The NSABP, RTOG, and GOG each bring strong scientific credentials and a solid history of contribution to the cancer research effort.
National Surgical Adjuvant Breast and Bowel Project (NSABP)
The NSABP’s trials have had a profound impact on the treatment of breast and bowel cancer and our understanding of the biology of these diseases. The group is perhaps best known for its series of surgical breast cancer studies that led to the elimination of the radical mastectomy and the confirmation that lumpectomy plus radiation therapy (RT) is an effective option for most women with invasive or noninvasive breast cancer. The NSABP also conducted a series of adjuvant therapy trials that evaluated systemic treatments for patients with node-positive, node-negative, and ductal carcinoma in situ (DCIS) breast cancer and a series of adjuvant therapy trials for patients with colon and/or rectal cancer. Many of today's standard adjuvant therapy regimens result directly from these trials. NSABP research was central to the development of the oncotype DX® tool for assessing recurrence risk and predictive significance of chemotherapy in women with early-stage, hormone receptor-positive cancer. Neoadjuvant therapy for the treatment of operable breast cancer, a current research focus of the group, is an approach that allows for high breast preservation and tumor downstaging rates and provides serial tumor specimen collections for early response assessment. The NSABP Biorepository houses tissue blocks, serum, and lymphocytes from more than 70,000 patients entered into NSABP breast and colorectal cancer trials and represents a valuable resource for current and future correlative science efforts for these diseases.
Radiation Therapy Oncology Group (RTOG)
RTOG research has set and/or validated many of the national and international standards for combined modality therapy of localized to intermediate-stage cancer in adult brain tumors, head and neck cancer, localized or locally advanced lung cancer, noncolorectal gastrointestinal cancer, genitourinary cancer, and localized and locally advanced prostate cancer. A number of recent RTOG-led trials have defined new practice standards: the first randomized brain tumor trial defining chromosomal deletions as prognostic and predictive biomarkers; the first phase III trial defining concurrent chemo radiation as the standard of care for laryngeal preservation; the phase III trial helping to decrease overtreatment by demonstrating the lack of survival benefit for routine inclusion of surgery in management of patients with mediastinal lymph node-positive non-small-cell lung cancer (NSCLC); and a series of trials clarifying the role and optimal duration of total androgen blockade for men with localized, locally advanced, or locally recurrent prostate cancer.
Gynecologic Oncology Group (GOG)
GOG embodies the only significant effort in the current cooperative group system to study gynecologic cancers and is regarded internationally as the leader in clinical trials in this domain. GOG research has yielded many practice-defining advances in the management of gynecologic cancers: 1) defining the current international standard of care for women with advanced ovarian cancer; 2) establishing intraperitoneal chemotherapy as the treatment of choice in the management of small-volume-residual advanced ovarian cancer; 3) identifying concurrent cisplatin-based chemo-RT as the treatment of choice for stages IB2-IVA carcinoma of the uterine cervix; 4) evolving the current treatment of choice for advanced or recurrent carcinoma of the cervix; 5) defining the spread pattern of endometrial carcinoma, currently the most common gynecologic cancer, which established the basis for the therapeutic evolution in early-stage endometrial carcinoma; 6) changing the paradigm for the management of locally advanced endometrial carcinoma by demonstrating roles for systemic therapy; 7) developing effective combination chemotherapy for advanced or recurrent endometrial carcinoma; and 8) setting the current standard of care for patients with uterine sarcomas, thought to be too uncommon to permit large trials, through a series of phase III studies.
As NRG Oncology, these three strong legacy groups will create a synergy that will have significant impact on the National Clinical trials network.