Oncologic Diseases

Leukemia

Drs. Gary Dahl and Norman Lacayo head the leukemia program at LPCH. We treat 40-50 new leukemic patients per year. Patients with Acute Lymphocytic Leukemia (ALL) are treated on Children’s Oncology Group (COG) protocols and those with Acute Myeloid Leukemia (AML) are treated on a St. Jude Children’s Research Hospital protocol AML’08. We have been laboratory and clinical collaborators with the St. Jude AML trials since 2002. All of our children with leukemia are also enrolled on the Northern California Childhood Leukemia study which is a leukemia epidemiology protocol where we collaborate with the University of California, Berkeley department of Epidemiology and other pediatric oncology programs in the area to collect leukemia cells and relevant epidemiologic information on all of our patients. We have been collecting samples since 1997 so we have significant data and tissues as a resource available to us to answer biologic and epidemiologic questions. We also participate in Therapeutic Advances in Childhood Leukemia (TACL), a national collaborative group providing innovative Phase I protocols for children with relapsed ALL.

Several translational research projects investigating biologic prognostic pathways in leukemia that may be therapeutic targets in the future are ongoing. We are involved with projects investigating gene expression, phosphoflow and investigating specific intracellular pathways involved in leukemia cell death. Stanford collaborators such as Drs. Dean Felsher, Gary Nolan and Brandy Sikic are active in these studies.

Sarcomas

The sarcoma program is headed by Dr. Neyssa Marina. Dr. Marina is a world-renknown expert on the treatment of osteosarcoma and Ewing sarcoma.  She is the principal investigator on an internaltional  study for the treatment of osteosarcoma.  The study includes investigators from the European Osteosarcoma Intergroup (EOI), the Cooperative Osteosarcoma Study Group (COSS) and the Scandinavia Sarcoma Group (SSG).  Stanford participates in studies by the Children’s Oncology Group (COG) and the Sarcoma Alliance for Research Through Collaboration (SARC).  In addition, we collaborate in clinical trials for young adults with medical oncology at Stanford University.  Our group includes an orthopedic oncology team, radiation oncology, pediatric surgery and pediatric oncology.  This group provides the necessary expertise to care for this complex group of patients.

We also have translational studies in Ewing’s sarcoma and Osteosarcoma  currently carried out in the laboratory of Dr. Alejandro Sweet-Cordero.

Neuroblastoma

The neuroblastoma program at Lucile Packard Children's Hospital (LPCH) is directed by Dr. Clare Twist. Dr. Twist serves on the COG Neuroblastoma Steering Committee, and is the Study Chair for the current COG Phase III Study for the treatment of children with Intermediate Risk Neuroblastoma. Dr. Twist is also the Principal Investigator at Stanford for the New Advances in Neuroblastoma (NANT) Consortium, a limited institution consortium which develops Phase I trials of novel therapies for patients with high risk and recurrent neuroblastoma.

Hepatoblastoma

LPCH is one of the world’s leading centers for liver disease and liver transplantation. The hepatoblastoma program is headed by Dr. Arun Rangaswami.  Since LPCH has expertise in liver transplantation, we are able to offer this therapy to patients with advanced hepatoblastoma.  Our group includes a GI team, liver transplant team, pediatric oncology and nutritional specialists, as necessary.  We also have expertise in the management of hepatocellular carcinoma and have offered liver transplant to some of those patients.