Children's Oncology Group Chair's Grant

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。 癌症以前是一种几乎一致致命的疾病，如果不能单独进行手术治疗，现在是 大多数儿童是可以治愈的。这一改善是临床医生共同努力的直接结果。 和实验室研究人员在合作、多中心临床试验的背景下。更重要的是 在一些特殊的儿科癌症中，总存活率最近得到了改善。然而， 并不是所有诊断类型的儿童癌症都有改善。认识到有必要 尽管在有限的患者数量和受限的情况下遇到困难，但仍加快了进展 资源，儿童肿瘤学小组(COG)成功地当选为联合努力制定 协调和稳健的研究议程，而不会牺牲之前 在特定疾病领域的竞争战略。基于扩展的风险分类的主要改进 这些努力导致了更多患者对疾病和宿主生物学的了解。 改进了风险组的定义，增加了患者和罕见癌症类型的亚组 需要更多的合作。从常规药物的强化和治疗强化 附表修改不太可能导致进一步的改进，提供了令人信服的理由和 迫切需要加强相关生物调查，加快鉴定和鉴定进程 特定儿科癌症分子靶点的验证。此外，渐进式进展要求 儿科癌症临床研究充分利用分子癌症治疗学的发展 一种比迄今用于儿童癌症的更快的药物开发范例，特别是对那些 对传统疗法有抵抗力的类型；这也是减少严重急性和慢性疾病的可能性所必需的 与当前治疗相关的长期后遗症。为了完成其治疗和预防的使命 对于儿童癌症，COG将设计和进行临床试验，继续以循证为基础 护理标准，对癌症生物学和宿主反应的可变性进行实验室调查 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 治疗干预的目的是改善婴儿、儿童、 青少年和患有癌症的年轻人。

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.