The overall objective of this proposal is to support the participation of the city of Hope National Medical Center (COH) in the investigational clinical trials of the Southwest Oncology Group (SWOG). The COH, an NCI- designated Cancer Research Center, has provided strong support for the clinical research activities of SWOG during the past four years. SWOG members at COH or its affiliates have provided leadership to the group in the area of bone marrow transplantation and the treatment of hematological malignancies through: the administrative chairmanship of the bone marrow transplantation committee, the coordination of several SWOG studies in this area, and the development of pilot data from COH that has formed the basis for new SWOG transplantation trials. In addition to its strengths in bone marrow transplantation, the pharmacological expertise of SWOG members at COH has been utilized in novel biochemical modulation trials for patients with breast and colorectal cancer; and the institution's leadership role in the development of novel immunotherapies has enhanced the activities of the developmental biologics and melanoma committees in which COH investigators currently play an important part. Finally, COH strengths in cytogenetics, the molecular virology of human papillomaviruses, and hematopathology have led to new laboratory-based clinical studies in the cytogenetics, gynecology, and leukemia biology working groups. In this regard, a pilot program which has established a human solid tumor cytogenetics laboratory at COH has contributed directly to the ability of SWOG to propose a similar, groupwide facility. Over the current funding cycle, the COH has met the accrual goal it established in its previous application by enrolling an average of 92 patients/year from 1989-91 with a high rate of eligibility and evaluability; over 90% of the patients accrued by COH to SWOG studies have come directly from patients treated at COH, putting COH in the upper third of SWOG members with respect to institutional patient accrual. Furthermore, because of the charitable endowment of the COH, a substantial proportion of patients enrolled on SWOG trials are from minority populations and lack any form of third-party medical insurance. Based upon an enlarging network of COH-affiliated CGOP institutions, on the availability of the largest bone marrow transplantation facility in California (30 beds for hematological disease, 9 beds for solid tumors), on the presence of a multidisciplinary team of physicians in Pathology, Surgery, and Radiation Oncology as well as Medical Oncology and Hematology, and on strong scientific leadership in the areas of clinical pharmacology, molecular virology, transplantation and cytogenetics, an increase in patient accrual to SWOG trials at COH to the level of 120-130 patients per year can be predicted over the coming funding cycle.
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