By Peter J. O’Dwyer, MD (left)
and Mitchell D. Schnall, MD, PhD

As summer winds down, and a new academic year begins, we hope that you have had time for relaxation. Just as a diastole follows each systole, the time to recharge empowers the renewed thinking and activity of the new season. The Romantics construed Fall as the “season of mists and mellow fruitfulness,” a scenario that hardly represents the hive of activity and enthusiasm that marks most of our institutions at this time of year. This fall promises to be a season full of opportunity and potential for ECOG-ACRIN, as long-planned innovations take root and develop into clinical trials.

By placing the National Cancer Institute (NCI) Community Oncology Research Program (NCORP) Annual Meeting in late August, the Division of Cancer Prevention and that of Cancer Control and Population Sciences start the ball rolling. This meeting took place on August 23 and 24 in Bethesda, Maryland, and was a forum in which attendees discussed and dissected novel research ideas, as well as the NCI’s vision for research in these areas. The structures that enable these studies are evolving rapidly, and there was enthusiasm to understand how the plans for the Cancer Screening Research Network (and our potential involvement in the studies of multi-cancer early detection tests) are moving ahead. There are several proposed projects in this area, both as NCI-supported ECOG-ACRIN trials, as well as PrECOG trials, that we hope to bring to the membership in the next year. As more and more tests are approved for use, the need for definitive studies of their value is highlighted. We were eager also to discuss the broader prevention portfolio relative to these, as well as cancer care delivery and symptom research.

Relevant to both NCORP and National Clinical Trials Network (NCTN) activities, discussions at our Spring 2023 Group Meeting—and dialogue since—emphasize gaps in our databases, especially in the arena of Social Determinants of Health. We’ve looked at our historical clinical data, and the completeness of datasets regarding patients’ cancers and the results of treatment is impressive. What is surprising is how little we know about the patients as people. Why is this important?  It is because health, disease, and the response to treatment are all inextricably linked to the living situation and the environment of the individual. Beyond environmental toxins such as alcohol and cigarette smoke, such factors as diet, income, the built environment, and others may have effects on tumor type (triple-negative breast cancer, for example), risk of side effects of therapy, and outcomes. We are eager to rectify these knowledge gaps, and will develop and standardize approaches that will be both patient- and site-friendly.

Finally, the Clinical Trials Innovation Unit that was set up by NCI Director Dr. Monica Bertagnolli to foster the accelerated development of novel trial approaches has made rapid progress and its first study is likely to be announced in the near future. As a collaboration between the Groups, the NCI, and the FDA in a collegial co-development model, the Unit has the potential to accelerate progress by removing barriers to imaginative research. The first project is likely to be a clinical trial, but there will be future requests for proposals and disease-spanning interventions, including approaches to data acquisition and interpretation. Other technological interventions are also invited. We look forward to activation of this new agenda for high-priority research.

Read the August 2023 issue here.