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SIOPEN has built with COG and neuro-

blastoma groups from Japan, China and

Australia a large clinical and biological

database of more than 9,000 neuro-

blastoma patients in order to define and

validate new staging system and new

biological prognostic biomarkers through

the International Neuroblastoma Research

Group [9] [22].

Groups such as the SIOP-Renal Tumours

Study Group support clinical trials groups

in other continents that run studies using

the same standard treatment backbones,

adapted to local circumstances.

The COG and the European Inter-group

for Childhood non Hodgkin lymphoma

(EICNHL) are currently running a

randomised phase III clinical trial to evaluate

the addition of rituximab, an anti CD20

monoclonal antibody, on standard intensive

chemotherapy treatment in high-risk

Burkitt’s lymphoma.

The European and American Osteosarcoma

Study Group (EURAMOS) has successfully

completed a large phase III study with

partners, which included the COG, the

European Osteosarcoma Intergroup, the

Cooperative Osteosarcoma Study Group,

and the Scandinavian Sarcoma Group.

The EURAMOS Strategy Group, made

up of these four multi-national groups,

as well as the relevant Australasian,

French, Italian, Japanese, and Spanish

osteosarcoma groups, is exploring options

for collaboration on an even larger platform.

In the next 10 years, international coope-

ration will be reinforced to evaluate

innovative targeted drugs within

extremely small and rare groups (defined

by biomarkers), such as children with

B-RAF mutated malignancies. Even in

less rare clinical situations, international

randomised clinical trials will be considered

more regularly to speed up evaluation of

innovative therapies.

Partnership with industry

For the last 50 years, progress has been

made in curing paediatric cancers by running

academic trials using anti-cancer drugs

that are available in hospital pharmacy

departments. Pharmaceutical companies

have not developed their anti-cancer agents

in the paediatric population, and nearly

half of drugs used daily to cure cancer in

children and adolescents do not have the

regulatory official authorisation, stated in

the ‘Summary of Product Characteristics’.

In Europe this situation has significantly

changed over the last five years because

regulatory initiatives, first in the U.S. and

then in Europe, obliged pharmaceutical

companies to test their drugs in the

paediatric population when relevant.