May 13 2025
Written by Vlad C. Sandulache MD PhD and Maria Kelly MD
May 2025 marks 100 years of history for research efforts in the U.S. Department of Veterans Affairs, focused on those who have sacrificed life and limb in the service of their country. NRG Oncology reformed a VA-MTF Subcommittee in the spring of 2022, in order to increase focus on patients with locally advanced malignancies including genitourinary, lung, head and neck and gastrointestinal. Given the extensive carcinogen exposure associated with both recent and past military service (e.g., burn pits, dioxin (aka Agent Orange), firefighting foam), Active Service Members and Veterans represent a significant, underserved patient population ideally suited for development and implementation of clinical trials targeting advanced solid tumors. The VA-MTF Subcommittee was charged with: 1) expanding accrual to NRG Oncology clinical trials in the Active Service Member and Veteran populations, 2) acting as a liaison between clinical trial development groups and the VA-MTF clinician cohort, and 3) facilitating biomarker and clinical algorithm development focused on aggressive solid tumors.
Between 2022 and 2025, through the efforts of VA-MTF Subcommittee members, accruals credited to NRG Oncology increased by 450% (n=33 in 2022, n=149 in 2024). This increase was accomplished through: 1) coordination of regulatory efforts across VHA sites, 2) coordination between VA-MTF clinicians and NRG Oncology study PIs to identify optimal studies for the Active Service Member and Veteran populations, 3) increased VHA funding for clinical trial support, and 4) coordination between NRG Oncology study PIs, VA-MTF clinicians and the NCI and VA Interagency Group to Accelerate Trials Enrollment (NAVIGATE). Two collaborative groups have now been developed across VHA facilities, tasked with development of precision oncology algorithms for prostate cancer and head and neck cancer, two disease sites with significant mortality in the Veteran population. As we celebrate past accomplishments, we remain acutely aware that our Active Service Member and Veteran populations struggle with a myriad of challenges, including the dire need for more effective and tolerable therapeutic regimens for advanced cancer.