{"doi":"10.1002/pbc.30569","title":"Children's Oncology Group's 2023 blueprint for research","abstract":"Pediatric oncology in 2023 is a study in contrasts. Decades of multi-institutional clinical trials have led to dramatic increases in 5-year survival rates across broad categories of childhood cancers. The number of survivors of childhood cancer continues to increase, estimated to be 500,000 in the United States as of 2020.1 The genomic landscape of most pediatric malignancies has been defined through comprehensive sequencing projects, leading to refinements in risk stratification and identification of more specific targets for potential therapeutic intervention. Precision treatment, beyond traditional cytotoxic chemotherapy, radiation, and surgery, has become a reality for some pediatric cancers. Regulatory changes have provided significant incentives to pharmaceutical companies to include children in clinical trial research with innovative therapies. However, each of these modern-day successes widens the gulf between challenges that remain. Improvements in outcome have not been uniform across all malignancies. The impressive gains seen in acute lymphoblastic leukemia and Hodgkin lymphoma stand in stark contrast to the absolute lack of progress in metastatic sarcomas and diffuse intrinsic pontine glioma. Although 5-year survival is a convenient benchmark, its use obscures two important issues. First, 5-year survival is not the same as 10- or 20-year survival.2 Too many 5-year pediatric cancer survivors will still succumb to their primary malignancy. Second, early survival is not without cost. Standard treatments carry a substantial burden of acute and chronic severe and potentially fatal complications, including accelerated cardiovascular disease, endocrinopathies, stroke, and secondary malignancies.3 The overall spectrum of late effects has not changed for most childhood cancer survivors because our most common treatment approaches have not changed substantially from those used in the 1970s. Despite its potential, precision treatment has not replaced cytotoxic chemotherapy and radiation for most pediatric cancers. Even more fundamental, clinical tumor sequencing to guide diagnosis and refine treatment is not broadly available to all children with cancer, especially at initial diagnosis. Finally, the economics of drug development drives much of the pharmaceutical industry's focus on targets relevant to the common carcinomas in adults rather than the less common alterations in leukemias and embryonal solid tumors in children. In 2023, the Children's Oncology Group (COG) is poised to play a pivotal role to build upon the prior achievements in pediatric oncology and address the remaining challenges. Formed in 2000 by the merger of four legacy pediatric cancer cooperative groups, COG is the National Cancer Institute's clinical trials organization devoted to childhood, adolescent, and young adult cancers. Since 2000, COG has conducted over 330 clinical trials for common and rare pediatric malignancies. With a centralized biorepository, COG facilitates the collection, storage, and distribution of more than 100,000 biospecimens annually from clinical trial participants and non-study biobanking. With more than 220 member institutions in the United States, Canada, Australia, New Zealand, and Saudi Arabia, the vast majority of children with cancer in these countries are treated at a COG site. Given the relative rarity of pediatric cancer, multi-institutional collaboration is essential to the timely conduct of research, and COG is uniquely positioned to do this in many pediatric and adolescent/young adult cancers. To summarize COG's recent achievement and outline our plans for the future, COG's scientific committees are publishing their blueprints in this special issue of Pediatric Blood and Cancer. Similar to the 2013 blueprints, these summaries outline how COG will address the remaining challenges in pediatric oncology. Each blueprint describes the priorities that the COG committees will pursue to improve outcomes for children with can","journal":"Pediatric Blood & Cancer","year":2023,"id":339949,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9112,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":623400,"name":"Lia Gore","orcid":"0000-0002-2546-4616","position":1,"is_corresponding":false},{"id":277185,"name":"Douglas S. Hawkins","orcid":"0000-0003-3602-1375","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":null,"created_at":"2026-07-19T01:10:49.535464Z","pmid":"37433635","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}