Childrens Center for Cancer and Blood Diseases

Director: Stuart E. Siegel, MD 
Co-director: Donald B. Kohn, MD

Jonathan Finlay, MB, ChB, may be the world’s most determined advocate for avoiding radiation therapy in children with brain cancer, the leading cause of cancer-related death in children under 16 years old.

A frequent part of treatment plans worldwide, brain irradiation can have devastating effects on intellectual development. So Dr. Finlay has spent the past 16 years creating alternatives as leader of the “Head Start” Brain Tumor Consortium. This international group of more than 40 participating centers, based at Childrens Hospital Los Angeles, develops and tests innovative protocols for young children newly diagnosed with malignant brain tumors.

The current protocol uses five months of standard, intensive doses of chemotherapy, followed by a single course of extremely high dose drug treatment (equivalent to a year’s worth in just six days) and a blood cell transplant with the patient’s own previously collected and preserved blood cells. Children under age six who achieve a complete remission receive no irradiation. Those ages six to 10 receive much lower than the standard doses. “At least 50 to 60 percent of the children stay in remission, without cognitive deficits. That’s good, but not good enough,” says Dr. Finlay, clinical director of the Neural Tumors Program at Childrens Hospital.

Another “Head Start” study will begin in the next two years, adding mild post-transplant drug treatment to target any surviving cancer cells. In collaboration with other North American pediatric cancer programs, Dr. Finlay also will initiate Phase I clinical trials in 2008 to establish maximum-tolerated dosage of potential new drugs. It is one more facet of his strategy: better drugs, utilized in better ways.