Forty years of collaboration, discovery and progress in pediatric neuro-oncology - Children's National

When Roger J. Packer, MD, organized the first International Symposium on Pediatric Neuro-Oncology (ISPNO) in 1986, he saw an opportunity to bring together experts from around the world who shared a common goal: advancing care and outcomes for children with brain tumors.

Four decades later, that vision has evolved into the world's premier pediatric neuro-oncology meeting, fostering collaboration across disciplines, accelerating the exchange of scientific discoveries and helping shape the future of the field.

That vision was on display once again at the 22nd International Symposium on Pediatric Neuro-Oncology, held June 28 through July 1, 2026, in Sydney, Australia. More than 1,000 attendees from 56 countries gathered for four days of scientific presentations, collaboration and discussion focused on improving care for children with central nervous system tumors.

For Dr. Packer, director of the Brain Tumor Institute and director of the Gilbert Family Neurofibromatosis Institute at Children's National, the symposium's 40-year milestone offers a chance to reflect on how the field has evolved and where it may be headed next.

From a small meeting to a global movement

The origins of ISPNO were modest.

"When we first conceptualized and had the first meeting, we convened a very small group, about 100 to 150 people interested in pediatric brain tumors," Dr. Packer says. "It was a mix of neurosurgeons, neurologists, oncologists and radiation oncologists."

The first major international symposium followed in Philadelphia, drawing more than 350 attendees, far exceeding expectations and helping establish the foundation for what would become ISPNO.

"We expected 200 people, and we got 350," Dr. Packer recalls. "From there, we decided to make this a truly international meeting that would reach all disciplines involved in the care of children with brain tumors."

Unlike many professional organizations, ISPNO was intentionally designed as a symposium rather than a society. Its purpose was simple: bring together basic scientists, translational researchers and clinicians to openly share ideas and discoveries.

"The goal has not been anything other than the rapid interchange of ideas and growing the field," Dr. Packer says.

That approach helped transform ISPNO into a global forum that today attracts well over 1,000 participants while expanding opportunities for clinicians and investigators from developing countries to participate and share their work.

A front-row seat to the molecular era

Over the last 40 years, pediatric neuro-oncology has undergone dramatic transformation. Dr. Packer recalls a turning point roughly a decade ago when researchers began sharing groundbreaking discoveries about the biology of pediatric brain tumors.

"There had been this explosion in our understanding of the biology of childhood medulloblastomas and an inkling that a similar explosion would occur in childhood gliomas," he says. "That was entering the molecular era of childhood brain tumor care."

Those insights ushered in a new generation of biologically driven therapies that have changed how tumors are classified and treated. What was once a field largely defined by surgery, radiation and chemotherapy is increasingly shaped by molecular targeted therapies and immunotherapy.

"Over the past two meetings, immunotherapy, especially cellular immunotherapy, has increasingly revolutionized the field and given us great hope," Dr. Packer says.

The symposium itself has reflected that evolution, drawing growing numbers of molecular biologists, immunologists and translational researchers alongside neurosurgeons, oncologists and neurologists.

Children's National driving the next generation of discovery

Many of the advances highlighted at ISPNO mirror work underway at Children's National.

"I think it's amazing to me that in the last two years, because of new resources, philanthropy and new ideas, we've been able to open eight to 10 new biologically based either cellular therapy or molecular targeted therapy protocols," Dr. Packer says. "About half of those will be emanating directly from work being done here and led by our investigators."

Among those efforts are Children's National-led CAR T-cell studies and novel approaches combining focused ultrasound technology with cellular therapies.

"We're the first to take the technology of focused ultrasound and combine it with cellular therapy," Dr. Packer says. "It's very exciting."

That spirit of innovation was evident throughout the 2026 symposium, where Children's National experts presented research spanning targeted therapies, cellular immunotherapy, artificial intelligence, neurofibromatosis and rare brain tumors.

Children's National at ISPNO 2026

Children's National physicians and researchers contributed across the scientific program as presenters, moderators, panel participants and poster authors. Highlights included:

Presentations and Leadership Roles

• Roger J. Packer, MD, Transformations in Therapy for Medulloblastoma in 2026: Where We Stand and Where We Must Go
• Roger J. Packer, MD, Presenter during the symposium Awards Ceremony
• Brian Rood, MD , chair, Children's Brain Tumor Network (CBTN) Lunchtime Symposium
• Dalia Haydar, PharmD, PhD , Selective Tumor-Associated Macrophage Targeting Enhances CAR T-Cell Therapy in Pediatric DIPG
• Dalia Haydar, PharmD, PhD, Targeting TAM and Microglial States to Potentiate B7-H3 CAR T-Cell Therapy in Group 3 Medulloblastoma
• Dalia Haydar, PharmD, PhD, Engineering Next-Generation CAR T Cells for Pediatric Brain Tumors: Dual Targeting Strategies
• Lindsay B. Kilburn, MD , Results from a PNOC phase I trial evaluating trametinib and everolimus in pediatric and young adult patients with high-grade glioma or recurrent low-grade glioma
• Lindsay B. Kilburn, MD , Results from Pediatric Brain Tumor Consortium trial PBTC-055 evaluating targeted therapies for recurrent or progressive low-grade glioma
• Marius George Linguraru, DPhil, MA, MSc , HOPE4KIDS: AI-Enabled Web Platform for Tumor and Age Agnostic Assessment of Brain Tumor Burden from MRI
• Eugene Hwang, MD , debate participant in We should allow AI to generate independent recommendations in cancer care and research

Poster Presentations

• Marius George Linguraru, DPhil, MA, MSc, Local Magnetic Resonance Imaging Radiomic Features of the Anterior Visual Pathway Differentiate Observation Versus Treatment in Children with NF1-OPG
• Marius George Linguraru, DPhil, MA, MSc, CAVS-NF1: Web-Based AI Tool for Longitudinal Volumetric Analysis of Anterior Visual Pathway in NF1
• Eugene Hwang, MD, JACOB: Joint Administration of cDNA for TP53, Checkpoint Inhibition and Boost/Hypofractionated Radiation
• Lindsay B. Kilburn, MD, Safety, Feasibility and Preliminary Efficacy of the First-in-Child Phase 1/2 Study of Escalating Dose Sonodynamic Therapy Using SONALA-001 Together With MR-Guided Focused Ultrasound in Pediatric Patients With Newly Diagnosed DIPG
• Adriana Fonseca, MD , Learning From Every Rare Case: The Early Impact of an International Pediatric Rare Brain Tumor Board
• Adriana Fonseca, MD, CNS Tumor Type Prevalence According to Age Group: An Analysis of 21,000 Cases Confirmed by Methylation Profiling
• Dipak Poria, PhD, Adriana Fonseca, MD, Building Preclinical Models for Ultra-Rare Pediatric Brain Tumors: Early Outputs of the International Rare Brain Tumor Program
• Dipak Poria, PhD, Adriana Fonseca, MD, Establishing Patient-Derived and iPSC-Organoid Models of High-Risk Childhood Astroblastoma
• Dalia Haydar, PharmD, PhD, From Design to DEFEAT: Optimizing Dual-Target B7H3/GPC2 CAR T Cells for Pediatric Brain Tumors
• Dalia Haydar, PharmD, PhD, TCR-CAR T Cells as a Novel Approach for Pediatric High-Grade Glioma Therapy
• Elton VanNoy, Modulating DNA Methylation During CAR T Manufacturing to Enhance Immunotherapy for Pediatric Glioma
• Kaleem Coleman, MicroRNA-Mediated Reprogramming of the Tumor Microenvironment: Enhancing CAR T-Cell Therapy for Diffuse Intrinsic Pontine Glioma
• Conrad Russell Cruz, Harnessing the Noncanonical Peptidome of Diffuse Midline Glioma for Adoptive T-Cell Therapies
• Ryan Corbett, PhD, A Compendium of Tumor-Enriched Splice Junctions in the Pediatric Brain Tumor Atlas
• Patricia Sullivan, PhD, Using TAPESTRY to Interactively Explore Tumor-Specific Alternative Splicing in Pediatric CNS Tumors

Looking toward the next 40 years

While much has changed since the first symposium, Dr. Packer believes the field is only beginning to realize the potential of recent scientific advances.

Survival rates for some pediatric brain tumors have improved dramatically, and treatments are becoming increasingly precise and less harmful. Looking ahead, he expects molecular therapies and immunotherapies to reshape outcomes for children facing the most challenging diagnoses.

"I think the next decade will bring transformational steps," he says. "We will take tumor types that are currently essentially incurable or have a very low likelihood of long-term survival to a point where we can treat them effectively and save the majority of children."

For Dr. Packer, however, the symposium's greatest accomplishment is not the size of the meeting or the number of attendees. It is the culture of collaboration that has defined ISPNO from the beginning.

"My advice is to think globally and not siloed," he says. "Ensure the sharing of knowledge freely without barriers."

Forty years after helping launch ISPNO, that philosophy continues to guide both the symposium and the work taking place at Children's National. As new discoveries move from the laboratory to clinical trials and ultimately to patients, the institution remains at the forefront of efforts to improve outcomes and quality of life for children with brain tumors around the world.