Table 1.

Aspects of Rare Cancer Research in the NCTN

Advantages	Challenges
Large number of sites increases access to the population	Cap on accrual to NCTN clinical trials necessitated by current budget woes
Diversity of participating sites (research, academic, community) increases generalizability of results	Molecular screening outside of the context of a therapeutic interventional trial is not adequately funded
Rich experience in clinical trial design and conduct within the NCTN	Single arm and observational trials receive lower priority for activation in NCTN
NCTN system obviates need for individual site contracts	Sites may choose to not activate studies that have anticipated low accrual
Central IRB reduces regulatory burden at the individual sites	Not all NCTN trials are eligible for CIRB; not all NCTN centers participate in the CIRB