About the Community Clinical Oncology Program
History and Accomplishments
Overview
Since its inception in 1983, the Community Clinical Oncology Program (CCOP) has linked community cancer specialists, primary care physicians, and other health care professionals to the NCI-supported Cooperative Groups and Cancer Centers to conduct NCI-approved cancer treatment, prevention, and control clinical trials. The numbers of trials, participating hospitals, physicians, and study subjects have increased over the years. Types of studies carried out have broadened from treatment to chemoprevention, symptom management, continuing care, and quality of life.
In 2005, 50 CCOPs and 13 Minority-Based CCOPs across the country received funding for participation in NCI-approved trials. Altogether, the program comprises 3,645 participating physicians and 415 participating hospitals working on more than 300 active treatment trials and more than 70 active prevention and control trials. CCOP sites accrued over 12,740 patients/participants to cancer treatment, prevention, and control trials in 2004. Prevention trials coordinated by the CCOP program accounted for a total of approximately 14,000 participants representing CCOPs and non-CCOP sites accrued for the year. Fully one-third of all patients accrued to all NCI treatment trials and prevention trials are enrolled at the CCOP sites.
The groups responsible for developing and implementing cancer prevention and control clinical trials are known as Research Bases: 14 Cooperative Groups and Cancer Centers have grants to serve as CCOP Research Bases.
Through the CCOP network's access to cured cancer patients, their families, and other individuals at increased risk for cancer, NCI has implemented several groundbreaking large cancer prevention trials:
- Breast Cancer Prevention Trial (BCPT)
In 1998, this 13,000-woman trial showed a 49% reduction in invasive estrogen-receptor positive breast cancer from tamoxifen in women at increased risk of the disease. Women over age 50 who took tamoxifen were found to be at increased risk of developing uterine cancer or blood clots in the lung or major vein. The trial led to the approval of tamoxifen by FDA as the first drug to reduce risk for developing cancer.
- Prostate Cancer Prevention Trial (PCPT)
In 2003, this 18,000-man trial that found that the drug finasteride reduces the risk of prostate cancer by 25 % in men at both low and high risk of the disease. However, while men who developed prostate cancer generally had early stage disease, those on finasteride were more likely to have cancers that appeared to be high grade.
- Study of Tamoxifen and Raloxifene (STAR)
In 1999, this 19,000-woman trial began to compare these drugs for the prevention of breast cancer. Results may be available by mid-2006.
- Selenium and Vitamin E Cancer Prevention Trial (SELECT)
This 35,000-man prostate cancer prevention study began in 2001 and will determine if these two dietary supplements can protect against prostate cancer.
In addition, smaller prevention clinical trials led by the CCOP program have yielded important findings, among them:
- In 2003, the Colorectal Adenoma Prevention Study (CAPS), a 635-person trial, showed that daily aspirin use can reduce the development of adenomas by 35% in patients with previous colorectal cancer.
- A 1,190 person study of 13-cis Retinoic Acid for head and neck cancer that showed no significant difference in overall survival, recurrence-free survival or likelihood of developing new head and neck cancers (second primary tumors) between groups with early stage disease receiving 13-cis retinoic acid or placebo daily. Results were reported in 2003.
- A 1,166 person study of people who had surgery to remove an early stage, non-small cell lung cancer (who were thus at high risk of having a recurrence and of developing new lung cancers) showed in 2003 that 13-cis retinoic acid did not reduce the risk for developing either a new second cancer or recurrence of the original cancer. The data did suggest that the drug may be harmful to those who smoke while taking it, but beneficial to those who have never smoked.
A portfolio of research projects focused on treating the side-effects of tumor-directed therapy and care for the advanced cancer patient are funded through a combination of investigator-initiated grants and the CCOP program. While landmark studies in pain management and the effective treatment of nausea and vomiting have been achieved through the CCOP network, a pressing need remains for research to better manage symptoms for cancer patients.
Supportive care research, encompasses the reduction of morbidities associated with cancer and cancer treatment as well as studies on managing acute symptoms during both the treatment phase and at the end of life. These investigations may be qualitative or quantitative, and incorporate physiologic and behavioral variables.
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20th Anniversary Report - Decades of Progress, 1983-2003, Clinical Community Oncology Program
In 1983, the Community Clinical Oncology Program began to link community cancer specialists, primary care physicians, and other health care professionals to Cooperative Groups and Cancer Centers. In time, the spectrum of research broadened to include chemoprevention and cancer control, including symptom management, continuing care, and quality of life.
Read the complete report or access it by sections at Anniversary Book Decades of Progress: 1983-2003 Community Clinical Oncology Program
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NCI Cancer Bulletin
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