The Room Where It Happens: Addressing Diversity, Equity, and Inclusion in NCTN Clinical Trial Leadership.

Many multicenter randomized clinical trials in oncology are conducted through the National Clinical Trials Network (NCTN), an organization consisting of five cooperative groups. These groups are comprised of multidisciplinary investigators who work collaboratively to conduct trials that test novel therapies and establish best practice for cancer care. Unfortunately, significant disparities in clinical trial leadership are evident. To examine the current state of diversity, equity, and inclusion (DEI) across the NTCN, an independent NCTN Task Force for Diversity in Gastrointestinal (GI) Oncology was established in 2021, the efforts of which serve as the platform for this Commentary. The taskforce sought to assess existing data on demographics and policies across NCTN groups. Significant differences in infrastructure and policies were identified across groups, as well as a general lack of data regarding the composition of group membership and leadership. In the context of growing momentum around DEI in cancer research, the National Cancer Institute (NCI) established an Equity & Inclusion Program which is working to establish benchmark data regarding diversity of representation within the NCTN groups. Pending this data, additional efforts are recommended to address diversity within the NCTN, including: standardizing membership, leadership, and publication processes; ensuring diversity of representation across scientific and steering committees; and providing mentorship and training opportunities for women and individuals from underrepresented groups. Intentional and focused efforts are necessary to ensure diversity in clinical trial leadership and to encourage design of trials that are inclusive and representative of the broad population of patients with cancer in the US.