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The management of patients with solid tumors has evolved in the last several decades coincidently with our understanding of disease biology.1 The paradigm shifts have been fueled by an explosion of molecular classifications2 and the birth of targeted therapy,3 and more recently, by immunotherapy.4
The volume of data available to practicing clinicians has led to specialization of care providers such that many of us see patients with disease limited to one or two organs. This specialization has certainly made it easier to keep abreast of the latest research for a given disease, and initiatives such as The Landmark Series5 have facilitated the acquisition of disease-specific knowledge from gold standard randomized, prospective trials. Nevertheless, “questions” far outnumber “answers,” and clinical dilemmas without data to support a decision are frequent, often transcending the organ-specific structure of today’s clinical departments.
How do we manage the patient with oligometastatic progression controlled via immunotherapy? Should aggressive tumor genomics or biomarkers alter the recommended sequence of therapy options? What role or roles does regional therapy play in the management of metastatic disease? These situations emphasize the need to keep informed of ongoing research in multiple arenas, which we argue is nearly impossible currently. Resources are available (e.g., clinicaltrials.gov),6 of course, but navigation can be cumbersome. In our society, information is immediate, visually appealing, and readily digestible. Why should information relevant to cancer surgery be different?
The Ongoing Trials in Surgical Oncology Series provides this level of information through visual abstracts backed by insight from the principal investigators. We started with colon cancer7,8,9,10 and will rotate the focus on a monthly basis. We aim to circumvent the time constraints that limit all of us by providing trial information across all the disciplines within surgical oncology in an easily assimilable format. We envision that this series will serve as the impetus for new trial ideas, bringing potential investigators together to facilitate multi-institution collaborations, and provide awareness about options for patients to streamline referrals.
We all are familiar with the suboptimal survival curves for each solid tumor type11 and painfully aware that they reflect the experiences of our patients. The clinical trial is an application for improved outcomes within the confines of scientific rigor. The argument certainly could be made that all patients should be enrolled in a trial, at least at some point during the course of their disease. We hope that the Ongoing Clinical Trials in Surgical Oncology series is a step in that direction.
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Hernandez, J.M., McMasters, K.M. Introducing the Ongoing Clinical Trials in the Surgical Oncology Series. Ann Surg Oncol 28, 4093–4094 (2021). https://doi.org/10.1245/s10434-021-10113-y
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DOI: https://doi.org/10.1245/s10434-021-10113-y