“We are increasingly recognizing the importance of biorepositories,” Dr. Schuller said. “On a national level, though, we really don’t have a good system of coordinating that to maximize the use of these preciously important samples.”
Explore this issue:February 2011
The NCI, in response, is recommending that the 10 Cooperative Adult Research Groups be combined into four. It noted that the four pediatric research groups previously were combined into one, and that group should remain.
According to the NCI, the new system will be able to perform better in cases of less common malignancies; in studies requiring sophisticated imaging; in those that require rapid molecular characterization of tumors and in those that involve access to nationally overseen tissue resources. And it will prioritize studies, taking into account all diseases and methods of care.
Dr. Schuller applauded these goals. “They really have important relevance to the challenges we have to do in this kind of work as we deal with these relatively infrequent malignancies,” he said.
As for the Head and Neck Steering Committee’s work, in 2008, after a two-day planning meeting, members concluded that HPV-positive and HPV-negative cancers must be considered two separate diseases requiring separate trials. The committee also recommended that a central reference lab be used for fast turnaround and that the treatment of choice should be intensity-modulated radiation therapy. That work is about to yield benefits, Dr. Schuller said.
In February, the Radiation Therapy Oncology Group is due to begin a Phase III trial in which radiotherapy plus cetuximab is measured against chemoradiotherapy in HPV-associated oropharynx cancer. The results could lead to wider use of radiotherapy and cetuximab, a less toxic alternative.
“We’re quite excited about this first-ever trial,” he said, “that hopefully is going to lead the way for us to really truly analyze the role of this therapy in this favorable group of HPV-associated cancers.”
William Shockley, MD, chief of facial plastic and reconstructive surgery at the University of North Carolina in Chapel Hill, said the new approach to research brings high hopes. “[Dr. Schuller’s] main point was that there are many organizations that have overlapping functions. And I think that one of the big things that he pointed out was that we are gong to see consolidation,” he said. “And, hopefully, as we consolidate some of our efforts, some of our tissue banks, some of our organizations, we’ll be able to see some improvements of efficiency in how quickly we can study things, how well we can study the treatment of cancer.”