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 #
3U10CA098543-10S3
Application #
8520442
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
$176,626
Indirect Cost
$4,644
Name
Children's Hospital of Philadelphia
Department
Type
DUNS #
073757627
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Marks, Lianna J; Pei, Qinglin; Bush, Rizvan et al. (2018) Outcomes in intermediate-risk pediatric lymphocyte-predominant Hodgkin lymphoma: A report from the Children's Oncology Group. Pediatr Blood Cancer 65:e27375
Dicken, Bryan J; Billmire, Deborah F; Krailo, Mark et al. (2018) Gonadal dysgenesis is associated with worse outcomes in patients with ovarian nondysgerminomatous tumors: A report of the Children's Oncology Group AGCT 0132 study. Pediatr Blood Cancer 65:
Hawkins, Douglas S; Chi, Yueh-Yun; Anderson, James R et al. (2018) Addition of Vincristine and Irinotecan to Vincristine, Dactinomycin, and Cyclophosphamide Does Not Improve Outcome for Intermediate-Risk Rhabdomyosarcoma: A Report From the Children's Oncology Group. J Clin Oncol 36:2770-2777
Williams, Lindsay A; Pankratz, Nathan; Lane, John et al. (2018) Klinefelter syndrome in males with germ cell tumors: A report from the Children's Oncology Group. Cancer 124:3900-3908
Rajbhandari, Presha; Lopez, Gonzalo; Capdevila, Claudia et al. (2018) Cross-Cohort Analysis Identifies a TEAD4-MYCN Positive Feedback Loop as the Core Regulatory Element of High-Risk Neuroblastoma. Cancer Discov 8:582-599
Ehrlich, Peter F (2018) Reply to: Synoptic operative reports for quality improvement in pediatric cancer care: Surgical protocol violations in children with renal tumors provides an opportunity to improve pediatric cancer care: A report from the Children's Oncology Group. Pediatr Blood Cancer 65:e27277
Burns, Melissa A; Liao, Zi Wei; Yamagata, Natsuko et al. (2018) Hedgehog pathway mutations drive oncogenic transformation in high-risk T-cell acute lymphoblastic leukemia. Leukemia 32:2126-2137
Dix, David B; Seibel, Nita L; Chi, Yueh-Yun et al. (2018) Treatment of Stage IV Favorable Histology Wilms Tumor With Lung Metastases: A Report From the Children's Oncology Group AREN0533 Study. J Clin Oncol 36:1564-1570
Bolouri, Hamid; Farrar, Jason E; Triche Jr, Timothy et al. (2018) The molecular landscape of pediatric acute myeloid leukemia reveals recurrent structural alterations and age-specific mutational interactions. Nat Med 24:103-112
Omidakhsh, Negar; Bunin, Greta R; Ganguly, Arupa et al. (2018) Parental occupational exposures and the risk of childhood sporadic retinoblastoma: a report from the Children's Oncology Group. Occup Environ Med 75:205-211

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