The Road to Success: Clinical Trials and the Children’s Oncology Group

by Becky C. Weaver, Chief Mission Officer, St. Baldrick's Foundation
June 23, 2014

The Children’s Oncology Group, or COG, has done some pretty awesome things to change the face of childhood cancer. The St. Baldrick’s Foundation has granted over $46 million to the COG so that kids with cancer can get the cures they need.

60% of kids with cancer are treated on clinical trials

It’s been said that the Children’s Oncology Group, or COG, is arguably the National Cancer Institute’s best success story. The COG’s clinical trials have increased the overall cure rate for childhood cancers from under 10% 50 years ago to over 80% today.

This is a road to success, but there are many miles to go before every child can be cured.

The COG’s clinical trials have increased the overall cure rate for childhood cancers from under 10% 50 years ago to over 80% today.

While there are 12 major categories, there are well over 100 different types of childhood cancers. Great strides have been made in curing some of these, but other cancers remain quite deadly.

With nearly 13,500 children and adolescents diagnosed each year in the U.S., the number of patients with each type is relatively small. The number at any one hospital is even smaller. Research relies on enrolling large numbers of patients on studies, or clinical trials, to ensure results are meaningful.

So in the 1950s, childhood cancer experts at multiple institutions began to work together to test new therapies, pioneering what is now known as cooperative research — and progress began. Several cooperative research groups merged to become one in 2000, creating the Children’s Oncology Group.

The COG is made up of more than 8,000 experts at 220 children’s hospitals, universities, and cancer centers across North America, Australia, New Zealand, and Europe. More than 90% of all children and teens fighting cancer in the U.S are cared for at a COG member institution.

Today, less than 5% of adults with cancer are enrolled in a clinical trial, but 60% of patients under the age of 29 are. For childhood cancers, clinical trials are not the exception; they are the standard of care, with each patient receiving either the best known treatment or one that may prove to be better.

Clinical trials are conducted to improve survival rates or to reduce side effects or long-term effects of treatment. Nearly 100 active clinical trials are open in the COG at any given time. Many experts review each trial before it is approved by the COG, the National Cancer Institute (NCI), and the local hospital where it is offered. A study may focus on new treatments, the underlying biology of childhood cancers, supportive care, or survivorship.

Dr. Vikramjit Kanwar with patient

A clinical research associate supported by a St. Baldrick’s Infrastructure Grant treats a patient at Albany Medical Center, a COG member institution.

In most trials, it is not clear which arm of the study is best until all patients have completed the trial and been observed for several years. If it does become clear during the study that one is better than the other, the trial is stopped and all patients are given the better treatment.

All information about diagnosis, treatment, and results from each patient is collected in a uniform way at each COG institution and submitted to the group to be analyzed. Findings are published, and the group then builds on this knowledge to make even more progress.

Through its clinical trials, the COG has treated more children with cancer than any organization in history and is responsible for much of the progress over the past 50 years.

Funding for all cancer research — for children, teens, and adults — is important, but the playing field is not even.

Despite this, its funding from the NCI has been cut 30% over the past 10 years, when adjusted for inflation. Recent changes in the way the NCI supports cooperative research threatened to have devastating effects on childhood cancer clinical trials, but negotiations have resulted in a plan that allows the COG more flexibility to help deal more efficiently with the budget cuts.

Funding for all cancer research — for children, teens, and adults — is important, but the playing field is not even. About 60% of all biomedical research in the U.S. comes from the pharmaceutical industry; of that, almost none is for childhood cancer. Philanthropic support for pediatric cancer research is also far less than for adult cancers.

Federal support of the COG is critically important to continuing on the road to progress in curing childhood cancer. It is essential to offering children and teens the best treatments and a way to higher cure rates through clinical trials.

Kids with cancer are depending on clinical trials to find better, safer cures. Tell Congress to increase funding for childhood cancer research and the COG, or make a donation to help St. Baldrick’s continue to support the COG.

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