The Neuro-oncology Program at Children’s Hospital Los Angeles treats children with brain tumors and spinal cord tumors, which are the second most common types of tumors in children. We are one of the largest pediatric neuro-oncology programs in the country with more than 150 new referrals per year from Southern California, nationally and internationally. Our program offers patients access to the latest treatment options being tested in clinical trials through participation in national and international research consortia.
Every patient receives comprehensive care from a multi-disciplinary team of physicians and nurses that include neuro-oncologists, neurosurgeons, neurologists, neuroradiologists, radiation oncologists, neuropathologists, neuro-endocrinologists, rehabilitation medicine specialists, neuropsychologists, and advanced practice nurses, who are national leaders in their respective fields.
About Our Program
The neuro-oncology team has a strong track record of conducting national and international early phase clinical trials. The team’s clinical research interests include designing irradiation-avoiding treatment strategies for infants and young children with malignant brain tumors and innovative treatment strategies for patients with Central Nervous System (CNS) germ cell tumors. We also conduct research for patients with neurofibromatosis, low grade gliomas, and diffuse intrinsic pontine gliomas (DIPG). We study molecularly targeted therapies and the role of inflammation in embryonal brain tumors including medulloblastoma and atypical teratoid rhabdoid tumor (AT/RT) to improve outcomes for these patients.
Our Neurosurgery Program at CHLA performs between 700 and 1,000 neurosurgical procedures a year, nearly 100 of which are tumor resections making our program one of the top five busiest programs in the country. Due to the diversity of diseases we treat, our physicians’ ability and expertise in treating CNS tumors is outstanding.
- Multidisciplinary Care
- Clinical Trials and Research
The Neuro-oncology Program within the Children’s Center for Cancer and Blood Diseases at Children’s Hospital Los Angeles is a unique hospital-wide program that consists of collaboration with multiple departments, including Neuropathology, Neuroradiology, Neurosurgery, Endocrinology, Neurology, Rehabilitation Medicine, Radiation Oncology, and the Center for Personalized Medicine.
The Radiation Oncology Program at CHLA is an internationally recognized leader in pediatric radiation oncology and one of only two radiation oncology programs in the nation focused exclusively on children. The Department of Radiology at CHLA includes four board certified neuroradiologists. There are 6 imaging PhDs in the department, 2 of whom are dedicated to brain tumor research.
The Neuropathology Program at CHLA includes three distinguished pediatric neuropathologists. Within the Department of Pathology and Laboratory Medicine also resides the Center for Personalized Medicine, whose mission is to discover the human genome’s potential to guide preventive medicine, targeted therapies and personalized health care for the benefit of generations to come.
The Long-Term Information, Follow-Up and Evaluation (LIFE) Cancer Survivorship & Transition Service provides services that help empower cancer survivors to embrace their future as healthy and fulfilled individuals. The service, started nearly 20 years ago, is a key part of the Children’s Center for Cancer and Blood Diseases.
In addition to being a member of the Children’s Oncology Group (COG), the Neuro-oncology Program is also a member of multiple national and international consortia involved in conducting innovative early phase clinical trials for children with poor prognosis central nervous system tumors.
- Children’s Oncology Group (COG)
- Pediatric Brain Tumor Consortium (PBTC)
- Neurofibromatosis Consortium
- Collaborative Ependymoma Research Network (CERN)
- Pacific Pediatric Neuro-oncology Consortium (PNOC)
For questions about available clinical trials, please contact Dr. Girish Dhall, Director of the Neuro-oncology Program.
Please click here to view our updated portfolio of clinical trials available at CHLA.
The Michael Hoefflin Foundation Fellowship in Pediatric Neuro-oncology is a training program for clinical investigators. Graduates become experts in the field of pediatric neuro-oncology. They acquire further expertise in multidisciplinary diagnostic and treatment approaches for pediatric neuro-oncology patients and in the coordination of their care with the rest of the health care team and medical system. This includes, but is not limited to, proficiency in interpreting neuro-imaging and neuropathology, as well as devising treatment plans inclusive of chemotherapy, autologous stem cell transplant, and radiation therapy. During their fellowship they conduct clinical research in pediatric neuro-oncology.
For more information about our Fellowship in Pediatric Neuro-oncology, please click here.
Our collaborators at the USC Viterbi School of Engineering have developed a pump which allows automated continuous or timed-intermittent intrathecal delivery of chemotherapy. The device has been validated in an in vivo model. Our program recently developed a novel transgenic murine medulloblastoma model, which develops leptomeningeal dissemination, and will be used to select candidate drugs for delivery via this device. This device has recently received HUD designation by the FDA, which would permit a first-in-human testing clinical testing. A pilot protocol for a first-in-human testing of this device, in children with leptomeningeal dissemination of CNS tumors, is currently in development.
Our Research Team at Children’s Hospital Los Angeles has developed a genomic assay that can be used to identify molecular subgroups of medulloblastoma: WNT, SHH, and Groups 3 and 4, which is superior to the histological grouping of medulloblastoma. Our studies of young children with medulloblastoma treated at CHLA with upfront chemotherapy regimens has shown that the patients in SHH or WNT subgroup enjoy greater than 90% survival. Based on these data, CHLA is co-leading the first prospective randomized clinical trial that will tailor the type and intensity of treatment based on these molecular subgroups and initial response of tumors to chemotherapy in infants and young children with medulloblastoma and primitive neuroectodermal tumors (PNET). This will provide the groundwork for use of ‘personalized medicine’ in treatment of children with medulloblastoma and PNET with the goal of preserving neurocognitive function and improved survival.
Additionally, we have several basic and physician-scientists working on the molecular biology of pediatric CNS tumors. Our research focuses on understanding angiogenic and metabolic mechanisms in pediatric brain tumors, defining molecular risk signatures for medulloblastoma that would identify children who can be spared radiation therapy, defining the role of tumor microenvironment in pediatric embryonal tumors, and using neuroimaging and tracking of stem cells to brain tumors. One of our researchers is an internationally recognized expert in magnetic resonance spectroscopy (MRS). The team has conducted and published extensively on the use of MRS for studying the metabolism of pediatric brain tumors, including both carbon and phosphorus spectra.