Treating childhood ALL serves as a paradigm for how treatment strategies evolve over time, and how treatment outcome can be improved via integration of new knowledge and new technologies. Modern multi-agent regimens are complex and similar outcomes are attained by groups that utilize different risk stratification algorithms and treatment strategies. New technologies have the potential to identify new therapeutic targets and to facilitate a transition to personalized medicine in pediatric cancer. This Symposium is designed to help trainees, junior faculty, and established investigators understand how modern COG ALL treatment regimens have evolved, and provide a perspective on how new developments will alter therapy in the future.