Roger J. Packer, MD, Senior Vice-President of Children’s National Health System, has been a key figure in the national movement in innovation and care of children with brain tumors, where he says research is “accelerating discovery” in the field. That has been magnified in the past five to seven years, he says, where there have been dramatic advances in the understanding of the biology of these tumors. Still, Dr. Packer himself is never satisfied, because children are still stricken with deadly brain tumors, and there is a need for improved treatment, with fewer side-effects.
As head of Children’s National’s Brain Tumor Institute and the Gilbert Family Neurofibromatosis Institute, Dr. Packer has conducted leading research into neurological disorders of children, the impact treatment has on neurological and cognitive outcomes – including those children treated for cancer – and ways to avoid or reduce treatment-related neurologic sequelae. He has led multiple studies on a national and international level for a variety of childhood brain tumors. In addition, Dr. Packer has worked diligently in leading neuro-oncology investigations, demonstrating that neurologists should carry a leadership role on interdisciplinary teams.
Dr. Packer has been a leader in the effort to push for development of new, biologic agents and coordinated care in partnerships with others at leading children’s hospitals and universities, as well as with the pharmaceutical industry. “There is also a need for rapid, reliable early predictors and biomarkers of success. There is a sense of urgency,” Dr. Packer says. “Children are dying and others who survive have too many long-term problems.”
Dr. Packer says there has been definite progress in fighting neurological ailments in children. Survival rates for childhood medulloblastoma, a highly malignant brain tumor, have increased to 90 percent in some in some cases, he says. For medulloblastoma and low-grade gliomas, types of tumors that start in the brain or spine, therapies also have become somewhat less toxic, including the use of reduced radiation doses and more precise radiotherapy.
"We have clearly made progress,” Dr. Packer says. “We are moving ahead in terms of clinical care for patients, handling the long term side effects of treatment, and seeing increased survival rates and quality of life.”
"In the last five to seven years, tools are finally there to accelerate discovery and make progress even faster. I can see a dramatic change in how we treat these patients in the near future,” Dr. Packer adds.
Still, Dr. Packer says, there needs to be greater progress, with advances in some areas sluggish. For some types of childhood brain tumor diseases, survival remains poor, with less than 20 percent of children surviving. In other situations, the needed radiation and chemotherapy cause unavoidable side effects, including drops in IQ of 10 to 30 points and severe learning disabilities in survivors.
“We must translate understanding into precise, molecularly targeted therapy to make progress,” Packer says. “We need to be inventive and careful, but we should not get caught up in the need for perfection. Partnerships are a key to improve care, and reduce mortalities, through development of needed drugs.”
Developing such partnerships has been a hallmark of Packer’s work. He is involved with national organizations such as the Pediatric Brain Tumor Consortium and the Children’s Oncology Group. Dr. Packer’s other major research interest is neurofibromatosis, and he chairs the only national clinical trials consortium for children with neurofibromatosis and leads investigations of diverse disease manifestations, including plexiform neurofibromas, which are benign or non-cancerous tumors that grow on nerves throughout the body, low-grade gliomas affecting vision or neurologic function, and cognitive deficits.
“Our Brain Tumor and Gilbert Family Neurofibromatosis institutes are leading the way in many areas, but we cannot work in silos. We strive to work with other leading programs around the world to accelerate discovery and translate the new insights into care,” states Dr. Packer.
Dr. Packer has received many honors for his work, most recently being named Medical Honoree from the Children’s Brain Tumor Foundation for his innovative work and leadership in the care of children with brain tumors.