6.2.3.a. Major strengths and research opportunities The five programs in the SJCCC comprise multidisciplinary groups of faculty who share common interests in their respective programmatic focus. Through decades of laboratory and clinical research, these programs have focused on the most common and challenging of childhood cancers and evolved into world-renowned enterprises that have shaped the treatment of these diseases across the globe. The success of our Center is driven by its five major strengths: (i) Our mission: For 50 years SJCRH has existed for the sole purpose of finding cures for children with cancer and other catastrophic diseases. Our principal focus is cancer. Each year, over 75% of our institution's resources are dedicated to the research and treatment of childhood cancer. Our founders and first hospital leaders determined that all clinical research conducted at SJCRH would be informed directly by an equally resourced basic laboratory effort and that our patients would be treated primarily on prospective clinical trials designed to drive the field forward, rather than by 'standard of care'. In this mission, we accept patients without regard to race, religion or ability to pay. This ethos, and our partnership with the federal and public communities, has created in the SJCCC a unique, national resource which attracts children with the most challenging of cancers and the brightest minds to understand and treat them. (ii) Our patients: Our research is mission-driven. Therefore, we invest heavily to treat and study patients recruited through well-coordinated institutional trials, as well as private and federally funded consortia. During the last five years, 56% (18,139 [2,317 interventional + 16,002 non-interventional]/ 32,522) of all clinical trial enrollments in the Center were to SJCCC investigator initiated studies. In addition, external peer reviewed trials, many of which are SJCCC member-led, accounted for another 38% of enrollments (1,521 interventional + 10,805 non-interventional). In keeping with our mission, our trials not only deliver cutting edge therapies, but invariably conduct innovative cancer biology, imaging, pharmacology, observational and other important research. This effort is facilitated and propagated by our Programmatic translational pipelines that yield unprecedented data to shape successive generations of clinical trials. (iii) Our people: Our mission, patient populations, resources and reputation consistently attract and retain the brightest minds in the world focused on the problem of pediatric cancer. The 156 members of our Center include some of the world's leading scientists and clinicians studying and treating childhood cancers. Among these, our Co-Leaders have served our Center for a combined total of over 170 research years, bringing stable leadership and cutting-edge research to our mission. In the atrium of the Danny Thomas building hangs the flags of 100 countries, representing the homelands of our employees: we recruit globally for the best talent. Being an NCI designated comprehensive cancer center is a critically important imprimatur that allows us to recruit outstanding people. (iv) Our resources: For 47 of our 50 year history, our Center has benefited from the support of NCI Cancer Center funding. These monies have helped build and maintain critical shared resources that have contributed to all research disciplines in our Center. SJCRH is one of the few non-profits, and the only freestanding NCI designated cancer center, to be listed by Fortune Magazine as one of the Top 100 Best Places to Work in the US. This reflects our institution's commitment to recruit and retain outstanding people. Our institution has also provided unrivalled resources to the SJCCC. During the last funding cycle, 100s of millions of institutional dollars have been invested in our Center including special projects such as the Pediatric Cancer Genome Project ($65M in the first three years, $30M over the next two years). Department of Chemical Biology and Therapeutics (>$60M to launch this department), and SJLIFE protocols (>$15M in first 5 years). This broad based investment has enabled our members to make new discoveries and open new avenues of research in our mission to identify cures for all children with cancer. (v) Our collaboration (Figure 6.9): Our focus on childhood cancers, that are all rare diseases, demands a collaborative culture in which members freely share ideas, technologies, projects and data. Our Programs are designed with this specific intent (Section 6.2.2.e., and below) and our institution is governed in a manner that recognizes and rewards mission-driven, team science. Our major strengths provide the Center with its greatest opportunities. More than ever, our three disease oriented Programs are positioned to continue their development of biology-based, progressive treatments for the most common and challenging pediatric leukemias, solid and brain tumors. Our large patient cohorts, including our long-term survivor groups, also afford us the unique opportunity to characterize and mitigate the specific life-long health challenges of childhood cancer survivors. And our comprehensive efforts in basic cancer biology, including mapping of the pediatric cancer genome and novel drug discovery efforts, promise continued opportunities to find cures for all children

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