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Advances in biomedical research are yielding significant opportunities to improve cancer prevention, detection, and treatment. However, the ability to translate biomedical discoveries into meaningful advances in cancer care depends on an effective clinical trials system. Publicly funded clinical trials play a vital role by addressing questions that are important to patients but are less likely to be top priorities of industry, which has an important primary focus on new drug development and FDA registration. For example, companies may have less incentive to conduct clinical trials to compare the effectiveness of different treatment options that are already approved for clinical use, combine novel therapies developed by different sponsors, develop therapies for rare diseases, determine optimal duration and dose of treatment with drugs in clinical use, test multimodality therapies, such as radiation therapy, surgery, or devices in combination with drugs, study screening and prevention strategies, or focus on rehabilitation and quality of life following therapy. The National Cancer Institute (NCI) supports the largest U.S. network for clinical trials of any type. The largest component of that network is the Clinical Trials Cooperative Group Program, which comprises 10 groups that involve more than 3,100 institutions and 14,000 investigators who enroll more than 25,000 patients in clinical trials each year.