The Children’s Oncology Group’s Central Nervous System Tumors Committee Battles the Most Common Childhood Solid Tumors
The central nervous system (CNS) is made up of the brain and the spinal cord. Together, these important organs control functions necessary to sustain life such as breathing, heart rate, movement, thinking and learning. CNS tumors are the most common solid tumors of childhood and certain subgroups of brain tumors have the highest mortality rate of any childhood cancer.
Working together to conduct research, the members of the Children’s Oncology Group’s (COG) CNS Committee are dedicated to improving treatments for resistant tumors; developing treatments for challenging high-risk tumor groups; identifying better biological ways of subdividing and tailoring treatment; and reducing side effects and late effects that affect a child’s ongoing quality of life.
Chaired by Ian Pollack, M.D., Chief of Pediatric Neurosurgery at Children’s Hospital of Pittsburgh, the CNS Committee is comprised of members from a variety of disciplines including pediatric oncology/hematology, neurosurgery, nursing, radiation oncology, pediatric neurology, pathology, cytogenics, endocrinology and more.
The challenge to the CNS committee has been that the survival rates for brain tumors have not seen as dramatic a change overall as other childhood cancer types because of the nature of CNS tumors – there is not a single type. However, the committee has made significant progress in the treatment of individual brain tumor subgroups including several that previously had very poor prognoses.
Today, children diagnosed with Medulloblastoma, the most common CNS malignancy, with favorable risk factors have a predicted survival rate of 80%, using chemotherapy with lower doses of radiation therapy than were required in the past to combat the cancer. In addition, the committee has been able to open research studies for virtually every type of brain tumor, giving children with CNS tumors and their families hope for a cure.
According to Dr. Pollack, the multi-disciplinary approach of the COG has been a key factor in the strides the committee has made in treating CNS tumors. Another factor is the multi-institutional composition of COG, since even large institutions only see small numbers of each of many types of brain tumors.
“When we [as a group] pool our patient data and share results, we learn how to treat tumor subgroups better and faster than we could have working alone as individual institutions,” said Pollack.
Pollack notes that the committee’s research efforts have resulted in breakthroughs in identifying biological factors that subdivide certain CNS tumor types by molecular markers. By screening these patterns of gene mutations, the team treating a child is better able to tailor the treatment for the best possible outcome.
The committee also has opened a number of studies looking at treatment to improve quality of life after therapy for pediatric cancer patients by studying the impact of treatment on IQ and functional status, such as how children do in school.
“It’s a long-term effort,” said Pollack. “Our progress has been impressive; but there is a lot of opportunity for more improvement.”
