Since the program was first established in 1991, MB-CCOPs have been integral to the study and understanding of how new agents, trial designs, and technologies are disseminated and implemented in both minority and special populations. The program evolved from the recognition that most cancer care for racial and ethnic minorities had been taking place in the clinics of urban academic institutions. By increasing access to cancer clinical trials in local communities, the CCOP network has helped reduce the unequal burden of cancer across society.
The MB-CCOPs contribute the highest concentration of minority participants to cancer trials. The sites provide cancer care in catchments composed of patient populations that are at least 30% minority. Much of their focus is on building the outreach and management capacity of the respective institutions, many of which face frontline health care challenges.
Research Bases have reached out to the MB-CCOPs to enhance cohort diversity in designing prevention and control trials. Such strategies included, for example, overpowering a statistical design to include 50% enrollment of Hispanics to collect data on chemotherapy-related stress in one study, and evaluating the effect of socioeconomic status on breast cancer incidence and the value of p53 as a prognostic marker among African-American breast cancer patients in another study.
The consistently high level of minority accrual from the MB-CCOPs was confirmed in a 2005 evaluation of the program. It showed that between 1995 and 2003, minorities comprised 51% to 67% of patients enrolled by the MB-CCOPs to Cooperative Group treatment trials, compared with less than 23% of the patients accrued by other Cooperative Group members and affiliates.
The NCI Board of Scientific Advisors noted in 2007 that NCI should consider using the MB-CCOP model for other programs that need greater accrual of minority participants. The MB-CCOP provides an invaluable resource to study accrual of underserved populations, including putting high-risk individuals onto prevention trials and understanding co-morbidity as a barrier to accrual among patients who are interested in participating in clinical trials.
MB-CCOP grantees actively mentor primary care physicians in institutions geared toward the underserved to increase the knowledgeable workforce implementing clinical trials in this population. Community-level safety net institutions that advocate locally for health care can share experiences providing cancer care to immigrants. The MB-CCOPs can also inform clinicians and researchers on the cultural impact of younger minorities and underserved populations residing in communities for whom future cancer care and prevention will be of utmost importance.
With nearly a third (30%) of participants accrued from CCOPs and MB-CCOPs, a sentinel node dissection vs. axillary node dissection study demonstrated the reduction of lymphedema and other surgical adverse effects, and thus reduced surgical morbidity. The primary outcomes results were reported in 2010 of the trial, NSABP B-32, A Randomized Phase III Clinical Trial to Compare Sentinel Node Resection (SNR) to Conventional Auxiliary Dissection (AD) in Clinically Node-Negative Breast Cancer Patients.