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The Front Line: Charles D. Blanke, MD, SWOG Chair
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A 2014 Summary Progress Report

Dec 29, 2014 - The close of the calendar year and the completion of our first annual progress report on our new NCTN grant combined to give me a chance to update you on some of SWOG's recent initiatives. I hope it doesn't seem too redundant vis-à-vis recent blogs! As promised in our NCTN grant application last year, pathway-driven research was a strong emphasis in 2014. The Lung Cancer Master Protocol (S1400) opened with five randomized sub-studies, with patients assigned solely based on underlying genetic tumor abnormalities. Our GI Committee opened S1406, a unique combination trial comparing standard therapy with standard of care plus a BRAF inhibitor, in patients with BRAF-mutated advanced colorectal cancer (CRC). GI also reported results of 80405 -- chemotherapy plus bevacizumab or cetuximab in patients with advanced CRC, based on RAS status, proving the two targeted agents are both reasonable choices for patients with wild-type cancers in first-line therapy. The Breast Committee has been conducting innovative research (S1007 and S1207) that should prove whether genetic profiling could identify which patients with resected disease will benefit from additional specific chemo-biologic therapy. The Lymphoma Committee analyzed and presented results of a phase II trial (S1108) of an aurora kinase A inhibitor in patients with rare, peripheral T-cell non-Hodgkin lymphomas.

Overall SWOG accrual to NCTN clinical trials remained strong in 2014, with expected enrollment slightly exceeding predictions (but not overly excessive to the point of setting off alarms). Our Statistical Center and Operations Center leadership worked together to develop a new accrual reporting method, to avoid overspending SWOG's capitated allowance. The new report was rolled out in the Fall 2014 Report of Studies.

SWOG maintained and additionally recruited a wide variety of academic, community, and international members last year. Our international members in Mexico and Korea in particular were active in accruing to SWOG trials, and the quality of their participation has been excellent. We drafted quality guidelines for international members and formed a sub-committee of the QA Committee to further improve the quality of trial participation. We also modified our existing Quality Initiative to tighten requirements for institutional performance, shorten data submission timelines, and clarify standard protocol wording. A VA consortium (MAVERIC) joined as full members, hopefully helping us break down in the near future barriers to getting veterans access to publicly-funded trials.

In the area of NCTN collaboration and collective management, a number of SWOG members contributed to true collaborative study development (trials coordinated by other groups), as well as accruing to other Network members' trials. Many studies were co-led by SWOG and another group. One example is S0410, a study of tandem autologous stem cell transplantation in patients with relapsed NHL, run in collaboration with the Bone and Marrow Transplant Clinical Trials Network. SWOG has also both actively participated in and led a variety of NCTN Committees, Task Forces, and Working Groups, in addition to contributing robustly to NCI Steering Committees (see my Dec 12th Front Line).

Finally, SWOG members have consistently and successfully leveraged federal funding for clinical trials. One example from the past year is S1400, a collaboration supported by approximately $43 million from the NCI and more than $120 million from other partners.

The Group did well in our first year under the new Program. I thank you for your help and wish you a happy and successful 2015!

 

 
     
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