In this special issue of the Bulletin, we pay tribute to pediatric oncology, focusing on the wide-reaching partnerships that have led to exemplary progress in treating children with cancer. As you will see, these partnerships have markedly reduced pediatric cancer mortality and will most certainly hasten our progress against other cancers, such as osteosarcoma and brain tumors, for which prognosis remains poor.

NCI sponsors several cooperative clinical trials groups to study pediatric cancers, the largest of which is the Children's Oncology Group (COG). In 2000, NCI facilitated the formation of COG through a merger of the Children's Cancer Group, the Pediatric Oncology Group, the Intergroup Rhabdomyosarcoma Study Group, and the National Wilms Tumor Study Group. Because of this network, accrual to pediatric clinical trials is remarkably high: Among eligible children younger than 5, 90 percent or more are currently treated as part of a clinical trial, compared with less than 5 percent participation in trials by the adult population.

NCI's Pediatric Oncology Branch is a member of COG. Through the Advanced Technology Program at NCI-Frederick and the Office of Science and Technology Partnerships, the Pediatric Oncology Branch has unique access to technology and procedures for genetic analysis, biomarker studies, and targeted therapy development - advances that can be tested in pre-clinical and early-phase clinical trials before moving to the larger extramural community.

NCI's Pediatric Oncology Branch led partnerships that facilitated the successful completion of several therapeutic advances that were first tested in children at the NIH Clinical Center. Among them was the first use of gene therapy, development of "volume photography" to measure growth of neurofibromatosis-1 tumors, and even the first multi-institute hospital unit designed specifically for children at the NIH Clinical Center.

NCI's Pediatric Oncology Branch often works closely with other NIH institutes to cosponsor important pediatric research projects, combining valuable resources and thereby speeding the delivery of new interventions. And collaboration between NCI's SEER Program, Office of Cancer Survivorship, and organizations such as the Lance Armstrong Foundation, help us monitor pediatric survivorship issues such as fertility, second cancers, and race and age-group disparities.

Children usually learn from adults, but sometimes the roles are reversed, and that has been true in pediatric oncology. Some fundamental aspects of cancer treatment today, such as combination chemotherapy and knowledge of tumor suppressor genes, can be traced to research first completed on pediatric cancer patients. Such advances appear in our "Milestones."

You may also notice the banner that spans the top of this special issue. It features artwork made by children who have stayed at the Children's Inn at NIH while undergoing cancer treatment, or children who attended therapy sessions led by Dr. Lori Wiener, a social worker and member of our Pediatric Oncology Branch. Both of these programs are highlighted in this special issue.

We at NCI are extremely proud of our Pediatric Oncology Branch and the rich interface of intramural and extramural research in childhood cancers. We always get a special lump in our throats and a smile when we have a successful outcome with one of our special kids.

Dr. John E. Niederhuber
Director, National Cancer Institute