SWOG (formerly the Southwest Oncology Group) is one of the largest cancer clinical trials cooperative groups in the United States. Funded primarily by research grants from the National Cancer Institute, the Group conducts clinical trials to prevent and treat cancer in adults, and to improve the quality of life for cancer survivors.
The Group is a network of more than 4,000 physicians who work in a variety of medical settings and have a strong interest in bringing innovative cancer treatments to their patients. SWOG trials are conducted by investigators at more than 500 institutions, including 22 of the National Cancer Institute's designated cancer centers.
The Group Chair's Office is at the University of Michigan in Ann Arbor, Michigan; the Operations Office is in San Antonio, Texas; and the Group's Statistical Center is at the Fred Hutchison Cancer Research Center in Seattle, Washington. More information about the Group's leadership is at our Leadership page.
Below is a brief chronological history of SWOG.
In 1955, the National Cancer Institute (NCI) formed a Clinical Studies Panel. During one of its early meetings, it was discussed that the study of leukemia would move forward more quickly if physicians worked together on clinical trials through a "cooperative group" mechanism, which would allow for broad collaboration among researchers from various medical institutions. This research method already had been proven successful in Veterans Administration hospitals when they studied tuberculosis. Several cooperative groups were organized as a result, including the Southwest Cancer Chemotherapy Study Group, which was funded in 1956 as a pediatric oncology (children's cancers) group. Its home base was in Houston, Texas.
In 1958, the NCI directed the Southwest Cancer Chemotherapy Study Group to study adult cancers, as well. This is important to note because today the Group studies adult cancers exclusively. The pediatric and adult divisions functioned separately with different administrative bodies. At that time, most member institutions in the Group were located in the southwestern part of the United States. Today, however, the Group's more than 500 institutions are located throughout the country, as depicted on the map at right.
SWOG sites in the United States (click image to enlarge)
Research in the Adult Division of the Southwest Cancer Chemotherapy Study Group began slowly, with early trials focusing on liquid cancers (leukemia, lymphoma and myeloma). In time, however, the Adult Division began to develop trials for all solid tumor cancers, with studies initiated when new agents became available.
The 1970s was a time of change for the Group. In 1971, the original constitution and bylaws were replaced by a constitution that more formally provided for two divisions of the Groupthe Adult Division and Pediatric Divisioneach with its own executive committee. In early 1973, the Group established six Disease Study Committees in the Adult Division.
In June 1973, the Southwest Cancer Chemotherapy Study Group was formally renamed the Southwest Oncology Group. The constitution was changed to include strict performance standards to evaluate its institutions and members.
In 1976, the Group incorporated the National Cancer Institute's Affiliate Program, to give individual physicians and small physician consortia the opportunity to become affiliated with a member institution in order to conduct cancer research.
Even more significant changes took place during this decade. Late in 1980, the Pediatric Division sought independent status and formed the Pediatric Oncology Group. This formally changed the mission of the Southwest Oncology Group to focus solely on cancer in adults.
In March, 1981, Charles A. Coltman, Jr., M.D., was elected chairman of the Southwest Oncology Group, a position he held for 24 years. The Group experienced significant growth and accomplishments under his leadership. The Operations Office was moved from Kansas City, where it had been since 1972, to the Cancer Therapy and Research Center (CTRC) in San Antonio, Texas. Dr. Coltman led CTRC's cancer treatment and research programs.
Shortly after his election as chairman, Dr. Coltman restructured the Group. The executive committee was replaced by a board of governors made up of principal investigators and representatives of discipline committees. The Group's scientific efforts and administrative responsibilities shifted to the disease committees.
Until the early 1980s, the majority of cancer research was conducted in large university teaching hospitals. But physicians trained at academic cancer centers were increasingly entering community practice, and many cancer patients had to travel great distances to cancer centers to participate in cutting-edge clinical trials. To remedy this situation, in 1983 the Group began participating in the Community Clinical Oncology Program (CCOP), a new program launched by the NCI's Division of Cancer Prevention. The CCOP expanded the principles of the Affiliate Program, mentioned earlier, by providing community-based physicians a way to conduct cancer research, bringing the latest in investigational cancer treatments to patients in their communities and giving more patients the opportunity to participate in clinical trials. As a result, hospitals, community oncologists and other local healthcare providers were transformed into a national network to conduct clinical trials. Cooperative groups such as the Southwest Oncology Group and some cancer centers served as their research bases. CCOP institutions focus on cancer control and prevention programs in addition to treatment trials.
The CCOP program grew steadily during the 1980s, and as a result of the increased efforts in cancer control activities, the Group developed a Cancer Control Research Committee to address the need for cancer prevention, symptom management and quality-of-life research. A formal Quality Control Program was developed in connection with the CCOP program to ensure the consistent submission of high-quality data.
Another significant change in the early 1980s was the relocation of the Statistical Center from Houston, Texas, to Seattle, Wash., under the direction of newly appointed Group Statistician, John J. Crowley, Ph.D. The new Statistical Center opened its doors on October 1, 1984, on the campus of the Fred Hutchinson Cancer Research Center.
In 1988, another program was established that had a significant impact on the Group. The Urologic Cancer Outreach Program (UCOP) was established to attract more urologists into the Group and to increase enrollment of patients to genitourinary trials.
In late 2007, CTRC was transferred to the University of Texas Health Science Center in San Antonio.
In 1990, the Southwest Oncology Group participated in the NCI's expansion of the CCOP to form the Minority-Based CCOP (MBCCOP). This program was started in an effort to provide better cancer care to minority patients in their communities and to involve more minority patients in clinical trials. Some minority populations are more vulnerable to certain types of cancer, are less likely to participate in clinical trials and often are medically underserved. The MBCCOP specifically addressed those concerns by offering membership to institutions with a 50 percent or greater minority patient population. The Sept. 13, 2005, special edition of the NCI Cancer Bulletin acknowledged the program's success, noting that over the last decade more than 5,500 minority patients have enrolled in treatment and prevention trials through the MBCCOP network. And while MCCOP institutions accounted for less than 20 percent of the CCOP network, they brought half of the minority patients into clinical trials.
In 1991, the Southwest Oncology Group established a non-profit foundation, the Southwest Oncology Group Foundation, to enable the Group to accept contributions to support its work. In 1992, a separate 501(c)(3) tax-exempt organization was formally established.
Also in 1991, the Committee on Women's Health was formed to focus on specific concerns of women in Group clinical trials. Over the years, the scope of the committee continued to evolve to also address issues concerning cancer in minorities, the aged and medically underserved populations. In 2002 the committee name was changed to the Committee on Special Populations, which would itself be superseded in 2007 by the committees within SWOG's new Cancer Control and Prevention program.
Midway through 1991, Dr. Coltman met with a leading physician from Japan, Masanori Fukushima, M.D., Ph.D. The purpose of their meeting was to establish a program to encourage researchers from the United States and Japan to work together to enhance the quality of Japanese clinical trials. The first United States - Japan Cancer Clinical Trials Summit was held in 1992. In succeeding years, participation in the summits grew to include premier cancer physicians from throughout the United States, Canada and Japan. The meetings focused on reviewing and exchanging information about clinical trials on a broad range of cancers including urological, gynecological, head and neck, esophageal, gastric, colorectal, and multiple myeloma, as well as bone and soft tissue sarcomas.
In October 1993, the Southwest Oncology Group launched the first large-scale prevention trial for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) was a double-blind study designed to evaluate whether taking the drug finasteride would prevent prostate cancer. More than 18,000 men were enrolled at over 220 sites located throughout the United States.
The trial was closed early on June 24, 2003, because of a finding that finasteride reduced the incidence of prostate cancer. The analysis of the data revealed that men in the finasteride group who were evaluated by means of a prostate biopsy were 24.8 percent less likely to develop prostate cancer when compared to the men evaluated in the placebo group. However, those trial participants who did develop prostate cancer while taking finasteride had a slightly higher incidence of high-grade tumors. The results of the study were published in the New England Journal of Medicine on July 17, 2003, and more than 35 additional peer-reviewed papers and abstracts have been published as a result of this study. For more information see the PCPT Page.
In 1998 the Southwest Oncology Group Foundation was formally renamed The Hope Foundation, to represent the international impact and vision of the Group.
In March 1999, an innovative program was developed by the Southwest Oncology Group to foster the role of young clinical investigators beginning a career in cancer clinical trials. The first Southwest Oncology Group Young Investigators Training Course was conducted in 2000. The intensive program, conducted annually, focuses on statistical principles, data collection and analysis, critical decision making, protocol development and other Group procedures. Each year a competitive application process is employed to select the young investigators who are invited to attend the course.
On July 25, 2001, the largest-ever prostate cancer prevention trial, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), was launched. SELECT was a phase III, double-blind, placebo-controlled four-arm study of selenium, vitamin E, selenium and vitamin E together, and placebo designed to assess the effect of these supplements on the incidence of prostate cancer. The study quickly exceeded its accrual goal, enrolling 35,533 men at 427 sites in the U.S. and Canada in just 33 months. Participants were healthy men age 55 and older (50 and older for African-American men) with no history of prostate cancer. In the fall of 2008, the trial's Data Safety and Monitoring Committee recommended that participants discontinue taking study supplements based on an interim finding of no preventive benefit for any of the arms. In 2009-2010, the almost 31,000 patients remaining on SELECT were transitioned to centralized follow-up. The biospecimens and associated clinical data collected as part of this trial are expected to provide raw materials for translational research for years to come.
On May 27, 2003, Dr. Coltman informed the Board of Governors that he would not seek re-election as Group chair. This set in motion the selection of a chair-elect, who would assume the chairmanship when Dr. Coltman's term expired at the spring 2005 Board of Governor's meeting. Several candidates were nominated and on July 2, 2003, the Board of Governors elected Laurence H. Baker, D.O., the next chair. Dr. Baker, who served as associate chair during Dr. Coltman's tenure, is professor of Internal Medicine and Pharmacology at the University of Michigan in Ann Arbor, Michigan.
At the fall 2003 Group meeting in Seattle, Dr. Baker announced that a new Headquarters Office would be established at the University of Michigan. He also introduced three University of Michigan faculty members as the Group's new executive officers, who would oversee the development and conduct of Group protocols: Harry P. Erba, M.D., Ph.D.; Bruce G. Redman, D.O.; and Anne F. Schott, M.D.
The spring 2005 Group meeting brought a new milestone for the Group. On April 8, 2005, Dr. Coltman stepped down as Group chairman and Dr. Laurence H. Baker became the new Group chair. Dr. Coltman then served as associate chair for cancer control and prevention for the Group until September 2007, at which time he was appointed chair emeritus.
One of Dr. Baker's first priorities as Group chair was to reorganize the Scientific Advisory Board, naming Richard I. Fisher, M.D., chair and expanding the board to include external advisors. Dr. Fisher has been a member of SWOG since 1985 and chair of the Lymphoma Committee since 1988. At the fall 2005 Group meeting, Dr. Baker announced that Dr. Fisher had been appointed as Deputy Group Chair.
With Dr. Baker's election as Group Chairman, the Scientific Advisory Board made the decision to move The Hope Foundation office from the Operations Office to the Headquarters Office. Dr. Baker serves as the Foundation's president, Dr. Coltman is chair, and Jo Horn, M.S.W., is director. In 2006 the Hope Foundation logo and Web site were redesigned to reflect a new vision for the organization.
The Group celebrated its 50th anniversary during the Fall 2006 Group Meeting in Seattle, Washington. The plenary session featured four prominent cancer researchers who brought the Group up to date on the NCI's plans for its cancer treatment and prevention programs, as well as future directions of the American Society of Clinical Oncology. Former Group leaders and administrators were guests during the plenary session and at the 50th anniversary celebration that evening.
In November 2006, Carolyn Hoban, D.Sc., joined the Group's executive officer team, overseeing the Group's Cancer Control and Prevention Committee and Translational Medicine Committee. She also supervises the Group's tumor and tissue banks.
As NCI funding levels fell and more SWOG trial proposals were denied by the NCI because of funding considerations, SWOG stepped up efforts to attract additional monies from external organizations. To allow worthy investigator-initiated trials to proceed even when the NCI had declined to fund them, the Group organized the SWOG Clinical Trials Initiative (SWOG-CTI). Founded for the express purpose of accepting non-federal dollars to support clinical trials, SWOG CTI is a limited liability company whose sole member is The Hope Foundation.
In September 2007, Frank L. Meyskens, Jr., M.D., from the University of California-Irvine Medical Center, was appointed Associate Chair of Cancer Control and Prevention. Dr. Meyskens, an international expert known for groundbreaking efforts to control and prevent cancer, would head all cancer control and prevention efforts for the Group. Dr. Meyskens presented the structure of the reorganized program at a February 2008 retreat, with stated goals of increasing the program's representation in disease committees, reaching out to clinical pharmacology, and developing training in cancer prevention and control for the next generation of SWOG investigators. The new Cancer Control and Prevention Program comprised these five committees:
- Prevention Committee
- Health Disparities and Outcomes Committee
- Molecular Epidemiology Committee
- Cancer Survivorship Committee
- Symptom Control and Quality of Life Committee
At the fall 2008 Group Meeting, Drs. Baker and Crowley were unanimously re-elected as Group Chair and Group Statistician, with their new four-year terms beginning in April of 2009.
2008 also saw a reconfiguration of SWOG's Patient Advocates Program, placing one or more advocates in each disease committee. To ensure advocates would be integrated quickly into the work of their committees, committee chairs were invited to nominate those advocates who would sit on their committee.
At a February 2008 committee review retreat, SWOG began work on its treatment grant competitive renewal application, due to the NCI's Cancer Therapy Evaluation Program (CTEP) the following year. By the end of 2009, NCI's CTEP had formally renewed SWOG's core treatment grant for the period 2010 through 2015, with a total package of SWOG grants from CTEP, including U10 grants going to its core member institutions to support their work with the Group, projected to be worth more than $120 million over the six-year award period.
In late 2009, the Group brought Manuel Valdivieso, M.D. on to its leadership team, in part to lay the groundwork for more long-term collaboration with oncologists and cancer centers internationally. The Group's treatment grant renewal late in 2009 included the first U10 grant for a SWOG member outside the US -- the University of British Columbia's cancer center in Vancouver. SWOG would expand in a southerly direction the following year, with the official membership in 2010 of Mexico's Instituto Nacional de Cancerologia (INCan), that country's equivalent of the U.S.'s National Cancer Institute.
The centerpiece of SWOG's international initiatives at this time was a trial funded by a $2.5 million grant from the Bill and Melinda Gates Foundation and conducted across seven nations in Central and South America to compare the effectiveness of three antibiotic regimens against infection with the Helicobacter pylori bacterium, which is associated with gastric cancer, one of Latin America's deadliest. The trial would reach its accrual goal of more than 1,400 patients by 2010.
SWOG partnered in 2009 with several institutions in a successful bid for $4 million in NCI funding to develop the Center for Comparative Effectiveness Research in Cancer Genomics, or CANCERGEN. CANCERGEN's mission is to create a comprehensive evaluation, assessment, and design process to identify which emerging cancer genomics technologies are the top candidates for study by SWOG's clinical trials network.
January 1, 2010 marked the official move of SWOG's Operations Office from the University of Texas to administrative control of The Hope Foundation. Operations Office employees moved to a new facility -- still in San Antonio, Texas -- and became employees of The Hope Foundation. The CTEP grant funding the Operations Office was also transferred to Hope.
After several decades as a nationwide -- even international -- network, SWOG in 2010 dropped the qualifier "Southwest" from its name. Group Chair Laurence Baker, D.O., announced at the Chicago group meeting in October of that year that the Southwest Oncology Group would henceforth be known simply as "SWOG." In conjunction with this change in name, the Group Chair's office sent a survey in late summer to the entire membership asking them to vote on new candidate logos and tag lines for the Group. SWOG members overwhelmingly chose a version of the Group's existing graphical mark -- the white double helix in a blue circle. This circle appears in the new logo with new typography and the Group's new tag line -- "Leading cancer research. Together."
For the more detailed history of SWOG,
see the Official Group History.