Current trials and future directions of the Eastern Cooperative Oncology Group Breast Cancer Committee

The Eastern Cooperative Oncology Group (ECOG) continues a major commitment to clinical trials in breast cancer. Trials nearing completion address adjuvant therapy in patients with negative nodes and the interaction of hormonal and cytotoxic adjuvant therapies. ECOG is committed to the performance of intergroup trials that are coordinated among the other major cooperative clinical trials groups in order to accrue the large numbers of patients required for optimal definition of trial results in as few years as possible. Most adjuvant trials to begin the months and years ahead will involve such collaboration. Issues to be addressed include the adjuvant benefit of ovarian ablation (surgical or medical) in addition to tamoxifen in the adjuvant therapy of women at relatively low risk; the significance of increasing dose intensity by a variety of techniques for the adjuvant therapy of women at higher risk of recurrence, including the use of autologous bone marrow transplantation and stem cell support with dose-intense therapy for women at the highest risk of recurrence; and the issue of combination scheduling of cytotoxic agents versus sequential single agents at higher dose intensity.