Maintaining a network of collaborating centres

Trials centres are able to establish, maintain and continue to develop a network of collaborating clinical investigators and their teams, expert advisers, independent assessors, and local data managers throughout the programme. For example, in testicu-lar cancer, a series of three successive MRC trials in stage I seminoma showed how the base of collaborating clinicians expanded over time, the first trial recruiting approximately 500 patients from twenty centres over four years, the second 600 patients from forty-five centres over three years, and the third 1500 patients from seventy-two centres over five years.

An efficient trials centre is able to keep collaborators informed of progress in all aspects of the programme, and to respond promptly and positively to any ideas, comments, criticisms or queries that collaborators may raise.

It is understandably difficult, however, for collaborators in a large programme of multi-centre trials to feel that they share in the ownership of the programme. They need to be shown that they are not just recruiting patients and providing data for the benefit and prestige of the trials centre, but that their views and their advice, often based on many years of experience, are not only valued but are actively sought and acted upon. This can be achieved in a number of ways by centre staff.

♦ Maintain personal links with collaborators, by telephone, at visits to centres, at meetings and conferences. Send them copies of annual reports, newsletters and reprints, and encourage them to visit the centre and comment on any aspects of the programme and the ways it is conducted.

♦ Contact the organizers of appropriate scientific conferences and, if acceptable, arrange to have a stand providing newsletters and displaying posters and information on all trials relevant to the conference. Arrange for someone always to be available at the stand to answer queries, to provide details of trials and outline protocols, and to record the names and addresses of potential collaborators.

♦ Offer to speak about one or more open trials, recently completed trials, and future plans at meetings organized locally by centres or by regions.

♦ Keep patient advocacy groups informed of the progress of all trials relevant to them, reminding them of the purposes and possible benefits.

In addition, there are a number of societies, some quite informal, concerned with particular cancers or areas of cancer research. These, too, can keep members informed about new developments and can generate productive discussion and new ideas. In conjunction with established trials centres, representatives of research groups for each of the main cancer sites or types can meet regularly to (1) review where matters stand in therapeutic research internationally, (2) discuss ideas for new trials, and (3) suggest how new trials can best be developed and activated. Small meetings of relevant researchers can then discuss particular issues in depth. In the United States, the National Cancer Institute, and in the United Kingdom, the National Cancer Research Institute provide forums for airing, discussing and developing new ideas, reviewing proposed trials, and setting priorities.

Meetings needed for developing and conducting multi-centre research programmes are likely to be of two main types: large collaborators' meetings and smaller planning group meetings. Regular newsletters and annual reports also help to maintain interest.

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