The Application of Evidence-Based Medicine to Achieve Progress in Pediatric Oncology

10/12/00


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Table of Contents

The Application of Evidence-Based Medicine to Achieve Progress in Pediatric Oncology

Outline

Childhood Cancer

Age-Adjusted SEER Cancer Incidence, 1991-95, Reflecting Cancers Occurring among Adults

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Childhood Cancer Clinical Research

Justification for Separate Studies for Children with Cancer

Survival Rates Have Dramatically Improved for Children with Cancer

Remarkable Past Progress Leukemia Mortality 1950-96

Childhood Acute Lymphoblastic Leukemia (ALL) Survival Rates:1960-1996

Childhood Lymphoma Mortality 1950-97

Remarkable Past Progress NHL Survival Rates:1960-1996

Contributions of NCI-Supported Nationwide Clinical Trials System to Improved Outcome

Why Randomized Phase III Clinical Trials??

Why Randomized Phase III Clinical Trials??

Selection Bias in High-dose Chemotherapy (HDCT) Trials

NCI-Supported Clinical Research for Children with Cancer--Phase III Trials

NCI-Supported Clinical Research for Children with Cancer--Phase III Trials

Randomized Trials for Pediatric Acute Lymphoblastic Leukemia: CCG-1922

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From Phase I to Phase III--Ifosfamide/Etoposide for Ewing’s Sarcoma

Randomized Trials for Pediatric Cancers - Ewing’s Sarcoma

Randomized Trials for Pediatric Cancers - Ewing’s Sarcoma

Results from Recent Phase III Trials for Children with Cancer

Study Questions for Recently Completed/Ongoing Phase III Trials

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Risk-Adjusted Therapy: Classifying Patients by Prognosis

Risk-Adjusted Therapy: Classifying Patients by Prognosis

Risk-Adjusted Therapy: Assigning Treatment Based on Prognosis

Risk-Adjusted Therapy Requires the Identification of Reliable Prognostic Factors

Scope of NCI-Supported Pediatric Clinical Trials Program

Pediatric Clinical Trials Cooperative Groups

Children’s Oncology Group

Pediatric Cooperative Group Clinical Trials Program --Participating Researchers

Pediatric Cooperative Group Clinical Trials Program --Supported Structures 1

Pediatric Cooperative Group Clinical Trials Program --Supported Structures 2

Pediatric Cooperative Group Clinical Trials Program --Supported Structures 3

Survivors of Childhood Cancer

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Selected CCSS Analyses in Progress

Unmet Needs

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Moving Towards a New Era

Molecularly Targeted Therapies for Childhood Cancers--2000

Bcr-Abl as Target for Treatment of Philadelphia Chromosome Positive ALL

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Bcr-Abl as Target for CML and Ph+ ALL Therapy

Summary 1

Summary 2: Progress Depends on Collaboration and Cooperation

Author: Malcolm Smith