Clinical trials in pediatric oncology over the past 30 years have led
to the situation today where most children with newly diagnosed cancer
can be treated effectively, and many are cured. Despite this dramatic
improvement in outcome for many children diagnosed with cancer, about
30-40% of children will die of their disease [1]. Although some attem
pts have been made to improve outcome by increasing the dose intensity
of existing therapies, intolerable side effects and marginal increase
s in cancer cell kill limit this approach. Clearly, effective new anti
-cancer agents are necessary to significantly improve the survival and
quality of life in children with cancer. Well-organized pediatric Pha
se I trials to establish the maximum tolerated dose (MTD), and Phase I
I trials to establish efficacy, are critical to the identification of
new anti-cancer agents.