Bringing CNS Members Together to Make Children’s Lives Better


Roger Packer, MD

Profile written by Philip L. Pearl, MD and William D. Gaillard, MD

Roger Packer, MD

A native Chicagoan and devoted Cubs fan, Roger Joseph Packer is the son of holocaust survivors. He hails from a community of Chicago that appears to win the density award for producing the most number of child neurologists per square foot, namely Gerald Erenberg, Allen Kaplan, David Rothner, Max Wiznitzer, and Marvin Fishman. Dr. Packer has often reflected about the strong work ethic of an immigrant community whose families suffered, among other losses, a generation unable to access higher education. Their children went on to great heights, including a number of influential careers in pediatric neurology. Dr. Packer’s career arc has been nothing short of meteoric.

Initially hoping to becomes a sportswriter, but with strong paternal influence directing him toward medicine, Dr. Packer remained in his hometown for both his undergraduate and medical education at Northwestern University. A harbinger of future success was his acceptance into medical school during his sophomore year of college, although he stayed on for a third year of liberal arts thanks to scholarship support. he was honored with membership in the Beta Beta Beta National Biologic Science honors Society during college and Alpha Omega Alpha during medical school. he still revels in meeting interviewees for child neurology fellowships who are Northwestern alumni. he was inspired by neurologist David Drachman, then at Northwestern, marveling at his ability to balance superb clinical skills with work as a clinician-scientist, and discovered child neurology while in medical school thanks to the work of Marianne Larsen.

Dr. Packer took his residency training in Pediatrics at Cincinnati Children’s Medical Center, where harold Fogelson was an important early mentor. he then took his fellowship in pediatric neurology at The Children’s hospital of Philadelphia (ChOP), where his academic career and foray into pediatric neuro-oncology began. During his final fellowship year he managed to take an MDA Clinical Fellowship at ChOP and an additional fellowship at Memorial Sloan-Kettering Cancer Center in New York, where important mentors included Jerry Posner and Jeffrey Allen. he has stated that what was important then was learning what wasn’t known. From this rose the clinical questions he has asked and answered through his career.

Dr. Packer joined the faculty as Assistant Professor of Neurology and Pediatrics at the University of Pennsylvania and ChOP in 1981 and received support from a junior Faculty Clinical Fellowship award from the American Cancer Society (1983- 1985). he rose rapidly in the academic ranks, becoming a full Professor by 1989 within a time frame normally required to rise to Associate Professor at that institution. his early papers covered a range of important clinical observations, with the first manuscript – as first author – appearing in Neurology in 1980 on Creutzfeldt-jacob disease in a 20-year-old; the article was co-authored with several luminaries in adult neurology, including the great academician, Arthur Asbury, and fellow trainee, David Cornblath. his training cohort also included john Sladky and Don Younkin. Subsequent papers were co-authored with other instantly recognizable names from ChOP history, including a paper on electromyography in infantile hypotonia with Peter Berman, and the significance of computed tomography in acute bacterial meningitis with Robert Zimmerman.

If one were to isolate and define three major pivotal moves in his career, the first would be this juncture, where he entered a rich milieu of superstars in neuroscience and oncology, including the aforementioned figures in Philadelphia as well as Audrey Evans in oncology, Lucy Rorke in pathology, Dan D’Angio in radiology, and Luis Schut, Derek Bruce, and Lee Sutton in neurosurgery. As Dr. Packer puts it, he was “allowed to play with superstars.” He found a way to organize them into a cohesive clinical and academic unit, fill in gaps, and develop a nidus serving as a future model for more program development through the course of his career.

Peter Berman, the Division Chief in Neurology at CHOP at that time, explained,

“That a child neurologist would contribute to and even enhance an academic program in pediatric neuro-oncology was at that time only an idea…It remains a testament to his productivity and talent for collaboration that within two years of that appointment (to the Neuro-oncology clinic) he was named the Director of the clinic.”

By 1990 Dr. Packer had published 85 original papers,110 abstracts, 35 chapters and reviews. he made seminal contributions to the characterization of pediatric brain tumors, development of treatment protocols, and discoveries of toxic effects of therapy with efforts to reduce those components while increasing survival and improving quality of life. Groundbreaking papers included: Packer et al: “Treatment of chiasmatic/hypothalamic gliomas of childhood with chemotherapy” (Annals of Neurology, 1988), and Packer et al: “Efficacy of adjuvant chemotherapy for patients with “poor-risk” medulloblastoma” (Annals of Neurology, 1988).

Then came the next major career juncture, when he left Philadelphia to become Chairman of the Department of Neurology at Children’s National Medical Center in Washington, DC. There he built an academic neurology department from four to over thirty child neurologists, with constant program building and innovation leading to multiple divisions including child neurology, neurophysiology, neuro- critical care, and neuro-oncology. In addition, he also fostered the development of international sister programs in Toronto, Padua, and Sydney, all the while continuing a remarkable pace of academic achievement, publishing nearly 200 more original papers.

The corpus of his work includes treatment protocols that have improved outcomes for children with dreaded brain tumors. When asked about these achievements he customarily and modestly demurs, commenting that the work is really the outcome of many remarkable people in collaboration and an enterprise he was just fortunate to join. Those remarkable people, however, invariably refer to therapy for optic gliomas as “the Packer Protocol.” Earmark papers included Packer et al: “Carboplatin and vincristine for progressive low-grade gliomas of childhood” (Journal of Clinical Oncology. 1993), and Packer et al: “Phase III prospective randomized study of craniospinal radiation therapy followed by one of two adjuvant chemotherapy regimens for newly- diagnosed average risk medulloblastoma” (Journal of Clinical Oncology, 2006). The latter study in particular showed encouraging event-free survival in children with medulloblastoma following reduced dose craniospinal radiation.

More recent investigations targeted evolving pathways informed by genetic studies and molecular pathways. Proof of principle is noted in publications such as Packer et al: “Objective response of multiply recurrent low-grade gliomas to bevacizumab and irinotecan” (Pediatric Blood Cancer, 2009), where monoclonal antibody therapy in previously untreatable tumors led to clinical improvement in hemiparesis and visual loss. here progress continues to be forged with an emphasis on treatment and improving outcomes by an experienced investigator who continues to see himself primarily as a clinician. While he has expressed frustration that the quality of life indices have not kept up with the improved survival rates in pediatric brain tumors, there is deserved pride that the outcome data of every single institutional study has been reproducible by other centers at a national level, verifying the veracity and impact of the work.

The third major juncture came about ten years ago upon accepting his current position as Executive Vice President of the Neuroscience and Behavioral Medicine Center at Children’s National, which encompasses the departments of Neurology, Neurosurgery, Psychiatry, Psychology, Genetics, Physical Medicine and Rehabilitation, and hearing and Speech. During his tenure at Children’s National, Dr. Packer has trained dozens of child neurologists and neuro-oncologists, many of whom have moved to other institutions as a new generation of leaders in neuro-oncology. At Children’s National, he again developed an outstanding team, working with representatives from the related disciplines including Bob Keating in Neurosurgery, Gilbert Vezina in Radiology, and Brian Rood, among others, in Oncology. he has built a department of neurologists with venerable senior faculty including Karin Nelson and Sam Shelburne, in addition to a score of mid career and junior level faculty, all of whom having benefited from his keen attention to their career development. Children’s National’s annual Neurology Update Course, initiated by Dr. Packer in 1990, has become an established conference attracting physicians regionally and nationally.

As a testimony to his productivity, contributions, and dissemination of knowledge, Dr. Packer is an author on 267 peer-reviewed manuscripts, 306 abstracts, 256 chapters/invited reviews, and is an editor or author of 19 monographs and books. When the CNS Newsletter distributed at last year’s annual meeting in Savannah published the CNS All-Time “Top 40” Authors for first author platform presentations, it was breathtaking – but not surprising – to find Dr. Packer at the top of the list with 22, with the next group of three tied for runner-up position having 13 and only six people in the 40-year history of annual meeting presentations credited with more than ten.

Dr. Packer is also known as a family man and the famous Packer pool parties held every July are a well known respite during the humid Washington summers for the families of faculty and trainees of the neuroscience center at Children’s National. he his wife, Bernice Ruth have two children, Zehava, married to Ophir, and Michael, married to Rachel, parents of Roger and Bernice’s beautiful granddaughter, Anabel.