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Accrual to National Cancer Institute-sponsored non-small-cell lung cancer trials: insights and contributions from the CCOP program.

BACKGROUND
The Community Clinical Oncology Program (CCOP) has been a success in augmenting accrual to cooperative group research trials from community-based institutions. We analyzed accruals to selected phase II and III cooperative group non-small-lung cancer (NSCLC) trials to determine specific accrual patterns that might guide the implementation of future studies and their application to community settings.


PATIENTS AND METHODS
Data from each of the adult multispecialty cooperative group trials that studied treatment interventions in NSCLC and completed accrual from 2000 to 2005 were gathered. We tabulated and analyzed information regarding the percentage of total accrual that derived from CCOPs according to cooperative group, extent of disease, trial phase, and modality of treatment.


RESULTS
CCOP contributions did not seem to vary greatly by phase of study or by extent of disease. In general, CCOP accrual to Radiation Therapy Oncology Group trials was lower than for the other cooperative groups. CCOP accrual to multimodality trials, in which systemic treatment was not the primary study question, was poorer. Trials of standard therapy with or without a new therapeutic agent in advanced disease tend to enjoy better accrual.


CONCLUSION
Multidisciplinary studies in NSCLC provide challenges for CCOPs and will require more effort and greater incentives. CCOP leaders should participate more actively in the design and implementation of cooperative group NSCLC trials in order to maximize their participation.