Tumors of the central nervous system (CNS), including tumors of the brain and spinal cord, are the most common solid tumors in children. These tumors are heterogeneous, meaning there are a number of different types of tumors and different biologic behavior. Pediatric CNS tumors differ from adult CNS tumors in histology, biology, pathophysiology, and location. Many childhood CNS tumors can be removed surgically. However, some tumors are located in critical areas, are malignant, have invaded surrounding areas or have spread to other parts of the CNS, and additional therapy is needed.
The armamentarium for the treatment of pediatric CNS tumors includes surgery, radiation and chemotherapy. For some tumors, such as diffuse intrinsic pontine gliomas and high-grade gliomas, current treatment strategies are insufficient and the tumor frequently comes back or begins to grow again. For other tumor types, such as medulloblastoma and ependymoma, initial treatment may be adequate for some, but if the tumor recurs, it is difficult to cure.
Our clinical program in neuro-oncology is focused on the development of new anticancer agents for the treatment of childhood CNS tumors. Our clinical studies involve performance of early clinical trials with pharmacokinetic modeling, as children may tolerate chemotherapeutic agents differently than adult patients. The major goals of the pediatric neuro-oncology section are rational, pharmacokinetic-based, drug development in the pediatric population, and investigation of novel therapeutic approaches through alternate delivery strategies, including convection-enhanced delivery.