Not Leaving Veterans Behind

May 10 2023

Written by Vlad C. Sandulache MD PhD and Maria Kelly MD, NRG Oncology Veteran Affairs and Military Treatment Facility Subcommittee Leadership

National Veterans Research Week (May 9-12) highlights advances in clinical care for our nation’s Veterans across the breadth of disease entities brought about through a continuous bench to bedside approach. For Veterans with cancer, recent advances in immuno-oncology, targeted agents and continued optimization of conventional treatment algorithms have brough about improved disease-free survival along with enhanced quality of life. Yet Veteran participation in NCTN therapeutic clinical trials remains low across the nation.

Formed in 2022, the NRG Oncology Veterans Affairs and Military Treatment Facilities Subcommittee seeks to: 1) improve communications between NRG Oncology and the Veterans Health Administration leadership, 2) increase input from oncologists practicing within the VHA toward development of new clinical trials and 3) identify resources and processes which can increase accrual of eligible Veterans to appropriate therapeutic clinical trials. Through formal and informal communications and collaborations among approximately 20 Medical, Radiation and Surgical oncologists the Subcommittee has steadily made progress toward these goals including continued discussions related to development of HN012 (Randomized Phase II/III Trial of Radiotherapy with Concurrent Xevinapant vs. Carboplatin/Paclitaxel vs. Cetuximab in Patients with Stage III‐IVB Head and Neck Cancer with a Contraindication to Cisplatin).

Dr. Michael Chang (Richmond VAMC) has agreed to act as a liaison between the Subcommittee members and the existing NCI and VA Interagency Group to Accelerate Trials Enrollment (NAVIGATE) program in order to facilitate opening of NCTN trials at institutions without previous expertise in relevant regulatory matters. Dr. Sandulache and Dr. Kelly are actively assisting Subcommittee participating members with submissions to the recently released RFA (4/3/2023) to expand the NAVIGATE program from 12 VAMCs to 16 over the coming year. An intermediate term goal is to develop, within the partnership between VHA and NRG Oncology, a “storefront” model which will utilize a familiar hub-and-spoke approach that has proven so successful in implementing the VHA nationwide Lung Precision Oncology Program (LPOP). To that end, the Bay Pines VAMC team led by Dr. Ryan J. Burri has taken on a leadership role by making the Bay Pines VAMC a primary NRG Oncology member, the first in the nation. Continued efforts, led by Dr. Kelly, to identify mechanisms which will address funding gaps for development and implementation of clinical trials across VAMCs regardless of NAVIGATE participation are reaching the highest levels of VHA leadership.

As we celebrate achievements translated to the bedside across VAMCs it is critical that we maintain a laser focus on a critical mission to continuously improve cancer care for Veterans, through broad activation of therapeutic trials across the country.

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