Children's Oncology Group Chair's Grant

在过去的四十年里，儿童癌症的存活率和治愈率都有了显着提高。 癌症以前是一种几乎一律致命的疾病，不适合单独手术治疗，现在 在大多数儿童中可治愈。这种改善是临床合作努力的直接结果。 和实验室研究者在合作，多中心临床试验的背景下。进一步显著 最近，一些特定的儿科癌症的总生存期有所改善。然而，在这方面， 在所有诊断类型的儿童癌症中都没有观察到改善。认识到需要 尽管在有限的患者数量和限制条件下遇到困难， 资源，儿童肿瘤学小组（COG）成功地选择了统一其努力，以制定一个 协调和强有力的研究议程，而不牺牲以前取得的进展， 在特定疾病领域的竞争战略。根据扩大的 这些努力导致了对大量患者的疾病和宿主生物学的理解。 风险组定义的完善以及患者和罕见癌症类型亚组的增加 需要更多合作。通过增加常规药物加强治疗， 时间表的修改不太可能导致进一步的改进，提供令人信服的理由， 迫切需要加强相关生物学研究，加快鉴定进程， 在特定儿科癌症中验证分子靶点。此外，逐步取得进展要求， 儿科癌症临床研究充分利用了分子癌症治疗学的发展， 一种比迄今为止用于儿童癌症的更快速的药物开发模式，特别是对于那些 对传统疗法有抵抗力的类型;这也是减少显著急性和 与当前治疗相关的长期后遗症。为了实现其治愈和预防的使命 儿童癌症，COG将设计和进行临床试验，将继续定义循证医学。 护理标准，进行实验室调查癌症生物学和宿主对 并将这些发现转化为新的，更有效和毒性更低的治疗方法。我们将确定 儿童癌症的原因并制定旨在预防癌症的策略。最后，我们将评估 治疗性干预，目标是改善婴儿，儿童， 患有癌症的青少年和年轻人。

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.