1940s

• Remission achieved in pediatric leukemia patients using an antifolate drug, aminopterin

1950s

• 6-mercaptopurine treats pediatric acute lymphoblastic leukemia (ALL)
• Combination chemotherapy introduced by NCI researchers
• NCI begins funding pediatric cooperative clinical trials

1960s

• Dactinomycin first used to treat Wilms tumor
• National Wilms Tumor Study Group formed and multi-modal therapy (radiation, chemotherapy, and surgery) first used in pediatric patients
• Prophylaxis of occult central nervous system leukemia markedly improves outcome for children with ALL
• Laminar airflow technology creates "sterile rooms" for chemotherapy patients

1970s

• Intergroup Rhabdomyosarcoma Study Group Committee pioneers repetitive-course, multi-agent chemotherapy for advanced rhabdomyosarcoma
• First successful bone marrow transplant (BMT) for leukemia
• Knudson describes the 2-hit hypothesis for retinoblastoma to describe genetics and heredity of cancer

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1980s

• First tumor-suppressor gene, in retinoblastoma, is cloned
• MYCN identified as a target of genomic amplification in neuroblastoma
• Adjuvant chemotherapy improves relapse-free survival for pediatric osteosarcoma
• Different treatment approaches for lymphoblastic lymphoma versus other lymphomas in children are realized
• Platinum-based combination chemotherapy improves response rates in pediatric germ cell tumors
• National Marrow Donor Program begins

1990s

• Autologous BMT and 13-cis-retinoic acid improve event-free survival for high-risk neuroblastoma
• Characteristic fusion genes identified for pediatric solid tumors
• Combined ifosfamide and etoposide improve outcomes for non-metastatic Ewing sarcoma
• Treatments achieve long-term survival rates of 80-90% for advanced Burkitt lymphoma
• Risk-directed therapy becomes treatment paradigm for children with ALL
• Genetic test for rare thyroid cancer enables prophylactic thyroidectomy before the age of 2
• NCI-funded Childhood Cancer Survivors Study begins

2000s

• Four legacy research groups merge as the Children's Oncology Group (COG)
• COG publishes long-term follow-up guidelines for pediatric cancer survivors
• Imatinib added to intensive chemotherapy improves early outcomes for Ph+ ALL
• 5-year survival rates for children with cancer (age 0-14 years) approach 80%