When a physician manages a child with a suspected or confirmed malignancy, timely access to coordinated specialty care may significantly improve outcomes. Maimonides Children’s Hospital is the only pediatric cancer program in Brooklyn that’s affiliated with the Children’s Oncology Group (COG).
COG is a global network of over 12,000 pediatric cancer specialists. It conducts high-quality, clinical-translational trials for various cancers, including frontline, relapse, and rare tumor studies. Through its collaborative research model, COG has helped raise the 5-year survival rate for many childhood cancers to over 80%1. Collaborating with COG enables the Maimonides Health team to work from a comprehensive, multidisciplinary model that integrates access to national clinical trials with its structured tumor board review.
Structured, multidisciplinary decision-making tailored to each patient
“The pediatric tumor board focuses on the multidisciplinary approach to diagnosing and treating children with all kinds of tumors, benign or cancerous,” says Mahmut Celiker, MD, pediatric hematologist/oncologist at Maimonides. “We review every case collaboratively, and treatment decisions are consensus-driven.”
The board brings together specialists from across disciplines, including hematopathologists, neuropathologists, neurosurgeons, neuroradiologists, pediatric oncologists, pediatric surgeons, radiation oncologists, and solid tumor pathologists.
For each case, the clinician most familiar with the patient presents the clinical history, symptoms, and exam findings. Radiologists follow with a detailed review of CT, MRI, or ultrasound imaging. When surgery or biopsy has been performed, pathologists present histopathology and molecular findings to establish or confirm the diagnosis.
“The oncologist doesn’t determine staging alone,” Dr. Celiker noted. “Surgeons, radiologists, and pathologists all contribute to defining the stage. It’s a collaborative process.”
Once diagnosis and staging are established, the board discusses treatment strategies. Options may include observation, surgery, chemotherapy, radiation therapy, or multimodal approaches tailored to the tumor type and the patient’s condition.
Evaluating clinical trial treatments to improve survival, quality of life
The tumor board considers eligibility for clinical trials at the earliest stages of treatment planning. They deliberate on clinical trial options while discussing diagnosis, staging, and standard treatment pathways.
The board evaluates these factors to decide whether a child meets the overall criteria for an available protocol: tumor type, stage, molecular characteristics, prior therapies, and the child’s overall clinical condition. If an appropriate trial is open, it’s presented as a potential part of the treatment plan.
As a member institution of COG, Maimonides can access nationally coordinated phase 2 and phase 3 clinical trials with clearly defined eligibility criteria. Participating in COG allows the team to match patients to standardized protocols. The protocols help improve survival, reduce toxicity, or enhance quality of life.
“Clinical trial participation can improve survival by using new modalities or using different combination of existing treatments, or can improve quality of life during treatment by decreasing long-term and short-time side effects while maintaining efficacy,” says Dr. Celiker. “Studies have shown that children who are treated on clinical trials do better than those who aren’t, even if they get the same exact treatment.”
How phase 2 and phase 3 trials work at Maimonides
Most pediatric oncology trials conducted at Maimonides are phase 2 or phase 3 studies.
“Phase 1 trials focus on determining the tolerable dose of a new medication and are usually conducted at a select few high-volume centers around the country,” Dr. Celiker explained. “At Maimonides, we primarily participate in phase 2 and phase 3 trials.”
- Phase 2 trials: Assess whether a treatment demonstrates activity in a specific cancer type
- Phase 3 trials: Compare new treatments or new combinations with established standard therapy, often using a randomized design
“In phase 3 trials, patients are typically randomized to receive either the standard treatment or the investigational approach,” Dr. Celiker said. “If a new treatment shows significantly better results, trials may stop early so all patients can benefit.”
Phase 4 research typically involves long-term follow-up of medications to assess whether any adverse events emergethat weren’t apparent during phase 3 trials. It’s very rare for the plan to change during phase 4, but follow-up is always carried out for safety reasons.
If no suitable trial is available locally, the team consults national clinical trial databases.
“If we believe a patient may benefit more from a trial at another center than from the standard therapy we can provide, we will reach out and discuss that option with the family,” Dr. Celiker said. “Our priority is always the best possible outcome for the child.”
Current clinical trials at Maimonides
The pediatric oncology program maintains an active portfolio of COG-affiliated clinical trials across multiple disease types. Current active clinical trials include treatment of children with new onset or recurrent acute lymphoblastic leukemia, acute myeloid leukemia, neuroblastoma, and brain tumors. Clinical trials for sarcomas, bone tumors, and germ cell tumors are open to children and young adults.
The referral destination for pediatric cancer care in Brooklyn
When referring physicians work with Maimonides, they experience a multidisciplinary tumor board review and access to nationally coordinated clinical trials. It’s a comprehensive framework for pediatric cancer management.
To learn more about Brooklyn’s only pediatric cancer program that’s affiliated with the Children’s Oncology Group, visit the pediatric hematology/oncology team at Maimonides Cancer Center. For referrals, call 718-765-2680.
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