The NSABP, RTOG, and GOG each bring strong scientific credentials and a solid history of contribution to the cancer research effort.
National Surgical Adjuvant Breast and Bowel Project (NSABP)
The National Surgical Adjuvant Breast and Bowel Project (NSABP) began in 1957 when a team of 23 surgeons pooled their talents to develop a better understanding of breast cancer. The NSABP’s trials have had a profound impact on the treatment of breast and bowel cancer and our understanding of the biology of these diseases. The group is perhaps best known for its series of surgical breast cancer studies that led to the elimination of the radical mastectomy and the confirmation that lumpectomy plus radiation therapy is an effective option for most women with invasive or noninvasive breast cancer. The NSABP also conducted a series of adjuvant therapy trials that evaluated systemic treatments for patients with node-positive or node-negative breast cancer, and ductal carcinoma in situ breast cancer, in addition to conducting a series of adjuvant trials for patients with colon and/or rectal cancer. For example, NSABP B-14 expanded the indication of tamoxifen for early breast cancer, and NSABP B-31 resulted in the approval of the novel agent, Herceptin. NSABP C-07 demonstrated that adding a new agent to conventional treatment significantly improved outcomes in early-stage colon cancer. Many of today's standard adjuvant therapy regimens resulted directly from the breast and colorectal trials conducted by the NSABP.
Tissue from NSABP B-14 and NSABP B-20 were the foundation for the development of Oncotype DX®. This tool, which is used worldwide, assesses recurrence risk and predicts benefit of chemotherapy in women with early-stage, hormone receptor-positive breast cancer. As a result of these data, women with a low recurrence score can now avoid chemotherapy.
NSABP designed, secured funding, and led two large breast cancer prevention trials known as the Breast Cancer Prevention Trial (P-1/BCPT) and the Study of Tamoxifen and Raloxifene (STAR). P-1 was the world’s first chemoprevention trial using tamoxifen.
The NSABP Foundation, originally formed in 1995, continues much of the work begun over 65 years ago by the NSABP, carrying out important and practice-changing clinical trials for breast and colorectal cancer with support from industry. The NSABP Foundation's research scope has broadened to include work in genetic and immunologic treatments for breast and colorectal cancers. With its decades of cancer research, more than 89,000 unique biospecimens have been collected and preserved by the NSABP in its Pittsburgh biorepository. This biorepository serves as an open resource to the scientific community for further research to improve clinical outcomes.
Radiation Therapy Oncology Group (RTOG)
RTOG research has set and/or validated many of the national and international standards for combined modality therapy of localized to intermediate-stage cancer in adult brain tumors, head and neck cancer, localized or locally advanced lung cancer, noncolorectal gastrointestinal cancer, genitourinary cancer, and localized and locally advanced prostate cancer. A number of recent RTOG-led trials have defined new practice standards: the first randomized brain tumor trial defining chromosomal deletions as prognostic and predictive biomarkers; the first phase III trial defining concurrent chemo radiation as the standard of care for laryngeal preservation; the phase III trial helping to decrease overtreatment by demonstrating the lack of survival benefit for routine inclusion of surgery in management of patients with mediastinal lymph node-positive non-small-cell lung cancer (NSCLC); and a series of trials clarifying the role and optimal duration of total androgen blockade for men with localized, locally advanced, or locally recurrent prostate cancer.
Gynecologic Oncology Group (GOG)
GOG embodies the only significant effort in the current cooperative group system to study gynecologic cancers and is regarded internationally as the leader in clinical trials in this domain. GOG research has yielded many practice-defining advances in the management of gynecologic cancers: 1) defining the current international standard of care for women with advanced ovarian cancer; 2) establishing intraperitoneal chemotherapy as the treatment of choice in the management of small-volume-residual advanced ovarian cancer; 3) identifying concurrent cisplatin-based chemo-RT as the treatment of choice for stages IB2-IVA carcinoma of the uterine cervix; 4) evolving the current treatment of choice for advanced or recurrent carcinoma of the cervix; 5) defining the spread pattern of endometrial carcinoma, currently the most common gynecologic cancer, which established the basis for the therapeutic evolution in early-stage endometrial carcinoma; 6) changing the paradigm for the management of locally advanced endometrial carcinoma by demonstrating roles for systemic therapy; 7) developing effective combination chemotherapy for advanced or recurrent endometrial carcinoma; and 8) setting the current standard of care for patients with uterine sarcomas, thought to be too uncommon to permit large trials, through a series of phase III studies.
As NRG Oncology, these three strong legacy groups will create a synergy that will have significant impact on the National Clinical trials network.