Priorities for the future for clinical research. Center perspective

Clinical research has by and large been responsible for the success achieved in treating pediatric cancer during the last 20 years. An important milestone has recently been reached with the passing of the halfway mark in the goal of curing all childhood cancer. It is important to re-evaluate our priorities and set future goals. The large multi-institutional cooperative groups have been the mainstay of past successes and should as their major goal continue work towards improvements in survival, particularly for those malignancies which continue to have a poor prognosis. The second priority should be the identification of potential long-term effects of childhood cancer and the effects associated with therapy. Concomitant with improvements in the cure rate it is our responsibility to ensure that cured patients can have the opportunity to enjoy productive, useful and happy lives. The third priority is to foster research of pilot clinical research to serve as a source of ideas to be used for future Phase III clinical trials. Moreover, increased efforts should be directed towards aspects of preventive oncology which requires increased knowledge regarding the etiology of childhood cancers.