This grant allows us to continue our fourteen years of participation in the scientific activities and clinical trials of the Southwest Oncology Group (SWOG). SWOG is an important and vital component of our overall institutional cancer research effort and it is the only grant-funded cooperative group affiliation for adult malignancies in our NCI- designated comprehensive cancer center. Our SWOG participation can be characterized as follows: (a) institutional patient accrual that is above average, increasing annually (currently 2nd quartile) and of high quality; (b) scientific and administrative contributions by our faculty (protocol coordination, committee leadership, etc.) that are above average and increasing annually (currently 2nd quartile); and (c) a Community Group Outreach Program (CGOP) that is currently modest (3rd quartile) but expanding and focused on increasing minority accrual. In this proposal we detail our plans and commitment to increase our patient accrual to SWOG and NCI-designated high priority clinical trials, to increase our scientific contributions and leadership, and to increase our accrual of women and minorities. Overall, clinical trials activities at our institution have increased yearly since our initial receipt of a cancer center core grant award in 1988. The recent successful recompetition of this core grant (funded for five years) and NCI designation as a comprehensive cancer center have provided additional stimuli and support for clinical investigators to develop innovative therapeutic initiatives. Multidisciplinary clinical programs with strong basic science interactions have developed in adult lung, esophageal, head and neck, breast, GI, CNS, urologic, gynecology and cutaneous cancers and in leukemia/lymphoma and sarcomas. These programs have developed innovative intramural pilot clinical studies which have increased the number of patient referrals to our center (benefitting both intramural and SWOG accrual) and which lead, in many cases, to SWOG trials. University of Michigan faculty chair or co-chair several committees (Lung, Melanoma, Radiation Therapy), and head over a dozen protocols including three national high priority studies. New initiatives are planned in several key areas over the next grant period including: new combined chemotherapy-radiotherapy and dose- intensity trials in lung cancer, innovative organ preservation trials in non-laryngeal head and neck cancer, new biological agent adjuvant trials in melanoma, and new cancer control proposals examining chemoprevention and cancer patient behavioral modification strategies. Finally, the expansion of our CGOP network in Flint, Michigan (with a population of 85% Black Americans) and our Comprehensive Breast Oncology Program represent substantive initiatives to improve accrual of minorities and women to SWOG clinical trials.
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