The eight-year project named LiBRha was ranked first in a July 2025 competition organised by the Polish Medical Research Agency for non-commercial projects with high implementation potential.

Titled “Liquid biopsy and comprehensive molecular testing of paediatric soft tissue sarcoma in Poland to improve diagnosis, risk stratification and outcome,” LiBRha will be carried out between 2025 and 2033 with a budget of more than PLN 26.2 million.

The consortium is led by the Medical University of Wrocław and involves 18 paediatric oncology and haematology centres across the country. According to the organisers, the scale of the project reflects an effort to systemically reorganise the diagnosis and monitoring of soft tissue sarcomas in children.

“We want access to full molecular diagnostics and liquid biopsy not to concern individual centres, but to be an element of everyday clinical practice throughout the country,” said Professor Bernarda Kazanowska, head of the project and a specialist from the Department and Clinic of Bone Marrow Transplantation, Paediatric Oncology and Hematology at the Medical University of Wrocław.

“Soft tissue sarcomas are rare and require extensive diagnostic experience and close cooperation between teams. This project is intended to create such conditions at the system level,” she added.

Soft tissue sarcomas are a highly heterogeneous group of malignant tumours that account for about 7 percent of all cancers in children. Despite advances in treatment, diagnosis and risk assessment still rely largely on histopathology, imaging and basic clinical factors.

“In many cases, we still rely mainly on histopathology, classic imaging and clinical factors such as age, tumour location or stage of disease advancement,” Kazanowska said. “This is not enough if we want to really precisely assess the response to treatment, the risk of recurrence, and reduce the toxicity of therapy in a specific child.”

LiBRha is designed as a prospective, multicentre study covering all paediatric oncology and haematology centres in Poland. Children diagnosed with soft tissue sarcoma will be treated according to a uniform diagnostic and therapeutic protocol.

The project introduces comprehensive molecular profiling into routine clinical practice, including whole genome sequencing, whole exome sequencing, transcriptome analysis and DNA methylation studies. According to the researchers, these tools will allow for more precise diagnoses, identification of prognostic and predictive markers and refined risk stratification that goes beyond traditional low-, intermediate- and high-risk categories.

A central innovation of LiBRha is the nationwide implementation of liquid biopsy for children with rhabdomyosarcoma. Liquid biopsy is based on the analysis of circulating tumour DNA in the blood and enables non-invasive monitoring of the disease over time.

“Liquid biopsy allows us to look at the ‘molecular life’ of the tumour without having to repeat surgical procedures and exposing the child to additional anaesthesia and the risk of complications,” Kazanowska said. “It allows to detect and monitor residual disease, identify lack of remission or early recurrence before it is visible in imaging and clinical tests.”

The Medical University of Wrocław serves as the clinical leader of the project and is responsible for coordinating research activities, collecting clinical data and analysing outcomes.

The Medical University of Lodz is the second main pillar of the consortium and acts as the central reference centre for pathology and molecular diagnostics. Biological material from all participating centres will be analysed there using standardised histopathological and molecular methods, a move intended to ensure consistency in diagnosis and treatment decisions nationwide.

As part of the project, a national biobank of paediatric soft tissue sarcoma material will also be established in Łódź. It will include tumour tissue as well as blood, bone marrow and cerebrospinal fluid samples and is expected to support future translational and international research.

The third key partner is the “Rescue Children with Cancer” Foundation, which is responsible for developing a nationwide data management system and coordinating a network of data administrators overseeing the quality, completeness and security of medical data.

“Rare childhood cancers require an extremely thoughtful approach,” Kazanowska said. “We cannot afford to make random decisions, because the margin of error is very narrow. LiBRha is expected to provide us with tools thanks to which each therapeutic decision will be as biologically and clinically justified as possible.” PAP

Roman Skiba

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