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Lichtman SM, Harvey RD, Damiette Smit MA, Rahman A, Thompson MA, Roach N, Schenkel C, Bruinooge SS, Cortazar P, Walker D, Fehrenbacher L. Modernizing Clinical Trial Eligibility Criteria: Recommendations of the American Society of Clinical Oncology–Friends of Cancer Research Organ Dysfunction, Prior or Concurrent Malignancy, and Comorbidities Working Group. J Clin Oncol 2017; 35:3753-3759. [DOI: 10.1200/jco.2017.74.4102] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Patients with organ dysfunction, prior or concurrent malignancies, and comorbidities are often excluded from clinical trials. Excluding patients on the basis of these factors results in clinical trial participants who are healthier and younger than the overall population of patients with cancer. Methods ASCO and Friends of Cancer Research established a multidisciplinary working group that included experts in trial design and conduct to examine how eligibility criteria could be more inclusive. The group analyzed current eligibility criteria; conducted original data analysis; considered safety concerns, potential benefits, research, and potential hurdles of this approach through discussion; and reached consensus on recommendations regarding updated eligibility criteria that prioritize inclusiveness without compromising patient safety. Results If renal toxicity and clearance are not of direct treatment-related concern, then patients with lower creatinine clearance values of > 30 mL/min should be included in trials. Inclusion of patients with mild to moderate hepatic dysfunction may be possible when the totality of the available nonclinical and clinical data indicates that inclusion is safe. Ejection fraction values should be used with investigator assessment of a patient’s risk for heart failure to determine eligibility. Patients with laboratory parameters out of normal range as a result of hematologic disease should be included in trials. Measures of patient functional status should be included in trials to better assess fit versus frail patients. Conclusion Expanding inclusion of these patients will increase the number and diversity of patients in clinical trials and result in a more appropriate population of patients.
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Affiliation(s)
- Stuart M. Lichtman
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - R. Donald Harvey
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Marie-Anne Damiette Smit
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Atiqur Rahman
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Michael A. Thompson
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Nancy Roach
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Caroline Schenkel
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Suanna S. Bruinooge
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Patricia Cortazar
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Dana Walker
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
| | - Louis Fehrenbacher
- Stuart M. Lichtman, Memorial Sloan Kettering Cancer Center, Commack, NY; R. Donald Harvey, Emory University School of Medicine, Atlanta, GA; Marie-Anne Damiette Smit and Atiqur Rahman, US Food and Drug Administration, Silver Spring, MD; Michael A. Thompson, Aurora Health Care, Milwaukee, WI; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Caroline Schenkel and Suanna S. Bruinooge, American Society of Clinical Oncology, Alexandria, VA; Patricia Cortazar, Genentech, South San Francisco; Louis
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Kim ES, Bruinooge SS, Roberts S, Ison G, Lin NU, Gore L, Uldrick TS, Lichtman SM, Roach N, Beaver JA, Sridhara R, Hesketh PJ, Denicoff AM, Garrett-Mayer E, Rubin E, Multani P, Prowell TM, Schenkel C, Kozak M, Allen J, Sigal E, Schilsky RL. Broadening Eligibility Criteria to Make Clinical Trials More Representative: American Society of Clinical Oncology and Friends of Cancer Research Joint Research Statement. J Clin Oncol 2017; 35:3737-3744. [PMID: 28968170 PMCID: PMC5692724 DOI: 10.1200/jco.2017.73.7916] [Citation(s) in RCA: 322] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose The primary purposes of eligibility criteria are to protect the safety of trial participants and define the trial population. Excessive or overly restrictive eligibility criteria can slow trial accrual, jeopardize the generalizability of results, and limit understanding of the intervention's benefit-risk profile. Methods ASCO, Friends of Cancer Research, and the US Food and Drug Administration examined specific eligibility criteria (ie, brain metastases, minimum age, HIV infection, and organ dysfunction and prior and concurrent malignancies) to determine whether to modify definitions to extend trials to a broader population. Working groups developed consensus recommendations based on review of evidence, consideration of the patient population, and consultation with the research community. Results Patients with treated or clinically stable brain metastases should be routinely included in trials and only excluded if there is compelling rationale. In initial dose-finding trials, pediatric-specific cohorts should be included based on strong scientific rationale for benefit. Later phase trials in diseases that span adult and pediatric populations should include patients older than age 12 years. HIV-infected patients who are healthy and have low risk of AIDS-related outcomes should be included absent specific rationale for exclusion. Renal function criteria should enable liberal creatinine clearance, unless the investigational agent involves renal excretion. Patients with prior or concurrent malignancies should be included, especially when the risk of the malignancy interfering with either safety or efficacy endpoints is very low. Conclusion To maximize generalizability of results, trial enrollment criteria should strive for inclusiveness. Rationale for excluding patients should be clearly articulated and reflect expected toxicities associated with the therapy under investigation.
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Affiliation(s)
- Edward S. Kim
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Suanna S. Bruinooge
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Samantha Roberts
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Gwynn Ison
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Nancy U. Lin
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Lia Gore
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Thomas S. Uldrick
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Stuart M. Lichtman
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Nancy Roach
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Julia A. Beaver
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Rajeshwari Sridhara
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Paul J. Hesketh
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Andrea M. Denicoff
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Elizabeth Garrett-Mayer
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Eric Rubin
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Pratik Multani
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Tatiana M. Prowell
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Caroline Schenkel
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Marina Kozak
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Jeff Allen
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Ellen Sigal
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
| | - Richard L. Schilsky
- Edward S. Kim, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; Suanna S. Bruinooge, Caroline Schenkel, and Richard L. Schilsky, ASCO, Alexandria, VA; Samantha Roberts, Marina Kozak, Jeff Allen, and Ellen Sigal, Friends of Cancer Research; Samantha Roberts, Genentech, Washington, DC; Gwynn Ison, Julia A. Beaver, Rajeshwari Sridhara, and Tatiana M. Prowell, US Food and Drug Administration, Silver Spring; Thomas S. Uldrick and Andrea M. Denicoff, National Cancer Institute, Bethesda, MD; Nancy U. Lin, Dana-Farber Cancer Institute, Boston; Paul J. Hesketh, Lahey Health Cancer Institute, Burlington, MA; Lia Gore, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO; Stuart M. Lichtman, Memorial Sloan-Kettering Cancer Center, New York, NY; Nancy Roach, Fight Colorectal Cancer, Springfield, MO; Elizabeth Garrett-Mayer, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Eric Rubin, Merck Research Laboratories, Kenilworth, NJ; and Pratik Multani, Ignyta, San Diego, CA
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