Clinical trials in the community. The community clinical oncology program experience

In 1983, the National Cancer Institute initiated the community clinical oncology program (CCOP), the goal of which was to hasten the adoption of state-of-the-art cancer medicine in community-based institutions. The strategy adopted was to link community oncologists to major cancer centers and research bases for the conduct of clinical trials. Since the program was initiated, a significant amount of literature has been developed, providing insight into the operation and success of the program. These reports have been combined with experience of the author, a principal investigator of an established CCOP, in an effort to characterize the critical features of the program. Experience to date indicates that CCOPs have been successful in accruing patients to cancer-treatment clinical trials, contributing approximately one third of patients placed in investigational protocols. Since 1987, CCOPs have been required to participate in nontreatment-related research in cancer prevention, detection, and mitigation of cancer symptoms, or cancer control research. After a slow beginning, both the research bases and CCOPs have accumulated experience in the development of and accrual of patients in cancer control protocols. This review suggests that CCOPs, as they mature, will fulfill their goal as an important mechanism for the transfer of technology and the conduct of clinical research.