OnCo
ideasIdea

An international consortium pooling the outcome of every treated child with cancer

Childhood cancers are rare, so no one country sees enough cases. Pool the treatment and outcome of every child treated anywhere into one governed dataset.

Paediatric oncology already treats most children on or according to cooperative-group protocols, with structured data. Linking cooperative-group databases (COG, SIOP Europe, and LMIC networks) into one federated real-world resource, including children treated off-protocol and in LMICs, would allow toxicity, late effects and rare subtype questions to be answered globally. The proposal funds the governance, common data model and federation.

Hypothesis
A pooled paediatric resource covering more than 80 percent of treated children in participating countries will answer rare-subtype and late-effect questions with cohorts five times larger than any current group and will be used to design the next generation of risk-adapted protocols.
Rationale
Paediatric oncology's cooperative structure is unique; the data exist in silos separated by group and continent, not by lack of standardisation.
What would test it
Federate COG and SIOP databases for two diseases (neuroblastoma, Ewing sarcoma); answer three pre-registered questions and report the marginal value of pooling.
Maturity
early clinical
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks
  • Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
  • Rare and paediatric cancers without markets · Taken together rare cancers are a fifth of all cancers, but each one alone is too small for a company to invest in.
  • Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.

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