Clin-STAR Journey Story:
Cancer and Aging Research Group

Oncologists Join Forces with Geriatricians and Other Clinician-Scientists in a Transdisciplinary Network: The Cancer and Aging Research Group

Cancer is often referred to as a disease of aging. The majority of cancers, about 60 percent, are diagnosed in older adults. And age-related physiological changes, as well as other conditions and accompanying medications, impact older patients' resilience in the face of cancer and its treatments.

Yet older adults are under-represented in the national cancer clinical trials that set the standard for cancer care, and few studies have focused on the unique challenges of these patients. What's more, many clinicians and researchers at the interface of cancer and aging work in isolation, without like-minded colleagues within their institutions.

To address the urgent need to improve care for older adults with cancer, and to build a community of experts, the Cancer and Aging Research Group (CARG) was formed in 2006, largely through the efforts of the late Arti Hurria, MD, at City of Hope Comprehensive Cancer Center. What started as a grassroots effort of a handful of investigators has since grown into a collaborative network of some 450 oncologists, geriatricians and other clinician-scientists from dozens of institutions, and at all stages of their careers.

An example of the type of transdisciplinary collaboration supported by Clin-STAR, CARG is led today by William Dale, MD, PhD; Heidi Klepin, MD, MS; and Supriya Mohile, MD, MS, and is supported by a grant from the National Institute on Aging. From its inception, the organization has worked to set research priorities, importantly in developing and implementing clinical trial design and geriatric assessment tools. Its success lies both in collegiality among its members and in an infrastructure that systematically fosters collaboration, mentoring, career development and leadership training.

CARG's members are dispersed across the country. In weekly or biweekly group phone calls, they discuss how to coordinate resources, expertise, and data to support research at the cancer and aging interface. The group was supported through seed grants from the John A. Hartford Foundation and City of Hope. These early efforts led to CARG’s first multi-center research study, which resulted in the CARG Chemotherapy Toxicity Tool. As word spread, and more people joined the calls, a mentoring system was set up pairing experienced geriatric oncologists with early career investigators.

In 2018 CARG reached a turning point: the National Institute on Aging funded an R21/R33 grant to support development of an infrastructure for CARG. Members can now volunteer to participate in six research cores: measures, supportive care, analytics, clinical implementation, health services, and communications. In addition, the NIA grant provides pilot funding for early career investigators or those who are new to the field of cancer and aging. Pilot grantees are required to consult experts in the CARG cores, and are encouraged to collaborate with researchers outside their home institutions. Funding from the NIA also supports CARG administrative staff based at City of Hope, under Dr. Dale.

Group calls, by phone or video, remain central to connecting the CARG network. Between 80 and 100 people participate in a typical call, and the agenda varies depending on requests submitted through the CARG website. Meetings often include providing feedback on a research project of wide interest, while also discussing career development; relaying news of initiatives from the National Cancer Institute or the Food and Drug Administration, sometimes inviting a program officer or other staff to join the call; advocacy; and diversity, equity and inclusion. Participants from all career stages bring their insights to these calls—and the connections made help sustain CARG and advance the field of geriatric oncology.

What's the key to building a transdisciplinary network?