At the general plenary at group meeting next month (yes, next month!), I'll again recognize our top-accruing institutions for the year – five member sites and five NCORPs. For the first time, that list will include an institution that's part of the Veterans Affairs (VA) healthcare system. 

The institution is the Massachusetts Veterans Epidemiology Research and Information Center, or MAVERIC. MAVERIC is a SWOG “storefront” member. Like LAPs or NCORP members, MAVERIC aggregates accruals from a consortium of institutions, serving as a hub that provides key administrative expertise and support allowing a group of 11 VA medical centers to participate in National Cancer Institute clinical trials.

Eight years ago, with a desire to bring NCI clinical trials to the veterans they cared for (and thanks to the tireless efforts of our VA working group, led by Stephen Bartlett, RPh), MAVERIC became a SWOG member.

MAVERIC’s Colleen Shannon, MPH  explains: “The alignment of the VISN-1 Clinical Trials Network Oncology Consortium’s vision of providing access to novel therapies aligned with SWOG leadership’s vision, allowing us to form the first VA SWOG storefront in May 2015.” Shannon is deputy director of the Veterans Integrated Services Network 1 (VISN-1) Clinical Trials Network.

Other key personnel at MAVERIC include Corri L. Dedomenico, who provides primary administrative support for the MAVERIC SWOG Storefront; Mary T. Brophy, MD, MPH, MAVERIC SWOG Storefront site PI and director of the VISN-1 Clinical Trials Network; and Michal G. Rose, MD, MAVERIC SWOG Storefront scientific lead.

The MAVERIC team says their relationship with SWOG has helped foster broader collaboration between the VA and the NCI in cancer clinical research, including programs such as the NCI and VA Interagency Group to Accelerate Trials Enrollment (NAVIGATE), the Big Data Scientist Training Enhancement Program (BD-STEP), and the Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) network, which is a joint effort of the two agencies and the Department of Defense.

When asked what has made MAVERIC so effective at opening and enrolling to NCI trials, they cite their long experience coordinating multi-site trials and their deep knowledge of VA infrastructure and policies. They also acknowledge strong support from leadership at all levels – from the medical center, to VISN-1, to the VA’s national Office of Research & Development.

One important factor is the SWOG storefront hub-and-spoke model, with its pooled recruitment targets and its potential to allow all VA sites – including smaller and more rural VAs – to recruit patients to NCI trials, a model that aligns with their mission of bringing trials to all VA patients regardless of location. 

MAVERIC has done much more than bring NCI cancer trials to military veterans at the VAMCs served by their storefront. They’ve test-driven and refined a model that is now being replicated and extended nationally, to efficiently make NCI cancer trials and their cutting-edge treatments available to veterans at VA facilities across the United States. 

The power of the model is perhaps most clearly evident in the growth of the MAVERIC storefront itself, from an initial five spokes in 2015 to the current 11.

“There is a tremendous need in VA to be able to access NCI trials, and this model is an exemplar of how to expand and meet the needs of VA and its veterans,” Shannon says.

Recognizing this need, and the viability of this model, last year SWOG and The Hope Foundation transformed the previous VA Integration Support Program to the VA Storefront Support Program. The first grant under this program was awarded last fall to the South Texas Veterans Healthcare System in San Antonio – now SWOG’s second storefront member. Storefront funding is awarded every two years, so the program will again open to applications in 2024. VAMCs considering applying next year may want to absorb some recommendations from the storefront pioneers at MAVERIC:

  • find a dedicated champion at your hub with experience conducting multi-site research
  • understand what it takes to be successful and form relationships early – broad leadership commitment and support across all departments
  • foster a community of investigators who will work together to identify the right trials for the patient population you serve
  • define what success looks like and establish stretch goals
  • support and mentor your research coordinators, remembering success rests on the shoulders of those doing the day-to-day work

I have worked at a VA medical center, and one of my first priorities on becoming SWOG chair was to reengage VAs in our research and expand access to our clinical trials to veterans everywhere. So, I couldn’t be prouder of what this team has accomplished, and I’m enormously gratified to see a consortium of VAMCs among our top-accruing members. It’s precisely where they belong.

Congratulations to MAVERIC and all the VAMCs that comprise it!

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Trial of the Week

S2001: Randomized Phase II Clinical Trial of Olaparib + Pembrolizumab vs. Olaparib Alone as Maintenance Therapy in Metastatic Pancreatic Cancer Patients with Germline BRCA1 or BRCA2 Mutations

Pancreatic cancer is the third-leading cause of cancer-related death, with most patients surviving for less than a year after diagnosis, and the disease is expected to jump from third to second place in just a few years. We need better treatments for these patients, plain and simple.

S2001 is enrolling patients with metastatic pancreatic adenocarcinoma who have germline mutations in BRCA1 or BRCA2. Patients must have previously been treated with first-line platinum-based chemotherapy that led to either stable or responding disease. 

The trial tests combining an immune checkpoint inhibitor (pembrolizumab) with the PARP inhibitor olaparib, which is FDA-approved for maintenance therapy with these patients.

The schema is simple: eligible patients are randomized to maintenance therapy of olaparib with or without pembrolizumab. The primary endpoint assessed is progression-free survival.

Activated in December of 2020, the study is now open at 259 sites nationally, and 38 patients have been enrolled, toward a goal of 88 patients.

The accrual leaders on the study are Vanderbilt University Ingram Cancer Center and University of Pennsylvania Abramson Cancer Center. 

S2001 study chairs are Vincent Chung, MD, of City of Hope, and Michael Jon Pishvaian, MD, PhD, of Johns Hopkins University School of Medicine.

With the trial open at 259 sites, and a disease that affects more than 55,000 patients annually, we can increase the rate of enrollment to this trial. 

Learn more at the SWOG S2001 page or the CTSU S2001 page.

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