The Gynecologic Oncology Group (GOG) is a cooperative group of 37 institutions with a major objective to conduct multidisciplinary clinical trials in six specific gynecologic malignancies: celomic epithelial carcinoma of the ovary, carcimona of the cervix, carcinoma of the endometrium, uterine sarcoma, carcinoma of the vulva, and germ cell malignancies of the ovary. This application is unique in several aspects: (1) the application, generated only one year after the last site visit as mandated by the Cancer Therapy Evaluation Program (CTEP), is the statement of planned changes; (2) the application responds not only to the critique at the last site visit, but also to nine specific points outlined by CTEP as most critical; (3) the proposed changes evolved during a year of severely restricted funding with the clear understanding that major alterations could not reasonably be effected in that short period but rather must be judged on potential. Of particular note are several changes in approach: (1) The GOG has developed a flexible, """"""""fast-track"""""""" mechanism for approval of pilot and phase I studies to enhance the incorporation of innovative new approaches into GOG trials. (2) The hierarch of the GOG has been altered to include a Group Vice-Chairman for Science and a Group Chairman's Scientific Advisory Council to provide a small group with authority to respond quickly to critical matters concerning the science of the GOG. (3) The Group has requested funding on a per capita reimbursement which will enhance patient accrual by directing funding to institutions actually performing well. (4) Major changes in the function of GOG headquarters have resulted in a plan to move all data-related functions to the Statistical Office and to focus the Administrative Office efforts on financial management (including per case reimbursement), protocol development, and meeting planning and conduct. These changes will result in innovative trials which can answer critical questions in gynecologic cancer in a timely fashion.
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