Fall 2010 SWOG Meeting: Cancer science "done in a hotel room in Chicago"
The fall 2010 SWOG semiannual group meeting was held in Chicago over three days in late October, and in numerous committee sessions and more intimate working group sessions, scientific priorities were agreed on, trials were proposed and developed, issues with ongoing studies were settled, reports on completed trials were made, and the science of cancer treatment and prevention was advanced.
In opening the meeting's well attended plenary session, Group Chair Laurence Baker, D.O., gave a special welcome to the director of the Instituto Nacional de Cancerologia (INCan) of Mexico, Alejandro Mohar Betancourt, M.D., Sc.D., who was there representing his organization as SWOG's newest member institution. INCan is Mexico's equivalent of the US's National Cancer Institute.
After pitching three studies struggling with low accrual (S0702, S0337, and S0709), Baker recognized the achievement of accrual champion Stanley J. Vogel, M.D., of Stormont-Vail Healthcare in Kansas, who had recently enrolled his 1,000th patient to a SWOG clinical trial.
The chair also thanked several departing committee leaders for their service to SWOG. These included Kathy Albain, M.D., who stepped down as co-chair of the Cancer Survivorship Committee; Lisa Rimsza, M.D., outgoing chair of the Lymphoma Translational Medicine Subcommittee; Jeffrey Sosman, M.D., outgoing chair of the Melanoma Translational Medicine Subcommittee; and Maurie Markman, M.D., who resigned as chair of SWOG's Gynecologic Committee.
Robert Krouse, M.D., was welcomed as new co-chair of the Cancer Survivorship Committee.
Plenary: SWOG's past, present, and future
SWOG's position in the rapidly shifting landscape for cooperative groups, a focus of much informal conversation in Chicago, was also the focus of the meeting's plenary session presentations.
Richard Schilsky, M.D., until recently chair of the Cancer and Leukemia Group B (CALGB), presented the recommendations and implications of the Institute of Medicine's (IOM's) April report on the future of NCI clinical trials and the cooperative groups. As one of the report's authors, Schilsky was able to highlight both what the document said and what it did not, noting for example that the report recommended consolidation of certain back office and front office operations of the cooperative groups, not the consolidation of the groups themselves.
"What it says," Schilsky pointed out, "is that based on peer review and quality, that some cooperative group scientific activities should potentially be consolidated, which I think will inevitably lead to the formation of perhaps more intergroup committees."
SWOG Group Chair Laurence Baker, D.O., then spoke, outlining steps SWOG has taken and will take to achieve the goals set in the IOM report, arguing for the importance of maintaining a vigorous publicly funded clinical trial system, and highlighting the recent launch of SWOG's Genomic Medicine Task Force and its early work helping set directions and priorities for biomarker driven trials.
Baker closed with a list of goals for the group:
- using the momentum of the IOM report and NCAB review to improve ourselves,
- using public funding as a strategic advantage and developing approaches more independent of industry,
- emphasizing more biomarker and biology driven trials, and
- working toward the development of a Latin American cooperative group a la the European Organisation for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC).
The third plenary presentation, given by SWOG Group Statistician John Crowley, Ph.D., was a lesson in adaptive clinical trial design -- the development of trials with prospectively planned changes in schema or analysis based on data accumulated as the trial progresses. Crowley examined the role such design strategies should, or in some cases should not, play in SWOG's future portfolio of studies.
Audio and slides for all three of the plenary presentations are available online.
In the session rooms
Breast cancer was the theme of the Nursing Committee Workshop, which featured presentations on the use of nanoparticles in breast cancer treatment, the toxicity of new breast cancer agents, and the recently launched S0800, which is studying the use of nanoparticle albumin bound paclitaxel (nab-paclitaxel) as part of neoadjuvant treatment of breast cancer.
The Clinical Research Associates (CRA) Committee plenary session included presentations on the use of genomics in treating early stage breast cancer, the perspectives of breast cancer patients themselves, and the specimen tracking system recently rolled out by the Cancer and Leukemia Group B (CALGB).
SWOG Breast Cancer Committee Chair Gabriel Hortobagyi, M.D., reviewed recent advances in personalized treatment of the disease at the CRA continuing education workshop.
At the Board of Governors meeting, new primary investigators were appointed for three sites: the Brooke Army Medical Center (Bradley McGregor, M.D.), the University of Michigan (Anne Schott, M.D.), and the University of Mississippi (Barbara Craft, M.D.).
Manuel Valdivieso, M.D., was named new chair of the Quality Assurance Committee and Robert Krouse, M.D., was approved as new co-chair of the Cancer Survivorship Committee.
The Board agreed to disband the Translational Medicine Committee. Translational Medicine Subcommittees within the disease committees remain, as does SWOG's commitment to the study of translational medicine. "We're not disbanding our efforts in translational medicine by any means," said Group Chair Baker.
The Board gave official sanction to the closing of the Gynecologic Cancer Committee and to the dissolution of the Scientific Advisory Board in favor of a more compact Scientific Leader Advisory Group that includes chairs from several of SWOG's disease and cancer control and prevention committees. Baker observed that this new group "really is the scientific leadership of SWOG."
The Hope Foundation reported to the Board on assets of $29.7 million and liabilities of $17.3 million as of the end of the third quarter of this year. Johanna Horn, director of the foundation, reported that the SWOG Clinical Trials Initiative, which is run as a limited liability corporation within The Hope Foundation, now maintains 43 correlate contracts with pharmaceutical companies in support of SWOG trials. Horn reported on the two recently appointed Coltman Fellows and reminded the group that the next application deadline for Coltman Fellowships is March 4, 2011.
SWOG's Board of Governors was told that The Hope Foundation Board had voted to allocate $1 million to support SWOG infrastructure, translational medicine, and clinical research projects over the coming year. Hope will issue a request for proposals for this funding by year's end. The application process will be open beyond SWOG, and the funding of such projects by Hope is "likely to be an ongoing process," said Baker. He pointed out that the foundation now has a board structure in place to better represent group interests, and they will begin using banked funds to support identified projects.
The Committee Chairs session on Saturday morning opened with an update from the Data and Safety Monitoring Committee, who reported they were concerned about slow accrual to study S0600, a study that has subsequently been permanently closed. They also reported futility findings for two of the four arms of study S0221, which has been temporarily closed to accrual while the protocol is updated in response to these findings. The DSMC also reported that interim analyses of studies S0727 and S0226 had been performed and those trials were continuing.
SWOG patient advocate for the Cancer Survivorship Committee, Anna Gottlieb, presented to the committee chairs on the topic of what patient advocates contribute, or can contribute, to the work of SWOG.
Nathan Eriksen, chief of administration, informed the board of updates to SWOG's data sharing policy, which in keeping with NCI dictates makes data more widely available to researchers outside of the group. The chairs agreed that this policy should stipulate that publications concerning SWOG data that lack SWOG authorship should include a disclaimer indicating that the views expressed do not represent those of SWOG.
Also discussed was an update to SWOG Policy 30 stipulating that patients on a SWOG study who transfer to another institution remain as SWOG-associated patients. Among other benefits, this should help the group develop a larger survivor database for potential survivorship studies.
Chairs engaged in a broad discussion of possible minimum accrual rates for CCOP component sites and SWOG affiliate members. While minimums for CCOP component sites were not adopted, the group chair did request that CCOP primary investigators review their component sites regularly to ensure they meet minimum participation guidelines.
Dana Sparks, director of operations and protocols, presented details of the protocol development timeline restrictions now being implemented based on the recommendations of the NCI's Operational Efficiency Working Group (OEWG). OEWG timeline requirements take full effect January 1, 2011. You can learn more about them at http://ccct.cancer.gov/files/OEWG-Report.pdf.
Further details and handouts from a number of the sessions are available on the fall 2010 SWOG group meeting page.