The Globalization of Cooperative Groups
Section snippets
Seeking Information on Globalization from Adult Cooperative Groups
The leadership of the National Clinical Trials Network (NCTN) was invited to participate in this review and asked to provide their experience on international collaborations, including information on countries, sites, investigators, and clinical trials and associated publications.
This article includes summary tables of the groups’ involvement in international collaborations, although data on patient accrual and publications are available for only those groups providing this information. Overall
Overview and the NCIC CTG Perspective
Established in 1980, the NCIC CTG has 273 phase III ongoing or completed studies, as well as 197 Investigational New Drug trials, enrolling a total of over 75,000 patients. NCIC CTG has collaborated with sites in 41 countries, across 54 trials, with 26,189 patients accrued. It is important to note the significance of the partnership with US cooperative groups and sites that contributed 18,624 of the 26,189 patients accrued through these collaborations. A summary of international participation
NSABP Experience
The list of international sites that have participated in current and past National Surgical Adjuvant Breast and Bowel Project (NSABP) studies covers the period from 1971 to the present. It includes 41 different institutions or organizations. Some of the organizations are actually themselves research groups, such as the Irish Clinical Oncology research Group (ICORG), which participated as full members of the NSABP. Overall, these sites have entered more than 14,000 patients into NSABP’s
RTOG Experience
The Radiation Therapy Oncology Group (RTOG) elected to globalize its activity in 2004. The first international site to be accepted was Tel Aviv Medical Center. Within a year, hospitals from South Korea and Australia were also invited to join as affiliates. Currently, 29 centers participate from 14 countries and 5 continents. The motivation for expanding towards an international catchment was both altruistic and pragmatic in nature. From an altruistic standpoint, enrollment of patients on RTOG
SWOG Experience
Over the past four decades, the Southwest Oncology Group (SWOG) has collaborated with 93 centers in 14 countries, including 66 sites in Canada. A total of 8,925 patients were accrued to 48 studies, including solid tumors and hematologic malignancies. Leading accruing sites were Canada (4,522), Puerto Rico (1,463), Mexico (678), and Spain (499). These studies generated the publication of 35 primary results papers. Included were the evaluation of imatinib mesylate in patients with
The Alliance Experience
The Alliance for Clinical Trials in Oncology was created as a merger between three “legacy” groups: American College of Surgeons Oncology Group (ACOSOG), Cancer and Leukemia Group B (CALGB), and North Central Cancer Treatment Group (NCCTG). The three legacy groups all had a strong history of international sites and collaborations. Among the groups, there have been numerous collaborators, involving 2 countries in Australia, 10 in Asia, 2 in North America, 3 in South America, and 21 in Europe,
Discussion
NCTN groups have a long-standing history of collaboration with international cancer units around the world. The most important incentive for these collaborations appears to be the desire to improve patient accrual of large phase III trials in the United States and Canada. Many international sites likewise benefit by the experience of working with well-organized and experienced clinical trials organizations that facilitate their access to newer and often expensive cancer treatments provided by
Acknowledgments
Supported in part by National Institutes of Health/National Cancer Institute grants U10 CA180888, U10 CA180819, UG1 CA189974, U10 CA12027, U10 CA37377, U10 CA69651, U10 CA69974, U10 CA21661, U10 CA37422, U10 CA180821, U10 CA1844; Canadian Cancer Society Research Institute (CCSRI) grant 021039; and the Bill and Melinda Gates Foundation. The authors wish to thank Sherry Breaux, MPH, Publications Operations Manager, Alliance for Clinical Trials in Oncology; Veronica Garcia, BS, SWOG Latin American
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From the Alliance for Clinical Trials in Oncology, NCIC CTG, NRG Oncology, RTOG and SWOG adult NCTN research groups.
Financial disclosure or conflict of interest statements for all products discussed or implied in the article: none.