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Chen HX, Song M, Maecker HT, Gnjatic S, Patton D, Lee JJ, Adam SJ, Moravec R, Liu XS, Cerami E, Lindsay J, Tang M, Hodi FS, Wu CJ, Wistuba II, Al-Atrash G, Bernatchez C, Bendall SC, Hewitt SM, Sharon E, Streicher H, Enos RA, Bowman MD, Tatard-Leitman VM, Sanchez-Espiridion B, Ranasinghe S, Pichavant M, Del Valle DM, Yu J, Janssens S, Peterson-Klaus J, Rowe C, Bongers G, Jenq RR, Chang CC, Abrams JS, Mooney M, Doroshow JH, Harris LN, Thurin M. Network for Biomarker Immunoprofiling for Cancer Immunotherapy: Cancer Immune Monitoring and Analysis Centers and Cancer Immunologic Data Commons (CIMAC-CIDC). Clin Cancer Res 2021; 27:5038-5048. [PMID: 33419780 PMCID: PMC8491462 DOI: 10.1158/1078-0432.ccr-20-3241] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/09/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Immunoprofiling to identify biomarkers and integration with clinical trial outcomes are critical to improving immunotherapy approaches for patients with cancer. However, the translational potential of individual studies is often limited by small sample size of trials and the complexity of immuno-oncology biomarkers. Variability in assay performance further limits comparison and interpretation of data across studies and laboratories. EXPERIMENTAL DESIGN To enable a systematic approach to biomarker identification and correlation with clinical outcome across trials, the Cancer Immune Monitoring and Analysis Centers and Cancer Immunologic Data Commons (CIMAC-CIDC) Network was established through support of the Cancer MoonshotSM Initiative of the National Cancer Institute (NCI) and the Partnership for Accelerating Cancer Therapies (PACT) with industry partners via the Foundation for the NIH. RESULTS The CIMAC-CIDC Network is composed of four academic centers with multidisciplinary expertise in cancer immunotherapy that perform validated and harmonized assays for immunoprofiling and conduct correlative analyses. A data coordinating center (CIDC) provides the computational expertise and informatics platforms for the storage, integration, and analysis of biomarker and clinical data. CONCLUSIONS This overview highlights strategies for assay harmonization to enable cross-trial and cross-site data analysis and describes key elements for establishing a network to enhance immuno-oncology biomarker development. These include an operational infrastructure, validation and harmonization of core immunoprofiling assays, platforms for data ingestion and integration, and access to specimens from clinical trials. Published in the same volume are reports of harmonization for core analyses: whole-exome sequencing, RNA sequencing, cytometry by time of flight, and IHC/immunofluorescence.
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Affiliation(s)
- Helen X Chen
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland.
| | - Minkyung Song
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland
| | - Holden T Maecker
- The Human Immune Monitoring Center (HIMC), Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California
| | - Sacha Gnjatic
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David Patton
- Center for Biomedical Informatics and Information Technology, NCI, Bethesda, Maryland
| | - J Jack Lee
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stacey J Adam
- Foundation for the National Institutes of Health, North Bethesda, Maryland
| | - Radim Moravec
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, NCI, Bethesda, Maryland
- Kelly Services, Rockville, Maryland
| | - Xiaole Shirley Liu
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ethan Cerami
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - James Lindsay
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ming Tang
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - F Stephen Hodi
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Catherine J Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
- Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gheath Al-Atrash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chantale Bernatchez
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sean C Bendall
- Department of Pathology, School of Medicine, Stanford University, Stanford, California
| | - Stephen M Hewitt
- Laboratory of Pathology, Center for Cancer Research, NCI, Bethesda, Maryland
| | - Elad Sharon
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland
| | - Howard Streicher
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland
| | | | | | | | - Beatriz Sanchez-Espiridion
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Srinika Ranasinghe
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mina Pichavant
- The Human Immune Monitoring Center (HIMC), Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California
| | - Diane M Del Valle
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joyce Yu
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | - Cathy Rowe
- Center for Biomedical Informatics and Information Technology, NCI, Bethesda, Maryland
- Essex Management, Rockville, Maryland
| | - Gerold Bongers
- Microbiome Translational Center, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert R Jenq
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chia-Chi Chang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey S Abrams
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland
| | - Margaret Mooney
- Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (NCI), Bethesda, Maryland
| | - James H Doroshow
- Division of Cancer Treatment and Diagnosis, NCI, Bethesda, Maryland
| | - Lyndsay N Harris
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, NCI, Bethesda, Maryland
| | - Magdalena Thurin
- Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, NCI, Bethesda, Maryland.
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Levy EB, Fiel MI, Hamilton SR, Kleiner DE, McCall SJ, Schirmacher P, Travis W, Kuo MD, Suh RD, Tam AL, Islam SU, Ferry-Galow K, Enos RA, Doroshow JH, Makhlouf HR. State of the Art: Toward Improving Outcomes of Lung and Liver Tumor Biopsies in Clinical Trials-A Multidisciplinary Approach. J Clin Oncol 2020; 38:1633-1640. [PMID: 32134701 DOI: 10.1200/jco.19.02322] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE National Cancer Institute (NCI)-sponsored clinical trial network studies frequently require biopsy specimens for pharmacodynamic and molecular biomarker analyses, including paired pre- and post-treatment samples. The purpose of this meeting of NCI-sponsored investigators was to identify local institutional standard procedures found to ensure quantitative and qualitative specimen adequacy. METHODS NCI convened a conference on best biopsy practices, focusing on the clinical research community. Topics discussed were (1) criteria for specimen adequacy in the personalized medicine era, (2) team-based approaches to ensure specimen adequacy and quality control, and (3) risk considerations relevant to academic and community practitioners and their patients. RESULTS AND RECOMMENDATIONS Key recommendations from the convened consensus panel included (1) establishment of infrastructure for multidisciplinary biopsy teams with a formalized information capture process, (2) maintenance of standard operating procedures with regular team review, (3) optimization of tissue collection and yield methodology, (4) incorporation of needle aspiration and other newer techniques, and (5) commitment of stakeholders to use of guideline documents to increase awareness of best biopsy practices, with the goal of universally improving tumor biopsy practices.
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Affiliation(s)
- Elliot B Levy
- Center for Interventional Oncology, Radiology and Imaging Sciences and Center for Cancer Research, National Institutes of Health, Bethesda, MD
| | - Maria I Fiel
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stanley R Hamilton
- Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David E Kleiner
- Laboratory of Pathology, National Institutes of Health, Bethesda, MD
| | | | - Peter Schirmacher
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - William Travis
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Michael D Kuo
- Department of Radiology Medical Artificial Intelligence Laboratory Initiative, The University of Hong Kong, Hong Kong
| | - Robert D Suh
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, CA
| | - Alda L Tam
- Department of Interventional Radiology, MD Anderson Cancer Center, Houston, TX
| | - Shaheen U Islam
- Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Katherine Ferry-Galow
- Laboratory of Human Toxicology and Pharmacology, Applied/ Developmental Research Support Directorate, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD
| | | | - James H Doroshow
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
| | - Hala R Makhlouf
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
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Leung SCY, Nielsen TO, Zabaglo L, Arun I, Badve SS, Bane AL, Bartlett JMS, Borgquist S, Chang MC, Dodson A, Enos RA, Fineberg S, Focke CM, Gao D, Gown AM, Grabau D, Gutierrez C, Hugh JC, Kos Z, Lænkholm AV, Lin MG, Mastropasqua MG, Moriya T, Nofech-Mozes S, Osborne CK, Penault-Llorca FM, Piper T, Sakatani T, Salgado R, Starczynski J, Viale G, Hayes DF, McShane LM, Dowsett M. Analytical validation of a standardized scoring protocol for Ki67: phase 3 of an international multicenter collaboration. NPJ Breast Cancer 2016; 2:16014. [PMID: 28721378 PMCID: PMC5515324 DOI: 10.1038/npjbcancer.2016.14] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/22/2016] [Accepted: 04/01/2016] [Indexed: 11/09/2022] Open
Abstract
Pathological analysis of the nuclear proliferation biomarker Ki67 has multiple potential roles in breast and other cancers. However, clinical utility of the immunohistochemical (IHC) assay for Ki67 immunohistochemistry has been hampered by unacceptable between-laboratory analytical variability. The International Ki67 Working Group has conducted a series of studies aiming to decrease this variability and improve the evaluation of Ki67. This study tries to assess whether acceptable performance can be achieved on prestained core-cut biopsies using a standardized scoring method. Sections from 30 primary ER+ breast cancer core biopsies were centrally stained for Ki67 and circulated among 22 laboratories in 11 countries. Each laboratory scored Ki67 using three methods: (1) global (4 fields of 100 cells each); (2) weighted global (same as global but weighted by estimated percentages of total area); and (3) hot-spot (single field of 500 cells). The intraclass correlation coefficient (ICC), a measure of interlaboratory agreement, for the unweighted global method (0.87; 95% credible interval (CI): 0.81–0.93) met the prespecified success criterion for scoring reproducibility, whereas that for the weighted global (0.87; 95% CI: 0.7999–0.93) and hot-spot methods (0.84; 95% CI: 0.77–0.92) marginally failed to do so. The unweighted global assessment of Ki67 IHC analysis on core biopsies met the prespecified criterion of success for scoring reproducibility. A few cases still showed large scoring discrepancies. Establishment of external quality assessment schemes is likely to improve the agreement between laboratories further. Additional evaluations are needed to assess staining variability and clinical validity in appropriate cohorts of samples.
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Affiliation(s)
- Samuel C Y Leung
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Torsten O Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lila Zabaglo
- Academic Department of Biochemistry, Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom
| | - Indu Arun
- Department of Pathology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sunil S Badve
- Department of Pathology and Laboratory Medicine, Indiana University Simon Cancer Center, Indianapolis, Indiana, USA
| | - Anita L Bane
- Department of Pathology and Molecular Medicine, Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, Ontario, Canada
| | - John M S Bartlett
- Transformative Pathology, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Signe Borgquist
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Martin C Chang
- Department of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Andrew Dodson
- Academic Department of Biochemistry, Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom
| | | | - Susan Fineberg
- Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Cornelia M Focke
- Department of Pathology, Dietrich-Bonhoeffer Medical Center, Neubrandenburg, Mecklenburg-Vorpommern, Germany
| | - Dongxia Gao
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Allen M Gown
- PhenoPath Laboratories, Seattle, Washington, USA
| | - Dorthe Grabau
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Carolina Gutierrez
- Lester and Sue Smith Breast Center and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | - Judith C Hugh
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Zuzana Kos
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Ming-Gang Lin
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Mauro G Mastropasqua
- Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Kurashiki, Okayama Prefecture, Japan
| | - Sharon Nofech-Mozes
- Department of Laboratory Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C Kent Osborne
- Lester and Sue Smith Breast Center and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
| | | | - Tammy Piper
- Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Takashi Sakatani
- Department of Pathology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan
| | - Roberto Salgado
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Brussels, Belgium
| | - Jane Starczynski
- Department of Cellular Pathology, Birmingham Heart of England, National Health Service, Birmingham, United Kingdom
| | - Giuseppe Viale
- Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Milan, Italy
| | - Daniel F Hayes
- Breast Oncology Program, Department of Internal Medicine, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, USA
| | - Lisa M McShane
- Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland, USA
| | - Mitch Dowsett
- Academic Department of Biochemistry, Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom
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St Germain D, Denicoff AM, Dimond EP, Carrigan A, Enos RA, Gonzalez MM, Wilkinson K, Mathiason MA, Duggan B, Einolf S, McCaskill-Stevens W, Bryant DM, Thompson MA, Grubbs SS, Go RS. Use of the National Cancer Institute Community Cancer Centers Program screening and accrual log to address cancer clinical trial accrual. J Oncol Pract 2014; 10:e73-80. [PMID: 24424313 DOI: 10.1200/jop.2013.001194] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Screening logs have the potential to help oncology clinical trial programs at the site level, as well as trial leaders, address enrollment in real time. Such an approach could be especially helpful in improving representation of racial/ethnic minority and other underrepresented populations in clinical trials. METHODS The National Cancer Institute Community Cancer Centers Program (NCCCP) developed a screening log. Log data collected from March 2009 through May 2012 were analyzed for number of patients screened versus enrolled, including for demographic subgroups; screening methods; and enrollment barriers, including reasons for ineligibility and provider and patient reasons for declining to offer or participate in a trial. User feedback was obtained to better understand perceptions of log utility. RESULTS Of 4,483 patients screened, 18.4% enrolled onto NCCCP log trials. Reasons for nonenrollment were ineligibility (51.6%), patient declined (25.8%), physician declined (15.6%), urgent need for treatment (6.6%), and trial suspension (0.4%). Major reasons for patients declining were no desire to participate in trials (43.2%) and preference for standard of care (39%). Major reasons for physicians declining to offer trials were preference for standard of care (53%) and concerns about tolerability (29.3%). Enrollment rates onto log trials did not differ between white and black (P = .15) or between Hispanic and non-Hispanic patients (P = .73). Other races had lower enrollment rates than whites and blacks. Sites valued the ready access to log data on enrollment barriers, with some sites changing practices to address those barriers. CONCLUSION Use of screening logs to document enrollment barriers at the local level can facilitate development of strategies to enhance clinical trial accrual.
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Affiliation(s)
- Diane St Germain
- National Cancer Institute, Bethesda; SAIC-Frederick, Frederick National Laboratory for Cancer Research, Frederick; The EMMES Corporation, Rockville, MD; St Joseph Hospital of Orange, Orange, CA; Billings Clinic Cancer Center, Billings, MT; Gundersen Health System, La Crosse; Waukesha Memorial Hospital (ProHealth Care), Waukesha, WI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE
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Polley MYC, Leung SCY, McShane LM, Gao D, Hugh JC, Mastropasqua MG, Viale G, Zabaglo LA, Penault-Llorca F, Bartlett JMS, Gown AM, Symmans WF, Piper T, Mehl E, Enos RA, Hayes DF, Dowsett M, Nielsen TO. An international Ki67 reproducibility study. J Natl Cancer Inst 2013; 105:1897-906. [PMID: 24203987 PMCID: PMC3888090 DOI: 10.1093/jnci/djt306] [Citation(s) in RCA: 431] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 09/03/2013] [Accepted: 09/16/2013] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In breast cancer, immunohistochemical assessment of proliferation using the marker Ki67 has potential use in both research and clinical management. However, lack of consistency across laboratories has limited Ki67's value. A working group was assembled to devise a strategy to harmonize Ki67 analysis and increase scoring concordance. Toward that goal, we conducted a Ki67 reproducibility study. METHODS Eight laboratories received 100 breast cancer cases arranged into 1-mm core tissue microarrays-one set stained by the participating laboratory and one set stained by the central laboratory, both using antibody MIB-1. Each laboratory scored Ki67 as percentage of positively stained invasive tumor cells using its own method. Six laboratories repeated scoring of 50 locally stained cases on 3 different days. Sources of variation were analyzed using random effects models with log2-transformed measurements. Reproducibility was quantified by intraclass correlation coefficient (ICC), and the approximate two-sided 95% confidence intervals (CIs) for the true intraclass correlation coefficients in these experiments were provided. RESULTS Intralaboratory reproducibility was high (ICC = 0.94; 95% CI = 0.93 to 0.97). Interlaboratory reproducibility was only moderate (central staining: ICC = 0.71, 95% CI = 0.47 to 0.78; local staining: ICC = 0.59, 95% CI = 0.37 to 0.68). Geometric mean of Ki67 values for each laboratory across the 100 cases ranged 7.1% to 23.9% with central staining and 6.1% to 30.1% with local staining. Factors contributing to interlaboratory discordance included tumor region selection, counting method, and subjective assessment of staining positivity. Formal counting methods gave more consistent results than visual estimation. CONCLUSIONS Substantial variability in Ki67 scoring was observed among some of the world's most experienced laboratories. Ki67 values and cutoffs for clinical decision-making cannot be transferred between laboratories without standardizing scoring methodology because analytical validity is limited.
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Affiliation(s)
- Mei-Yin C Polley
- Affiliations of authors: Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD (MCP, LMM); Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada (SCYL, DG, EM, TON); Department of Laboratory Medicine and Pathology, University of Alberta, Alberta, Canada (JCH); Division of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy (MGM); Division of Pathology and Laboratory Medicine, European Institute of Oncology, and University of Milan, Milan, Italy (GV); Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, United Kingdom (LAZ); Department of Pathology, Centre Jean Perrin, Clermont-Ferrand, and Université d'Auvergne, France (FP-L); Transformative Pathology, Ontario Institute for Cancer Research, Toronto, Ontario, Canada (JMSB); PhenoPath Laboratories, Seattle, WA (AMG); Department of Pathology, MD Anderson Cancer Center, Houston, TX (WFS); Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh, United Kingdom (TP); The EMMES Corporation, Rockville, MD (RAE); Breast Oncology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI (DFH); Academic Department of Biochemistry, Royal Marsden Hospital, London, United Kingdom (MD); on behalf of the International Ki67 in Breast Cancer Working Group of the Breast International Group and North American Breast Cancer Group
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Langford AT, Resnicow K, Dimond EP, Denicoff AM, Germain DS, McCaskill-Stevens W, Enos RA, Carrigan A, Wilkinson K, Go RS. Racial/ethnic differences in clinical trial enrollment, refusal rates, ineligibility, and reasons for decline among patients at sites in the National Cancer Institute's Community Cancer Centers Program. Cancer 2013; 120:877-84. [PMID: 24327389 DOI: 10.1002/cncr.28483] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/20/2013] [Accepted: 09/26/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study examined racial/ethnic differences among patients in clinical trial (CT) enrollment, refusal rates, ineligibility, and desire to participate in research within the National Cancer Institute's Community Cancer Centers Program (NCCCP) Clinical Trial Screening and Accrual Log. METHODS Data from 4509 log entries were evaluated in this study. Four logistic regression models were run using physical/medical conditions, enrollment into a CT, patient eligible but declined a CT, and no desire to participate in research as dependent variables. RESULTS Age ≥ 65 years (OR = 1.51, 95% CI = 1.28-1.79), males (OR = 2.28, 95% CI = 1.92-2.71), and non-Hispanic black race (OR = 1.53, 95% CI = 1.2-1.96) were significantly associated with more physical/medical conditions. Age ≥ 65 years was significantly associated with lower CT enrollment (OR = 0.83, 95% CI = 0.7-0.98). Males (OR = 0.78, 95% CI = 0.65-0.94) and a higher grade level score for consent form readability (OR = 0.9, 95% CI = 0.83-0.97) were significantly associated with lower refusal rates. Consent page length ≥ 20 was significantly associated with lower odds of "no desire to participate in research" among CT decliners (OR = 0.75, 95% CI = 0.58-0.98). CONCLUSIONS There were no racial/ethnic differences in CT enrollment, refusal rates, or "no desire to participate in research" as the reason given for CT refusal. Higher odds of physical/medical conditions were associated with older age, males, and non-Hispanic blacks. Better management of physical/medical conditions before and during treatment may increase the pool of eligible patients for CTs. Future work should examine the role of comorbidities, sex, age, and consent form characteristics on CT participation.
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Affiliation(s)
- Aisha T Langford
- University of Michigan, School of Public Health, Ann Arbor, Michigan
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7
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Denicoff AM, McCaskill-Stevens W, Grubbs SS, Bruinooge SS, Comis RL, Devine P, Dilts DM, Duff ME, Ford JG, Joffe S, Schapira L, Weinfurt KP, Michaels M, Raghavan D, Richmond ES, Zon R, Albrecht TL, Bookman MA, Dowlati A, Enos RA, Fouad MN, Good M, Hicks WJ, Loehrer PJ, Lyss AP, Wolff SN, Wujcik DM, Meropol NJ. The National Cancer Institute-American Society of Clinical Oncology Cancer Trial Accrual Symposium: summary and recommendations. J Oncol Pract 2013; 9:267-76. [PMID: 24130252 PMCID: PMC3825288 DOI: 10.1200/jop.2013.001119] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Many challenges to clinical trial accrual exist, resulting in studies with inadequate enrollment and potentially delaying answers to important scientific and clinical questions. METHODS The National Cancer Institute (NCI) and the American Society of Clinical Oncology (ASCO) cosponsored the Cancer Trial Accrual Symposium: Science and Solutions on April 29-30, 2010 to examine the state of accrual science related to patient/community, physician/provider, and site/organizational influences, and identify new interventions to facilitate clinical trial enrollment. The symposium featured breakout sessions, plenary sessions, and a poster session including 100 abstracts. Among the 358 attendees were clinical investigators, researchers of accrual strategies, research administrators, nurses, research coordinators, patient advocates, and educators. A bibliography of the accrual literature in these three major areas was provided to participants in advance of the meeting. After the symposium, the literature in these areas was revisited to determine if the symposium recommendations remained relevant within the context of the current literature. RESULTS Few rigorously conducted studies have tested interventions to address challenges to clinical trials accrual. Attendees developed recommendations for improving accrual and identified priority areas for future accrual research at the patient/community, physician/provider, and site/organizational levels. Current literature continues to support the symposium recommendations. CONCLUSIONS A combination of approaches addressing both the multifactorial nature of accrual challenges and the characteristics of the target population may be needed to improve accrual to cancer clinical trials. Recommendations for best practices and for future research developed from the symposium are provided.
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Affiliation(s)
- Andrea M. Denicoff
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Worta McCaskill-Stevens
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Stephen S. Grubbs
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Suanna S. Bruinooge
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Robert L. Comis
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Peggy Devine
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - David M. Dilts
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Michelle E. Duff
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Jean G. Ford
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Steven Joffe
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Lidia Schapira
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Kevin P. Weinfurt
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Margo Michaels
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Derek Raghavan
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Ellen S. Richmond
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Robin Zon
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Terrance L. Albrecht
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Michael A. Bookman
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Afshin Dowlati
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Rebecca A. Enos
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Mona N. Fouad
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Marjorie Good
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - William J. Hicks
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Patrick J. Loehrer
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Alan P. Lyss
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Steven N. Wolff
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Debra M. Wujcik
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Neal J. Meropol
- National Cancer Institute; Education Network to Advance Cancer Clinical Trials, Bethesda; The EMMES Corporation, Rockville, MD; Delaware Cancer Consortium, Dover; Helen F. Graham Cancer Center, Newark, DE; American Society of Clinical Oncology, Alexandria, VA; Coalition of Cancer Cooperative Groups; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Cancer Information & Support Network, Auburn, CA; Oregon Health & Science University, Portland, OR; Pancreatic Cancer Action Network; Brooklyn Hospital Center, New York, NY; Massachusetts General Hospital, Boston, MA; Duke Clinical Research Institute, Durham; Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Michiana Hematology Oncology and Northern Indiana Cancer Research Consortium, South Bend, IN; Barbara Ann Karmanos Cancer Institute, Detroit, MI; University of Arizona Cancer Center, Tucson, AZ; University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland; The Ohio State University, Columbus, OH; University of Alabama at Birmingham, Birmingham, AL; Indiana University Simon Cancer Center, Indianapolis, IN; Heartland Cancer Research CCOP, St. Louis, MO; Meharry Medical College; and Vanderbilt-Ingram Cancer Center, Nashville, TN
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Zaren HA, Nair S, Go RS, Enos RA, Lanier KS, Thompson MA, Zhao J, Fleming DL, Leighton JC, Gribbin TE, Bryant DM, Carrigan A, Corpening JC, Csapo KA, Dimond EP, Ellison C, Gonzalez MM, Harr JL, Wilkinson K, Denicoff AM. Early-phase clinical trials in the community: results from the national cancer institute community cancer centers program early-phase working group baseline assessment. J Oncol Pract 2013; 9:e55-61. [PMID: 23814525 PMCID: PMC3595451 DOI: 10.1200/jop.2012.000695] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) formed an Early-Phase Working Group to facilitate site participation in early-phase (EP) trials. The Working Group conducted a baseline assessment (BA) to describe the sites' EP trial infrastructure and its association with accrual. METHODS EP accrual and infrastructure data for the sites were obtained for July 2010-June 2011 and 2010, respectively. Sites with EP accrual rates at or above the median were considered high-accruing sites. Analyses were performed to identify site characteristics associated with higher accrual onto EP trials. RESULTS Twenty-seven of the 30 NCCCP sites participated. The median number of EP trials open per site over the course of July 2010-June 2011 was 19. Median EP accrual per site was 14 patients in 1 year. Approximately half of the EP trials were Cooperative Group; most were phase II. Except for having a higher number of EP trials open (P = .04), high-accruing sites (n = 14) did not differ significantly from low-accruing sites (n = 13) in terms of any single site characteristic. High-accruing sites did have shorter institutional review board (IRB) turnaround time by 20 days, and were almost three times as likely to be a lead Community Clinical Oncology Program site (small sample size may have prevented statistical significance). Most sites had at least basic EP trial infrastructure. CONCLUSION Community cancer centers are capable of conducting EP trials. Infrastructure and collaborations are critical components of success. This assessment provides useful information for implementing EP trials in the community.
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Affiliation(s)
- Howard A. Zaren
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Suresh Nair
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Ronald S. Go
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Rebecca A. Enos
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Keith S. Lanier
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Michael A. Thompson
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Jinxiu Zhao
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Deborah L. Fleming
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - John C. Leighton
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Thomas E. Gribbin
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Donna M. Bryant
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Angela Carrigan
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Jennifer C. Corpening
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Kimberly A. Csapo
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Eileen P. Dimond
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Christie Ellison
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Maria M. Gonzalez
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Jodi L. Harr
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Kathy Wilkinson
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
| | - Andrea M. Denicoff
- Nancy N. and J.C. Lewis Cancer & Research Pavilion, St Joseph's/Candler Hospital, Savannah, GA; Lehigh Valley Health Network, Allentown; Albert Einstein Cancer Center, Philadelphia, PA; Gundersen Lutheran Health System, La Crosse; ProHealth Care Regional Cancer Center, Waukesha, WI; The EMMES Corporation, Rockville; SAIC-Frederick; Clinical Monitoring Research Program, National Cancer Institute at Frederick, Frederick; St Joseph Medical Center, Towson; National Cancer Institute, Bethesda, MD; Providence Cancer Center, Portland, OR; Lacks Cancer Center, Saint Mary's Health Care, Grand Rapids, MI; The Cancer Program of Our Lady of the Lake and Mary Bird Perkins Cancer Center, Baton Rouge, LA; Spartanburg Regional Healthcare System, Spartanburg, SC; Sanford Cancer Center, Sioux Falls, SD; St Joseph Hospital of Orange, Orange, CA; Penrose-St Francis Health Services, Colorado Springs, CO; and Billings Clinic Cancer Center, Billings, MT
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Go RS, Zaren H, Nair SG, Lanier KS, Thompson MA, Enos RA, Zhao J, Fleming DL, Leighton JC, Gribbin TE, Bryant DM, Carrigan A, Corpening JC, Csapo KA, Dimond EP, Ellison C, Gonzalez MM, Harr JL, Wilkinson K, Denicoff A. Early-phase (EP) clinical trials (CTs) in the community: Results from the National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) Early-Phase Working Group (EPWG) Baseline Assessment Study (BAS). J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e16561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16561 Background: The NCCCP is a network of 30 community cancer center (CCC) sites that strive to expand cancer research capacity and deliver advanced care in the community. The EPWG was formed to facilitate NCCCP site participation in EP (phase I-II) CTs, thus allowing patients (pts) to be treated within their communities. This study describes the CT infrastructure at NCCCP sites and its association with EP accrual. Methods: A BAS was conducted to obtain data on NCCCP site CT infrastructure, funding, sponsor affiliations, and barriers to EP CTs. To evaluate EP performance, EP accruals during July 2010-June 2011 were obtained. High accruing sites were those with EP accrual above the median EP accrual per 1,000 new analytical cases seen in 2009 or 2010. Results: 27 sites, caring for ~56,000 new cancer pts annually, participated in the study. Median number of accruing EP trials/site was 6 (mean 7.4). Median EP accrual/site was 14 (mean 16). Median EP accrual rate was 7/1,000. Trials with a phase I component were open at 21 sites. Most sites (24) are members of multiple CGs (median 4) and enroll pts via the CTSU (70%). The more common barriers to EP trial implementation were related to infrastructure (59%), cost (52%), and access to trials (41%). When accrual rates to NCCCP CTEP EP trials only were analyzed, we found that between high vs low accruing sites, respectively, higher accrual rates were associated with higher number of CRAs devoted to EP trials (median 3.25 vs 1; P= .05) and lower proportion of funding from industry (median 18% vs 40%; P=.02). We did not, however, find significant associations when EP trials were examined across all sponsors. Conclusions: CCCs are capable of conducting, and actively participating in, EP trials. Infrastructure and collaborations are critical components of success. Our study provides useful information for those planning to begin EP trials in the community setting. [Table: see text]
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Affiliation(s)
| | - Howard Zaren
- St. Joseph's/Candler Health System, Inc, Savannah, GA
| | | | - Keith S. Lanier
- Providence Cancer Center, Oncology and Hematology Care Clinic, Portland, OR
| | | | | | | | | | | | | | - Donna M. Bryant
- The Cancer Program of Our Lady of the Lake and Mary Bird Perkins, Baton Rouge, LA
| | | | | | | | - Eileen P. Dimond
- National Cancer Institute, Division of Cancer Prevention, Bethesda, MD
| | | | | | - Jodi L. Harr
- Penrose-St. Francis Health Services, Penrose Cancer Center, Colorado Springs, CO
| | | | - Andrea Denicoff
- National Cancer Institute, Cancer Therapy Evaluation Program, Bethesda, MD
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Leyland-Jones BR, Ambrosone CB, Bartlett J, Ellis MJC, Enos RA, Raji A, Pins MR, Zujewski JA, Hewitt SM, Forbes JF, Abramovitz M, Braga S, Cardoso F, Harbeck N, Denkert C, Jewell SD. Recommendations for collection and handling of specimens from group breast cancer clinical trials. J Clin Oncol 2008; 26:5638-44. [PMID: 18955459 DOI: 10.1200/jco.2007.15.1712] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Recommendations for specimen collection and handling have been developed for adoption across breast cancer clinical trials conducted by the Breast International Group (BIG)-sponsored Groups and the National Cancer Institute (NCI)-sponsored North American Cooperative Groups. These recommendations are meant to promote identifiable standards for specimen collection and handling within and across breast cancer trials, such that the variability in collection/handling practices that currently exists is minimized and specimen condition and quality are enhanced, thereby maximizing results from specimen-based diagnostic testing and research. Three working groups were formed from the Cooperative Group Banking Committee, BIG groups, and North American breast cancer cooperative groups to identify standards for collection and handling of (1) formalin-fixed, paraffin-embedded (FFPE) tissue; (2) blood and its components; and (3) fresh/frozen tissue from breast cancer trials. The working groups collected standard operating procedures from multiple group specimen banks, administered a survey on banking practices to those banks, and engaged in a series of discussions from 2005 to 2007. Their contributions were synthesized into this document, which focuses primarily on collection and handling of specimens to the point of shipment to the central bank, although also offers some guidance to central banks. Major recommendations include submission of an FFPE block, whole blood, and serial serum or plasma from breast cancer clinical trials, and use of one fixative and buffer type (10% neutral phosphate-buffered formalin, pH 7) for FFPE tissue across trials. Recommendations for proper handling and shipping were developed for blood, serum, plasma, FFPE, and fresh/frozen tissue.
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Hudis CA, Barlow WE, Costantino JP, Gray RJ, Pritchard KI, Chapman JAW, Sparano JA, Hunsberger S, Enos RA, Gelber RD, Zujewski JA. Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: the STEEP system. J Clin Oncol 2007; 25:2127-32. [PMID: 17513820 DOI: 10.1200/jco.2006.10.3523] [Citation(s) in RCA: 620] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Standardized definitions of breast cancer clinical trial end points must be adopted to permit the consistent interpretation and analysis of breast cancer clinical trials and to facilitate cross-trial comparisons and meta-analyses. Standardizing terms will allow for uniformity in data collection across studies, which will optimize clinical trial utility and efficiency. A given end point term (eg, overall survival) used in a breast cancer trial should always encompass the same set of events (eg, death attributable to breast cancer, death attributable to cause other than breast cancer, death from unknown cause), and, in turn, each event within that end point should be commonly defined across end points and studies. METHODS A panel of experts in breast cancer clinical trials representing medical oncology, biostatistics, and correlative science convened to formulate standard definitions and address the confusion that nonstandard definitions of widely used end point terms for a breast cancer clinical trial can generate. We propose standard definitions for efficacy end points and events in early-stage adjuvant breast cancer clinical trials. In some cases, it is expected that the standard end points may not address a specific trial question, so that modified or customized end points would need to be prospectively defined and consistently used. CONCLUSION The use of the proposed common end point definitions will facilitate interpretation of trial outcomes. This approach may be adopted to develop standard outcome definitions for use in trials involving other cancer sites.
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MESH Headings
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Intraductal, Noninfiltrating/mortality
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/therapy
- Chemotherapy, Adjuvant/standards
- Clinical Trials as Topic/standards
- Endpoint Determination/standards
- Female
- Humans
- Neoplasm Invasiveness/pathology
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/therapy
- Radiotherapy, Adjuvant/standards
- Survival Rate
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Affiliation(s)
- Clifford A Hudis
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Zujewski J, Enos RA, Mason S. Clinical trials referral resource. Current phase III breast cancer clinical trials. Oncology (Williston Park) 2006; 20:696, 700, 702. [PMID: 16841794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Abrams JS, Enos RA, Schoenfeldt M. Clinical trials referral resource. Current phase III, NCI-supported, Cooperative Group Clinical Trials in breast cancer. Oncology (Williston Park) 2004; 18:463-4, 467-8, 470. [PMID: 15134354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Abstract
The following is a summary report of an extensive review of the literature from 1966 to 2001 on growth and development in children receiving kidney, liver and heart transplants. The literature was assessed for relevancy to current clinical practice and for reliability and generalizability of the inferences based on the study design, controls, sample size, age distribution, confounding factors, use of standardized instruments, and consistency with other findings. While studies on growth are included in the review, the main emphasis is on research in cognitive and psychosocial development since these areas have been far less thoroughly studied and contain various methodological deficiencies. On the basis of the literature review both general methodological recommendations and specific recommendations for future research studies are made. Access to the full is provided on the World Wide Web at http://light.emmes.com/pedstransplantation/.
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Affiliation(s)
- Richard N Fine
- Department of Pediatrics, Stony Brook Health Sciences Center, State University of New York at Stony Brook, NY, USA
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Conley BA, Enos RA, Cheson BD. Clinical trials referral resource. Targeted therapy in squamous cell cancers of the head and neck. Oncology (Williston Park) 2002; 16:621-2, 625-6. [PMID: 12108889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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