Indiana University Medical Center (IUMC) has made major administrative and scientific contributions to the ECOG. This member institution has substantially increased its leadership role in the group during the past grant period: Drs. Einhorn and Loehrer were both elected to serve on the Executive Committee; Dr. Loehrer is currently the Chairman of the Genitourinary Committee; and many other IUMC investigators have served as subcommittee chairmen and study chairs. The major scientific strength of IUMC is in the design of clinical trials in solid tumors. While Indiana University is positioned to provide unique contributions to ECOG in the area of geniturinary malignancies, this member has also demonstrated scientific leadership and innovation for ECOG in the fields of lung cancer, breast cancer, and thymoma. Several ECOG studies have been presented at the American Society of Clinical Oncology meetings, including the plenary session, by IUMC investigators. Select contributions and their impact on the advancement of medical oncology research follow. IUMC investigators have achieved national and international acclaim for research in urological oncology, which has allowed Indiana University to strength the overall GU program of the ECOG. Under the direction of Dr. Patrick Loehrer as chairman of the GU Committee, ECOG completed two large randomized trials in germ cell tumors which prove the importance of bleomycin as part of treatment for patients with """"""""good risk"""""""" disease (E4887) and evaluated the role of ifosfamide in patients with """"""""poor risk"""""""" disease (E3887). ECOG also completed a major trial in metastatic bladder cancer (E5886) which proved that M-VAC combination chemotherapy was superior to cisplatin with respect to response rate and survival. Follow-up trials initiated by IUMC investigators, including E3890 (escalated M-VAC), E3889 (ifosfamide), E1892 (Taxol), and vinblastine + ifosfamide + gallium nitrate (piloted at IUMC), have paved the way for the next generation of studies for metastatic urothelial carcinoma. In breast cancer, Dr. Sledge chaired a multi-institutional pilot trial with Taxol + Adriamycin which formed the bases of E1193. Also, in the Lung Committee, IUMC has played a significant role in the design and completion of numerous studies, including small cell lung cancer and thymomas. While not reflected in the ECOG accrual numbers, IUMC has designed and completed numerous pilot studies with the foreknowledge that these studies could be implemented and completed more promptly at Indiana University than through the cooperative group mechanism, and would, therefore, facilitate future phase III ECOG protocols. Specific examples of this can be seen in testicular cancer (VIP/VB, Taxol), bladder cancer (VIG) and in breast cancer (Taxol plus Adriamycin). With the scientific and administrative leadership of IUMC within ECOG firmly established, the focus of this member within the next grant period will be toward increased accrual. Two means of accomplishing this goal are 1) the addition of well-established clinical trial participants as affiliates to IUMC (such as the IRCC and the HOG), and 2) the development of multi-disciplinary clinics to access a wider patient population.
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