The National Cancer Institute's (NCI) Clinical Trials Cooperative Group Program has played a key role in developing new and improved cancer therapies. However, the program is falling short of its potential, and the IOM recommends changes that aim to transform the Cooperative Group Program into a dynamic system that efficiently responds to emerging scientific knowledge; involves broad cooperation of stakeholders; and leverages evolving technologies to provide high-quality, practice-changing research.Table of ContentsFront MatterExecutive SummaryOverview of Conclusions and Recommendations1 Introduction2 The Science of Developing Cancer Therapy3 Operations, Oversight, and Funding of Cancer Clinical Trials4 Physician and Patient Participation in Cancer Clinical TrialsAppendix A: Previous and Ongoing Analyses Undertaken by NCIAppendix B: Committee Member and Staff BiographiesAcronymsGlossary