To date, one must conclude that the pace of progress in disease control and preservation of functional integrity and quality of life for pediatric brain tumors remains below that of most other major types of childhood cancers. In translating multiple innovative therapies from the laboratory to early phase clinical testing in pediatric patients with CNS diseases, our future PBTC clinical trials will focus more on understanding genomics related to the treatment of these tumors, as well as pharmacogenomics in PBTC phase II trials. The OBC is in the process of converting the computing infrastructure that supports the PBTC to the MediData Rave system and will definitely have it in place by the time the new grant period starts. We have already begun to utilize the NCI-sponsored Cancer Trials Support Unit (CTSU) for regulatory support. Patient registration for all PBTC trials initiated in the new grant period will be via the CTSU Oncology Patient's Enrollment Network (OPEN). Thus, these changes will facilitate closer collaborations with the COG, which is using MediData Rave and the CTSU. This will facilitate providing data from PBTC trials to the COG for the implementation of subsequent trials. In addition, these systems provide a means for facilitating selected COG member institutions to participate in PBTC trials that require accrual of patients with very rare CNS tumors, as may be required for trials of new agents that target tumors with specific pathways activated or with specific genetic abnormalities. The Mission of the PBTC is to contribute rapidly and effectively to the understanding and cure of pediatric CNS tumors through innovative, multidisciplinary, multi-Institutional clinical trials based upon evolving knowledge of brain tumor biology and using study designs and analyses based on state-of-the-art statistical science. The PBTC is committed to integrating clinical trials with correlative pharmacology, biology, neuroimaging and genomics studies. PBTC investigators recognize their profound responsibility to study the special needs of their patients and families, as they face enormous challenges during and after therapy.
Central nervous system (CNS) tumors represent 20% of childhood cancers, but are the leading cause of cancer-related childhood deaths. Five-year overall survival (OS) in children with diffuse intrinsic pontine glioma (DIPG), high-grade gliomas, (HGG), ependymoma (EP) or medulloblastoma (MB) are 10%, 20%, 60% and 70% respectively, with dismal outcome for patients with recurrent disease.
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