The goal of this proposal is to improve knowledge of and treatment of cancer through participation of the Medical College of Ohio (MCO) with the Eastern Cooperative Oncology Group (ECOG). The method used will be to continue the successful amalgam of the scientific exPertise, organizational resources and outreach network of the Medical College with the patient resources and enthusiasm for clinical research in the Toledo community that has resulted in a broadly based cohesive clinical research group in Toledo. The success of the combined Toledo program is attested to by an annual accrual of over 155 patients onto ECOG studies, extensive multimodality scientific contributions to ECOG activities, leadership in ECOG committees and participation in group meetings. The core elements of MCO's participation and this proposal are the scientific contributions by the radiotherapists, surgeons, and medical oncologists, particularly in gastrointestinal neoplasms, and the data management and quality control responsibility that the MCO maintains for the entire Toledo program, including those affiliates that are funded through the CCOP mechanism. The MCO will contribute to the scientific design and critique of clinical research in the ECOG through development of protocols for group- wide use; leadership and participation in disease oriented, modality, cancer control and health practices, and toxicity committees performance of pilot studies based upon local expertise and potential group-wide applicability; and timely publication of group studies. New therapeutic modalities, such as interstitial hyperthermia in conjunction with radiotherapy and chemotherapy, photodynamictherapy and intraoperative radiation therapy will continue to be developed and refined for integration into group- wide clinical trials. Developmental studies in chemoprevention of cancer will be brought to the ECOG through the Cancer Control and Health Practices Committee research on cancer prevention in high risk groups. The MCO will continue its active participation in ECOG group-wide trials and coordinate and monitor the quality of data from the entire Toledo Program. Through the design of scientifically sound ECOG studies based upon pre-clinical and early clinical trials at this institution and participation in group-wide studies, the MCO will continue to contribute to improvement in the care of patients with cancer.