Cancer during childhood and adolescence has been transformed since the 1950s from a death sentence into long-term survival for most who get state-of-the-art treatment. Success has come mainly through more intense use of decades-old drugs developed originally for adult cancers.  Many survivors pay a price, however: lifelong, serious adverse effects.  And for some types of cancer, there are no cures.

Now, continued improvements in survival and less toxic outcomes will be achieved only with new chemical and biological agents. Despite a wealth of tantalizing leads from basic science, there is a near-complete void in commercial R&D for pediatric cancer. As devastating as cancer is in children, the numbers affected are too small to drive innovation in the private sector.

There is another way to harness the disparate activities already in existence to discover and develop new drugs for pediatric cancers. Making Better Drugs for Children with Cancer describes a practical approach to joining the capabilities of the National Institutes of Health, academic laboratories, and the pharmaceutical industry in a virtual R&D network. The proposed "public-private partnership" is modeled on networks in place for cystic fibrosis, tuberculosis, malaria, and other conditions.  The report also recommends actions that could eliminate the current delays in pediatric testing of new cancer drugs in development for adult cancers.