During the past four decades, survival rates and cure for childhood cancer have improved dramatically. Previously a nearly uniformly fatal disease when not amenable to surgical management alone, cancer is now curable in the majority of children. This improvement is a direct result of the collaborative efforts of clinical and laboratory investigators in the context of cooperative, multi-center clinical trials. Further significant improvements in overall survival have been recently attained in some specific pediatric cancers. However, improvement has not been observed in all diagnostic types of childhood cancer. Recognizing the need to accelerate progress despite the difficulties encountered with limited patient numbers and constrained resources, the Children's Oncology Group (COG) successfully elected to unify its efforts to develop a coordinated and robust research agenda without sacrificing the progress that had resulted from previous competitive strategies in specific disease areas. Major refinements in risk classification based on expanded understanding of disease and host biology in larger numbers of patients have resulted from these efforts. Refinements in the definition of risk groups and increasing subgroups of patients and rare cancer types necessitate even more cooperation. Therapeutic intensification from augmentation of conventional agents and schedule modification is unlikely to result in further improvement, providing a compelling justification and emergent need to enhance correlative biologic investigation and accelerate the process of identification and validation of molecular targets in specific pediatric cancers. Moreover, incremental progress requires that pediatric cancer clinical investigation fully exploit evolving developments in molecular cancer therapeutics in a more rapid drug development paradigm than heretofore utilized for childhood cancer, especially for those types resistant to conventional therapies;this is also required to reduce the potential for significant acute and long-term sequelae associated with current therapy. In order to achieve its mission to cure and prevent childhood cancer, the COG will design and conduct clinical trials that will continue to define evidence-based care standards, conduct laboratory investigations into cancer biology and variability in host response to treatment and translate these findings into new, more effective and less toxic treatments. We will identify causes of childhood cancer and develop strategies aimed at cancer prevention. Finally, we will evaluate therapeutic interventions with a goal of improving the quality of life and survivorship in infant, children, adolescents and young adults with cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
7U10CA098543-10
Application #
8255647
Study Section
Subcommittee G - Education (NCI)
Program Officer
Smith, Malcolm M
Project Start
2003-07-07
Project End
2014-02-28
Budget Start
2012-04-13
Budget End
2013-02-28
Support Year
10
Fiscal Year
2012
Total Cost
$27,140,285
Indirect Cost
$1,548,634
Name
Children's Hospital of Philadelphia
Department
Type
DUNS #
073757627
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Hastings, Caroline; Gaynon, Paul S; Nachman, James B et al. (2015) Increased post-induction intensification improves outcome in children and adolescents with a markedly elevated white blood cell count (?200 × 10(9) /l) with T cell acute lymphoblastic leukaemia but not B cell disease: a report from the Children's Oncology Br J Haematol 168:533-46
Dreyer, ZoAnn E; Hilden, Joanne M; Jones, Tamekia L et al. (2015) Intensified chemotherapy without SCT in infant ALL: results from COG P9407 (Cohort 3). Pediatr Blood Cancer 62:419-26
Tilan, Jason U; Krailo, Mark; Barkauskas, Donald A et al. (2015) Systemic levels of neuropeptide Y and dipeptidyl peptidase activity in patients with Ewing sarcoma--associations with tumor phenotype and survival. Cancer 121:697-707
Lerman, Daniel M; Monument, Michael J; McIlvaine, Elizabeth et al. (2015) Tumoral TP53 and/or CDKN2A alterations are not reliable prognostic biomarkers in patients with localized Ewing sarcoma: a report from the Children's Oncology Group. Pediatr Blood Cancer 62:759-65
Whitlow, Puja G; Caparas, Mae; Cullen, Patricia et al. (2015) Strategies to improve success of pediatric cancer cooperative group quality of life studies: a report from the Children's Oncology Group. Qual Life Res 24:1297-301
Salzer, Wanda L; Jones, Tamekia L; Devidas, Meenakshi et al. (2015) Decreased induction morbidity and mortality following modification to induction therapy in infants with acute lymphoblastic leukemia enrolled on AALL0631: a report from the Children's Oncology Group. Pediatr Blood Cancer 62:414-8
Servaes, Sabah; Khanna, Geetika; Naranjo, Arlene et al. (2015) Comparison of diagnostic performance of CT and MRI for abdominal staging of pediatric renal tumors: a report from the Children's Oncology Group. Pediatr Radiol 45:166-72
DuBois, Steven G; Krailo, Mark D; Gebhardt, Mark C et al. (2015) Comparative evaluation of local control strategies in localized Ewing sarcoma of bone: a report from the Children's Oncology Group. Cancer 121:467-75
Dharmarajan, Kavita V; Friedman, Debra L; Schwartz, Cindy L et al. (2015) Patterns of relapse from a phase 3 Study of response-based therapy for intermediate-risk Hodgkin lymphoma (AHOD0031): a report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys 92:60-6
Wagner, Lars M; Fouladi, Maryam; Ahmed, Atif et al. (2015) Phase II study of cixutumumab in combination with temsirolimus in pediatric patients and young adults with recurrent or refractory sarcoma: a report from the Children's Oncology Group. Pediatr Blood Cancer 62:440-4

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