The project proposes continuation of a comprehensive pediatric oncology program at Childrens Hospital of Los Angeles (CHLA). This program is designed to improve the treatment of children with cancer by conducting clinical investigations as a member of the Childrens Cancer Study Group (CCSG) and by independently conducting other research which is directly related to the mission of CCSG. CHLA is a major pediatric referral center for the Pacific Southwest and has one of the largest pediatric oncology services in the nation. An interdepartmental program has developed which involves basic and clinical scientists and has evolved into a multidisciplinary model for the management of pediatric cancers. Participation of investigators of CHLA in CCSG enables quantitative comparative clinical investigations aimed at establishing the best mode of any cancer therapy. The unique resources of CHLA permit development of new therapeutic approaches for groupwide application. These include participation of NCI Phase I Working Group and the Late Effects Study Group, the evaluation of new dose schedules and combination of established agents predicted by in vitro and in vivo pharmacological studies, immunological characterization of selected neoplasms, effects of cancer and its treatment on hematopoiesis, intensive chemotherapy in the protected environment, optimum nutritional support in childhood malignancies, approaches to psychosocial rehabilitation of the pediatric cancer patient and family, and preclinical studies in molecular and cellular pharmacology, tumor cell biology, carcinogenesis and chemoprevention, in vitro and invivo tumor model systems. A network of community physicians participates in the CCSG Cancer Control Program for Clinical Cooperative Groups under the sponsorship of CHLA which enables the use of optimal therapy in children who are not referred for initial cancer care. Through the propsed continuation, the comprehensive program at CHLA will seek as its ultimate goal an integrated therapeutic and investigative approach to childhood cancer.
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