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Lopes LF, Macedo CRPD, Aguiar SDS, Barreto JHS, Martins GE, Sonaglio V, Milone M, Lima ER, Almeida MTDA, Lopes PMAA, Watanabe FM, D'Andrea MLM, Pianovski MA, Melaragno R, Vianna SMR, Moreira MES, Bruniera P, de Oliveira CZ. Lowered Cisplatin Dose and No Bleomycin in the Treatment of Pediatric Germ Cell Tumors: Results of the GCT-99 Protocol From the Brazilian Germ Cell Pediatric Oncology Cooperative Group. J Clin Oncol 2016; 34:603-10. [PMID: 26729441 DOI: 10.1200/jco.2014.59.1420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We describe the results of a risk-adapted, response-based therapeutic approach from the Brazilian GCT-99 study on germ cell tumors. PATIENTS AND METHODS From May 1999 to October 2009, 579 participants were enrolled in the Brazilian GCT-99 study. Treatment, defined as specific chemotherapy regimen and number of cycles, was allocated by means of risk-group assignment at diagnosis with consideration for stage and primary tumor site. Patients at low risk received no chemotherapy. Patients at intermediate risk (IR) with a good response (GR) received four cycles of platinum and etoposide (PE), for total doses of platinum 420 mg/m(2) and etoposide 2,040 mg/m(2). Patients at IR with a partial response (PR) received three cycles of PE plus three cycles of ifosfamide, vinblastine, and bleomycin. Patients at high risk (HR) with a GR received four cycles of PE and ifosfamide (PEI) at total doses of platinum 420 mg/m(2), etoposide 1,200 mg/m(2), and ifosfamide 30 g/m(2). Patients at HR with a PR received six cycles of PEI. RESULTS The risk-group distribution was 213 LR, 138 IR, and 129 HR for 480 evaluable patients. Overall survival (OS) and event-free survival (EFS) rates at 10 years were, respectively, 90% and 88.6% in the IR-GR group (n = 126) and 74.1% and 74.1% in the IR-PR group (n = 12). Ten-year rates for the HR-GR group (n = 86) were an OS of 66.8% and an EFS of 62.5%. The HR-PR group (n = 43) had an OS of 74.8% and an EFS of 73.4%. In univariable and multivariable analysis, increased serum lactate dehydrogenase level and histology for a metastatic immature teratoma were prognostic of a worsened outcome. CONCLUSION Reduction of therapy to two drugs did not compromise survival outcomes for patients in the IR-GR group, and escalation of therapy with PEI did not significantly improve OS and EFS in patients at HR.
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Affiliation(s)
- Luiz Fernando Lopes
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil.
| | - Carla Renata Pacheco Donato Macedo
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Simone Dos Santos Aguiar
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Jose Henrique S Barreto
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Gisele Eiras Martins
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Viviane Sonaglio
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Marcelo Milone
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Eduardo Ribeiro Lima
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Maria Teresa de Assis Almeida
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Paula Maria Azevedo Allemand Lopes
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Flora Mitie Watanabe
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Maria Lydia Mello D'Andrea
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Mara Albonei Pianovski
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Renato Melaragno
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Sonia Maria Rossi Vianna
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Mauber Eduardo Schultz Moreira
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Paula Bruniera
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
| | - Cleyton Zanardo de Oliveira
- Luiz Fernando Lopes, Brazilian Society of Pediatric Oncology; Carla Renata Pacheco Donato Macedo, Instituto de Oncologia Pediatrica-GRAACC, Universidade Federal de São Paulo; Viviane Sonaglio, Hospital A.C. Camargo; Maria Teresa de Assis Almeida, Universidade de São Paulo, ITACI FMUSP; Maria Lydia Mello D'Andrea, Hospital Infantil Darcy Vargas; Renato Melaragno, Hospital Santa Marcelina; Sonia Maria Rossi Vianna, Hospital do Servidor Publico Estadual; Paula Bruniera, Santa Casa de Misericordia de São Paulo, São Paulo; Luiz Fernando Lopes and Gisele Eiras Martins, Hospital de Cancer Infanto Juvenil de Barretos; Cleyton Zanardo de Oliveira, Hospital de Cancer de Barretos, Barretos; Simone dos Santos Aguiar, Centro Infantil Boldrini & CIPED/FCM/Unicamp, Campinas; Marcelo Milone, Centro de Tratamento Fabiana Macedo de Morais/GACC, São Jose dos Campos; Jose Henrique S. Barreto, Hospital São Rafael/ONCO Bahia, Salvador; Eduardo Ribeiro Lima, Hospital da Baleia, Belo Horizonte; Paula Maria Azevedo Allemand Lopes, Hospital da Criança de Brasilia Jose Alencar, Brasilia; Flora Mitie Watanabe, Hospital Infantil Pequeno Principe; Mara Albonei Pianovski, Hospital Erasto Gaertner, Curitiba; and Mauber Eduardo Schultz Moreira, Hospital Universitario de Santa Maria, Santa Maria, Brazil
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Olson TA, Murray MJ, Rodriguez-Galindo C, Nicholson JC, Billmire DF, Krailo MD, Dang HM, Amatruda JF, Thornton CM, Arul GS, Stoneham SJ, Pashankar F, Stark D, Shaikh F, Gershenson DM, Covens A, Hurteau J, Stenning SP, Feldman DR, Grimison PS, Huddart RA, Sweeney C, Powles T, Lopes LF, dos Santos Agular S, Chinnaswamy G, Khaleel S, Abouelnaga S, Hale JP, Frazier AL. Pediatric and Adolescent Extracranial Germ Cell Tumors: The Road to Collaboration. J Clin Oncol 2015; 33:3018-28. [PMID: 26304902 PMCID: PMC4979195 DOI: 10.1200/jco.2014.60.5337] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During the past 35 years, survival rates for children with extracranial malignant germ cell tumors (GCTs) have increased significantly. Success has been achieved primarily through the application of platinum-based chemotherapy regimens; however, clinical challenges in GCTs remain. Excellent outcomes are not distributed uniformly across the heterogeneous distribution of age, histologic features, and primary tumor site. Despite good outcomes overall, the likelihood of a cure for certain sites and histologic conditions is less than 50%. In addition, there are considerable long-term treatment-related effects for survivors. Even modest cisplatin dosing can cause significant long-term morbidities. A particular challenge in designing new therapies for GCT is that a variety of specialists use different risk stratifications, staging systems, and treatment approaches for three distinct age groups (childhood, adolescence, and young adulthood). Traditionally, pediatric cancer patients younger than 15 years have been treated by pediatric oncologists in collaboration with their surgical specialty colleagues. Adolescents and young adults with GCTs often are treated by medical oncologists, urologists, or gynecologic oncologists. The therapeutic dilemma for all is how to best define disease risk so that therapy and toxicity can be appropriately reduced for some patients and intensified for others. Further clinical and biologic insights can only be achieved through collaborations that do not set limitations by age, sex, and primary tumor site. Therefore, international collaborations, spanning different cooperative groups and disciplines, have been developed to address these challenges.
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Affiliation(s)
- Thomas A. Olson
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Matthew J. Murray
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Carlos Rodriguez-Galindo
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James C. Nicholson
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Deborah F. Billmire
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Mark D. Krailo
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Ha M. Dang
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - James F. Amatruda
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Claire M. Thornton
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - G. Suren Arul
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sara J. Stoneham
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Farzana Pashankar
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Daniel Stark
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Furqan Shaikh
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - David M. Gershenson
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Allan Covens
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jean Hurteau
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sally P. Stenning
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Darren R. Feldman
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Peter S. Grimison
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Robert A. Huddart
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Christopher Sweeney
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Thomas Powles
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Luiz Fernando Lopes
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Simone dos Santos Agular
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Girish Chinnaswamy
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sahar Khaleel
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sherif Abouelnaga
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Juliet P. Hale
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - A. Lindsay Frazier
- Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Juliet P. Hale, Royal Victoria Infirmary NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Frazier AL, Hale JP, Rodriguez-Galindo C, Dang H, Olson T, Murray MJ, Amatruda JF, Thornton C, Arul GS, Billmire D, Shaikh F, Pashankar F, Stoneham S, Krailo M, Nicholson JC. Revised risk classification for pediatric extracranial germ cell tumors based on 25 years of clinical trial data from the United Kingdom and United States. J Clin Oncol 2015; 33:195-201. [PMID: 25452439 PMCID: PMC4279239 DOI: 10.1200/jco.2014.58.3369] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To risk stratify malignant extracranial pediatric germ cell tumors (GCTs). PATIENTS AND METHODS Data from seven GCT trials conducted by the Children's Oncology Group (United States) or the Children's Cancer and Leukemia Group (United Kingdom) between 1985 and 2009 were merged to create a data set of patients with stage II to IV disease treated with platinum-based therapy. A parametric cure model was used to evaluate the prognostic importance of age, tumor site, stage, histology, tumor markers, and treatment regimen and estimate the percentage of patients who achieved long-term disease-free (LTDF) survival in each subgroup of the final model. Validation of the model was conducted using the bootstrap method. RESULTS In multivariable analysis of 519 patients with GCTs, stage IV disease (P = .001), age ≥ 11 years (P < .001), and tumor site (P < .001) were significant predictors of worse LTDF survival. Elevated alpha-fetoprotein (AFP) ≥ 10,000 ng/mL was associated with worse outcome, whereas pure yolk sac tumor (YST) was associated with better outcome, although neither met criteria for statistical significance. The analysis identified a group of patients age > 11 years with either stage III to IV extragonadal tumors or stage IV ovarian tumors with predicted LTDF survival < 70%. A bootstrap procedure showed retention of age, tumor site, and stage in > 94%, AFP in 12%, and YST in 27% of the replications. CONCLUSION Clinical trial data from two large national pediatric clinical trial organizations have produced a new evidence-based risk stratification of malignant pediatric GCTs that identifies a poor-risk group warranting intensified therapy.
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Affiliation(s)
- A Lindsay Frazier
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT.
| | - Juliet P Hale
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Carlos Rodriguez-Galindo
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Ha Dang
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Thomas Olson
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Matthew J Murray
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - James F Amatruda
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Claire Thornton
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - G Suren Arul
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Deborah Billmire
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Furqan Shaikh
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Farzana Pashankar
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Sara Stoneham
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - Mark Krailo
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
| | - James C Nicholson
- A. Lindsay Frazier and Carlos Rodriguez-Galindo, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA; Juliet P. Hale, Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust, Newcastle upon Tyne; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals NHS Foundation Trust; Matthew J. Murray, University of Cambridge, Cambridge; Claire Thornton, Royal Victoria Hospital, Belfast Health Trust, Belfast; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birgmingham; Sara Stoneham, Children's and Young Persons Cancer Services, University College London Hospital Trusts, London, United Kingdom; Ha Dang, Children's Oncology Group; Mark Krailo, University of Southern California, Los Angeles, CA; Thomas Olson, Children's Healthcare of Atlanta, Emory University, Atlanta, GA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center Dallas, Dallas, TX; Deborah Billmire, Riley Hospital for Children, Indianapolis, IN; Furqan Shaikh, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; and Farzana Pashankar, Yale Cancer Center, New Haven, CT
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