Children's Oncology Group Chair's Grant

描述(由申请人提供)： 在过去的40年里，儿童癌症的存活率和治愈率都有了显著的提高。以前癌症几乎是一种致命的疾病，如果不能单独通过手术治疗，现在大多数儿童的癌症是可以治愈的。这一改进是临床和实验室研究人员在合作的多中心临床试验背景下共同努力的直接结果。最近，在一些特殊的儿科癌症中，总体生存率得到了进一步的显着改善。然而，并不是所有诊断类型的儿童癌症都有改善。儿童肿瘤学小组认识到，尽管患者人数有限，资源有限，但仍需要加快进展，因此成功地选择统一努力，制定协调和有力的研究议程，而不牺牲以前在特定疾病领域的竞争战略所取得的进展。由于这些努力，在扩大对疾病和宿主生物学的理解的基础上，对风险分类进行了重大改进。完善风险群体的定义，增加患者和罕见癌症类型的亚群，需要更多的合作。通过增加常规药物和修改治疗方案来强化治疗不太可能导致进一步的改善，这提供了一个令人信服的理由和迫切需要，以加强相关的生物学研究，并加快识别和验证特定儿科癌症的分子靶点的过程。此外，循序渐进的进展要求儿科癌症临床研究充分利用分子癌症疗法的不断发展，采用比迄今用于儿童癌症的更快的药物开发范式，特别是对那些对传统疗法耐药的类型；这也是减少与当前治疗相关的重大急性和长期后遗症的可能性所必需的。为了实现治疗和预防儿童癌症的使命，COG将设计和进行临床试验，继续定义循证护理标准，对癌症生物学和宿主对治疗反应的变异性进行实验室调查，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战略。最后，我们将评估治疗干预措施，以提高婴儿、儿童、青少年和年轻癌症患者的生活质量和存活率。

DESCRIPTION (Provided by applicant): 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.