The Children’s Oncology Group (COG) is the largest pediatric clinical trials organization in the world including over 200 sites internationally. The Behavioral Science Committee within COG emerged from the Psychology Discipline Committee in 2006 to include greater standardization; integration of psychometrically robust measures; more involvement of behavioral scientists; and inclusion within more clinical trials. This presentation emphasized the importance of methodological rigor and standardization for behavioral science within COG. Following these basic principles, the use of social networks to leverage scientific gains, and examples of how behavioral science can inform clinical trials research were highlighted. After the development of a solid foundation of involved behavioral scientists using traditional neurocognitive measures, behavioral scientists have begun to use technology to maximize feasibility and accrual, and to answer targeted research questions about psychosocial or neuropsychological outcomes that are emerging as primary endpoints in clinical trials.
With increasing rates of cure, attention has increasingly focused on addressing late effects of pediatric cancer and its treatment for survivors. One devastating late effect that occurs for a significant number of survivors of pediatric cancers, particularly those that involve diseases of the central nervous system, is neurocognitive late effects. Several pharmacological and neuro-rehabilitative (behavioral) treatment strategies have been evaluated to ameliorate cognitive functioning in this group, but to date, no single approach has been associated with full restoration of abilities. Moreover, our ability to define and predict the severity and scope of neurocognitive difficulties in children who are at-risk remains limited. This presentation also reviewed the rationale and emerging evidence for innovative use of computer-based assessment and interventional approaches in survivors of pediatric cancer, with an emphasis on how technology may be effectively utilized within multi-center trials and cooperative groups.
Robert B. Noll, PhD
Children’s Hospital of Pittsburgh, Pittsburgh
Professor, Pediatrics, Psychiatry and Psychology
University of Pittsburgh Medical Center, Pittsburgh
Kristina K. Hardy, PhD
Pediatric Neuropsychologist, Division of Neuropsychology
Children’s National Medical Center, Washington
Assistant Professor of Psychiatry and Behavioral Science
The George Washington University School of Medicine, Washington