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The Front Line
The Front Line: Charles D. Blanke, MD, SWOG Chair

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SWOG's Work Product: More Than Just Answers to Clinical Trial Objectives?

Aug 28, 2015 - SWOG's mission is to improve the practice of cancer medicine, in order to improve outcomes and enhance quality of life for patients with malignancies. As an organization, our primary route to achieving these ends are clinical trials; we seek answers to our trial objectives, and we publish these in peer-reviewed articles and present them to colleagues at major meetings.

But classic Phase II and III clinical trial results aren't the only work product that will help move us toward our goal. SWOG's trials database holds patient clinical and outcomes data from more than 1,000 research studies, and information on more than 200,000 volunteers. Can we build an informatics platform to access the valuable information that inheres in this data set and others like it? Is that an appropriate role for a network group?

We say, simply, yes.

SWOG Executive Officer Craig Nichols and his colleagues have been analyzing data sets from past clinical trials in germ cell tumors, working toward an updating of the International Germ Cell Consensus Classification (IGCCC) guidelines. The original IGCCC guidelines were developed in the early 1990s, and Nichols's team hypothesizes that they underestimate the quality of patient outcomes today and that an analysis that includes more recent patient outcomes data is warranted. (This was also the focus of a recent Young Investigator Training Course project by Dr. Claudio Jeldres, with sponsorship of the GU Committee and the Cancer Control and Prevention Committees.) A more accurate prediction of outcomes from standard treatments should better inform clinical trial design.

Dr. Nichols and a team from SWOG are now working with ASCO on a pilot project to take this several steps further and develop a global guideline set in germ cell tumors, the first in a library of comprehensive, disease-specific information sets that would include treatment pathways and tools for patients.

In a new era in which we have access to "big data" and the means to mine it effectively, should we expand our traditional definition of SWOG's work product? Should publications that come out of efforts such as this germ cell tumor pilot be credited as SWOG publications? Should such research be given SWOG administrative and financial support?

If our end goal is changing medical practice to improve patient outcomes, this could clearly be done not only via direct trial results but also via secondary use of data and new guidelines.

Moreover, I think the most elemental question here is: Could cancer patients benefit from this work? I believe the answer is clearly "yes." But I raise these questions here because I'm eager to hear your thoughts on them. Please let me know.


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