We seek to continue active participation in the SECSG with which we have been successfully associated for 13 years. Our main goal through this participation is to continue performing clinical trials in the evaluation of chemotherapeutic agents and newer modalities of therapy in patients with neoplastic disease. This program continues to have a major impact in the health care system of Puerto Rico since it is the only recognized multidisciplinary program in this island of 3 million inhabitants. At the moment it involves investigators in three major teaching hospitals in San Juan and one affiliate investigator in Ponce, the second city in Puerto Rico. Clinical trials will be conducted in these institutions with support provided by a well coordinated multidisciplinary team including radiation therapists, surgical and medical oncologists, clinicians and pathologists. This program will provide for the continuation of activities which began in 1969 and which have provided and, hopefully, will continue to provide the only mechanism whereby patients in Puerto Rico will be able to participate in well designed, peer reviewed clinical trials. The main institution, the UPR School of Medicine, serves as the major teaching hospital and tertiary care medical center for the whole island. As is the case with most cooperative groups, major emphasis will be placed on thorough protocol review and implementation, as well as quality control. Because of the high incidence of epithelial tumors of the head and neck and upper gastrointestinal system im Puerto Rico, we expect to provide an unusual resource within the SECSG. This should lead to major investigation of newer adjuvant approaches for these tumors. The same is true for the leukemias and lymphomas where the University of Puerto Rico School of Medicine serves as the major treatment center in Puerto Rico. Our particularly high incidence of promyelocytic leukemia will offer an unusual opportunity to study this disease. The addition of basic scientists and their expertise in carcinogenesis, epidemiology and pharmacology through our Cancer Center will provide still additional areas of investigational interest linked to the clinical trials sponsored by this grant. Our specific goals can best be summarized as follows: 1. development of newer strategies for the treatment of the major neoplastic disorders common in our environment, and continuation of a multidisciplinary approach to the treatment of these tumors.
