For More Than 20 Years, CCOPs Define Commitment, Success

There are many examples of successful National Cancer Institute (NCI) programs that span every part of our research enterprise. With this special issue of the NCI Cancer Bulletin, we are honoring a program that has come to represent the very definition of success: the Community Clinical Oncology Program (CCOP).

In 1982, a Request for Applications was issued soliciting participants for a unique program that would bring together community hospitals, the growing cadre of community oncologists, and other local health care providers into a nationwide network for conducting cancer clinical trials. Who could have imagined just how effective this program would become? But here we are, more than 20 years later, with CCOPs having enrolled more than 172,000 patients into cancer treatment and prevention trials.

From the beginning, there were those who doubted the program would work, who believed community providers could not stand up to the rigors of conducting large clinical trials. But time and again, these critics have been proven wrong. Analysis of CCOPs' performance over the years has consistently shown that they are not only skilled at recruiting patients, but also produce quality data and ensure the adoption of new standards of care by community providers.

The CCOPs' role in treatment trials has been critical. But under the inspired, excellent leadership of Dr. Peter Greenwald and his staff in the Division of Cancer Prevention (DCP) - including the program's current head, Dr. Lori Minasian, and its previous leader of 10 years, Dr. Leslie Ford - the cancer prevention and control arena is where the CCOPs have helped stake new ground. Indeed, the first drug ever approved for cancer prevention, tamoxifen, might never have been if the CCOP network had not conducted the Breast Cancer Prevention Trial, on which the approval was based.

From the beginning, the individuals and institutions participating in the CCOP network have had a remarkable commitment to its success. That commitment can be seen in the unselfish and cooperative manner in which they work with the NCI Cooperative Group and Cancer Centers, collectively known as the Research Bases. During a time when we are still working to more effectively integrate team science into cancer research, the CCOPs' collaboration with the Research Bases has been the epitome of teamwork.

A perhaps underappreciated component of the CCOPs is their participation in symptom management trials. These trials may not garner as many headlines as treatment and prevention trials, but their importance in developing interventions to reduce side effects such as nausea and mucositis is undeniable.

Finally, there is no greater indicator of success than imitation, which is why two institutes at the National Institutes of Health (NIH) have followed the CCOP model in developing community-based clinical trial networks to test new treatments for HIV and drug abuse.

In many respects, the success of the CCOPs is not a surprise. The genesis of the term "cancer community" is rooted in the unwavering commitment displayed by so many individuals in this country to defeating this disease. So it should come as no shock that, more than 20 years ago, when NCI reached out to communities to play a new role in advancing cancer research, they exceeded every expectation - and continue to do so.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute