title: Collaborative Research in Childhood Cancer Survivorship: The Current Landscape.
abstract: Survivors of childhood cancer carry a substantial burden of morbidity and are at increased risk for premature death. Furthermore, clear associations exist between specific therapeutic exposures and the risk for a variety of long-term complications. The entire landscape of health issues encountered for decades after successful completion of treatment is currently being explored in various collaborative research settings. These settings include large population-based or multi-institutional cohorts and single-institution studies. The ascertainment of outcomes has depended on self-reporting, linkage to registries, or clinical assessments. Survivorship research in the cooperative group setting, such as the Children's Oncology Group, has leveraged the clinical trials infrastructure to explore the molecular underpinnings of treatment-related adverse events, and to understand specific complications in the setting of randomized risk-reduction strategies. This review highlights the salient findings from these large collaborative initiatives, emphasizing the need for life-long follow-up of survivors of childhood cancer, and describing the development of several guidelines and efforts toward harmonization. Finally, the review reinforces the need to identify populations at highest risk, facilitating the development of risk prediction models that would allow for targeted interventions across the entire trajectory of survivorship.
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark. sbhatia@peds.uab.edu.
authors: Smita
authors: S
authors: Bhatia
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Saro H
authors: SH
authors: Armenian
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Gregory T
authors: GT
authors: Armstrong
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Eline
authors: E
authors: van Dulmen-den Broeder
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Michael M
authors: MM
authors: Hawkins
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Leontien C M
authors: LC
authors: Kremer
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Claudia E
authors: CE
authors: Kuehni
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Jørgen H
authors: JH
authors: Olsen
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Leslie L
authors: LL
authors: Robison
authors: Smita Bhatia and Saro H. Armenian, City of Hope National Medical Center, Duarte, CA; Gregory T. Armstrong, Leslie L. Robison, and Melissa M. Hudson, St Jude Children's Research Hospital, Memphis, TN; Eline van Dulmen-den Broeder, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; Leontien C.M. Kremer, Academic Medical Center, Amsterdam, the Netherlands; Michael M. Hawkins, University of Birmingham, Birmingham, United Kingdom; Claudia E. Kuehni, University of Bern, Bern, Switzerland; and Jørgen H. Olsen, Danish Cancer Society Research Center, Copenhagen, Denmark.
authors: Melissa M
authors: MM
authors: Hudson
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D004059:Diffusion of Innovation; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D033183:Interdisciplinary Communication; D007391:International Cooperation; D008495:Medical Oncology / Q000191:economics / Q000592:standards / Q000639:trends; D009369:Neoplasms / Q000175:diagnosis / Q000191:economics / Q000401:mortality / Q000628:therapy*; D010372:Pediatrics / Q000191:economics / Q000592:standards / Q000639:trends; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult