For Dr. Felgenhauer, a love for pediatrics began in Spokane in the early 1980s when she worked as a pediatric Certified Physician's Assistant (PA-C). As a PA-C she worked both in general pediatrics and pediatric hematology/oncology. She later attended medical school, and completed her residency and fellowship in Seattle at the University of Washington/Seattle Children's and Fred Hutchinson Cancer Research Center. Dr. Felgenhauer returned to Spokane in 1996 where she began her practice in the field of pediatric hematology & oncology. She has been the Principal Investigator for COG at Sacred Heart Children's Hospital since 2004. (You can find more information about COG on their website http://www.childrensoncologygroup.org/ )
In her work with COG she has participated in numerous clinical research trials. Her participation has enabled patients at Sacred Heart Children's Hospital access to research treatments. She recently completed running a COG clinical trial for metastatic Ewing's sarcoma. Ewing's sarcoma is a malignant (cancerous) bone tumor that affects children. Ewing's sarcoma can occur any time during childhood and young adulthood, but usually develops during puberty, when bones are growing rapidly. The results of this clinical trial should be published soon.
Sacred Heart Children's Hospital and Providence Regional Cancer Center are currently participating in several clinical research trials for hematology including hosting registries for ITP and neutropenia. While all pediatric hematologists / oncologists are trained to incorporate clinical trials into their everyday medical practice, Dr. Felgenhauer goes above and beyond. In addition to participating in COG clinical trials, she also serves on COG Boards and serves as the Principal investigator for national trials. She is one of the vice-chairs for the Adolescent and Young Adult Committee for COG, and is a member of the COG Voting Body Steering Committee. She is also the principal investigator for the Universal Data Collection protocol for bleeding disorder patients. The Universal Data Collection (UDC) system is being carried out with the help of federally funded hemophilia treatment centers (HTCs) in the United States.
www.cdc.gov/ncbddd/blooddisorders/udc/udc-hemophilia.html)
Dr. Felgenhauer also participated in a trial for which the results were recently presented at the June meeting of the American Society for Clinical Oncology . The study results established new treatment standards for patients with acute lymphoblastic leukemia (ALL). ALL is a fast growing cancer of white blood cells diagnosed in more than 4,000 children and adolescents each year.
The current treatment for ALL is to use the agent methotrexate. Methotrexate has been an essential component in treating children with ALL more than 50 years. However, the doctors have not known what the best dose for this medication should be nor the best time during treatment to give the medication. Clinical research studies have been done to help answer these questions. While the current treatment has led to improved cure rates for ALL, relapse rates in the central nervous system (CNS) have not declined as significantly, representing an ongoing need for better treatment options.
To reduce these CNS relapses, this recent study tested a methotrexate regimen that delivers a dose 50 times the starting dose of the prior escalating regimen. The hypothesis was that doing so would increase the chance that methotrexate would infiltrate the central nervous system. The pediatric oncology clinic enrolled 14 patients onto this study.
The medication regime tested in the study showed an improvement in "relapse-free survival" after 5 years. This means the patients tested with the new regime for the study had fewer CNS relapses than those with the usual treatment. The study was done in both children and young adults.
"Pediatric ALL was once a deadly form of leukemia, and now it's one of the most curable. This trial helps us address an important need for patients with this disease. With these results, we now have an approach that will raise cure rates even higher," said Eric C. Larsen, MD, principal investigator of the study and director of the Maine Children's Cancer Program and the Division of Pediatric Hematology/Oncology at the Barbara Bush Children's Hospital at Maine Medical Center. "Based on the findings from this trial, all current and upcoming treatment protocols for children with newly diagnosed high-risk B-precursor ALL will use this regimen."
To read more about the study click here.