Fred Hutchinson Cancer Center, University of Washington, Seattle Children's Hospital, Seattle, Washington.
Benioff Children's Hospitals, University of California, San Francisco, California.
Cancer Epidemiol Biomarkers Prev. 2022 Sep 2;31(9):1675-1682. doi: 10.1158/1055-9965.EPI-22-0125.
Children and adolescents diagnosed with cancer can now expect an average 85% 5-year overall survival, with significant improvements in longer-term morbidity and mortality reported over the past several decades. However, the long-term impact of therapeutic agents and modalities introduced in recent years remains unclear and will require dedicated follow-up in the years ahead. The Children's Oncology Group (COG), a part of the NCI's National Clinical Trials Network, with over 200 sites across North America and beyond, enrolls more than 10,000 patients onto research protocols annually, inclusive of first-line clinical trials and nontherapeutic studies. COG provides a platform to conduct survivorship research with several unique strengths: (i) a huge catchment to ascertain relatively rare but important adverse events, (ii) study populations that are otherwise too rare to study in smaller consortia, including access to highly diverse patient populations, (iii) long-term follow-up of clinical trial populations linked to the original trial data, and (iv) a natural platform for intervention research. Enhancements in COG infrastructure facilitate survivorship research, including a COG patient registry (Project:EveryChild), availability of a long-term follow-up tracking resource, and successful deployment of various remote-based study procedures to reduce the burden on participants and participating institutions.
现在，被诊断患有癌症的儿童和青少年的平均 5 年总生存率预计为 85%，在过去几十年中，报告的长期发病率和死亡率有了显著改善。然而，近年来引入的治疗药物和方法的长期影响尚不清楚，未来几年需要专门进行随访。儿童肿瘤学组（COG）是美国国立卫生研究院国家临床试验网络的一部分，在北美及其他地区拥有 200 多个站点，每年有超过 10000 名患者参与研究方案，包括一线临床试验和非治疗性研究。COG 提供了一个进行生存研究的平台，具有几个独特的优势：（i）一个巨大的收集区，可以确定相对罕见但重要的不良事件，（ii）研究人群否则太稀少，无法在较小的联合会中进行研究，包括获得高度多样化的患者人群，（iii）临床试验人群的长期随访与原始试验数据相关联，以及（iv）干预研究的自然平台。COG 基础设施的增强促进了生存研究，包括 COG 患者登记处（项目：每个孩子），长期随访跟踪资源的可用性，以及各种远程研究程序的成功部署，以减轻参与者和参与机构的负担。
