a possibility, but it was still a shock when they said those words and I was really scared.鈥
Sgessiel added: 鈥淚t was awful. Gio was a healthy, active, child. She was always playing sports and eating the right things. You just don鈥檛 think it could happen to you. We were devastated.鈥
Gio underwent chemotherapy. She experienced sickness and lost her hair 鈥 something that she was very worried about. However, her friends rallied around her, and they even shaved their heads in solidarity.
鈥淐hemo was really hard,鈥 Gio added. 鈥淚 was in hospital a lot and missed a lot of school. I couldn鈥檛 believe my friends when they arrived at my home with no hair! They have really helped me. The chemo reduced the tumour but not as much as the doctors wanted.鈥
Gio then took part in a trial of new medication which is known to have a good response to neuroblastoma. However, the side effects of the medication, which included hallucinations, became too much for Gio and she had to be put back onto a regular cycle of chemotherapy.
It was then, that her doctor suggested taking part in the MiNivAN trial at the University of Southampton.
Led by Professor Juliet Gray, at the Centre for Cancer Immunology, the MiNivAN study combines 131-I mIBG targeted radiation therapy with two different antibodies, Nivolumab and Dinutuximab beta.
Dinituximab beta, an anti-GD2 antibody, has been widely used in neuroblastoma and targets the cancer cells, allowing them to be seen and killed by one鈥檚 own immune system.
In contrast, Nivolumab targets the immune system rather than the tumour itself, boosting the body鈥檚 immune response to the cancer.
The study is led by the team in Southampton, in collaboration with colleagues in London, US and Germany and patients with neuroblastoma from across the UK have travelled to Southampton to take part in the study. It is it funded by a consortium of charities including Solving Kids Cancer UK, J.A.C.K and Band of Parents. It aims to test whether this combination of antibodies can be given together with the mIGB therapy, with the aim that the complementary effects will enhance the immune the effects and leave children with long-term immunity against their disease.
The study was launched in 2018 and has recently finished recruiting. Gio, who is now 14, is one of the last patients to receive the treatment and is expected to complete the trial in February.
鈥淭he trial has been a positive experience so far. I鈥檝e felt well enough to continue to dance and sing with my church group, who have been so supportive. That鈥檚 been very important in my overall wellbeing. When I鈥檓 dancing and singing, nothing else matters, so to be able to continue has been a gift.鈥
Giovanna
Professor Juliet Gray said: 鈥淪adly, high risk neuroblastoma is one of the most challenging childhood cancers, with less than half of children surviving this aggressive disease despite really intensive treatment. New and less toxic treatments are desperately needed.
鈥淲ork in the laboratory has shown that combining radiation therapy with two different types of antibodies, one which targets the tumour and one which targets the immune system, is potentially a very powerful way of eradicating neuroblastoma tumours and they appear to work together to generate strong, protective immunity to the tumour. This is what we are testing in the MINivAN trial.鈥
鈥淲e are really pleased to have finished recruiting for the trial, which has been a massive undertaking by everyone involved due to the number of centres involved. We are really encouraged by some of the results we鈥檝e seen. We will now analyse all the data to establish whether we have the evidence to test this treatment further in larger trials. We鈥檇 like to thank all the patients and families who has taken part in the trial and helped us to try and find new and better ways to treat this really difficult cancer.鈥
The Centre for Cancer Immunology, which opened in 2018, was the first centre dedicated to immunology research. Entirely funded through philanthropy, the Centre aims to push the boundaries of cancer research and drive forward new, life-saving immunology treatments.