Some significant examples of collaborations and use of EVS resources and services are briefly outlined in this section covering NCI, and in later sections covering NIH, government and standards organizations, and caBIG® and other organizations in the cancer research and biomedical community. This NCI section includes the following profiles:
- NCI Division of Cancer Treatment and Diagnosis (DCTD)
- NCI DCTD and Division of Cancer Prevention (DCP)
- NCI Division of Cancer Prevention (DCP)
- NCI Office of Communications and Education (OCE)
- NCI Division of Cancer Control and Population Sciences (DCCPS)
- NCI Division of Extramural Activities (DEA)
- Other NCI
The Cancer Therapy Evaluation Program (CTEP) has had many and sustained collaborations with EVS from 1999 onwards, including:
- Harmonization and use of NCIt drug and molecular target information in CTEP systems.
- Harmonization and integration of CTEP disease classification with NCIt, PDQ and MedDRA in NCIm.
- Joint development, together with other partners, of the redesigned Common Terminology Criteria for Adverse Events (CTCAE) v.4, which has been widely adopted since its release in 2010 (see the detailed description below).
CTCAE, created by CTEP in 1983, is used throughout the entire oncology community as the standard classification and severity grading scale for adverse events in cancer therapy clinical trials and other oncology settings. It is also used in a number of non-oncology trials and settings.
Version 4, released in May 2009, is a major update based on extensive international participation by stakeholders and experts. It is harmonized with MedDRA at the Adverse Event (AE) level, includes revised AE terms and severity indicators to reflect clinical effects identified with current oncology interventions, and is a caBIG® vocabulary standard. This version is used by more than 50 academic and research organizations, as well as many commercial and non-profit organizations. Five different Apple applications utilize the NCI Thesaurus version of the CTCAE data, and cite NCIt as the source.
CTCAE is designed to integrate into information networks for safety data exchange, and plays a major role in data management for AE data collection, analysis, and patient outcomes associated with cancer research and care. EVS played a central role in designing and managing this effort, working closely with CTEP, DCP, caBIG®, the FDA, and many participants from the broader community. The revision was developed and deployed using various EVS tools including the BiomedGT Wiki, Protégé editing tools, LexEVS terminology server, NCI Term Browser, and the EVS ftp site http://evs.nci.nih.gov/ftp1/CTCAE/About.html .
- EVS is supporting gene nomenclature used in a new CDP Biomarker project, including updating HUGO in the EVS servers so it is accessible to CDP curators.
- In an extension to this project, EVS will be creating gene and protein sequence variations in the NCIt, according to HGVS guidelines, for genes/proteins of therapeutic interest as requested by CDP. The initial request is 150 genes (in progress), with about 180 protein variants, 300 gene variants, 300 fusion genes, and 300 fusion proteins.
- This work is to support creation of an application to retrieve content from the NIH Clinical Trial Database into the NCI Clinical Trials Reporting Program (CTRP), and is being done jointly with DCTD, NCI/OCE, NCI/CCR and NIH/NLM.
EVS staff provides terminology support for the Community Clinical Oncology Program (CCOP), including concepts for use in coding four (4) major clinical trials involving 85,000 patients. An estimated total of 500 studies use NCI Thesaurus terminology.
DCP has used EVS, and worked consistently with EVS, since 2002, including the following collaborations and uses:
- Use of NCIt agent information in DCP systems.
- Joint work on improved coverage of nutritional and other preventive agents.
- Joint work in wider working groups and other initiatives to harmonize broader NCI agent coding practices.
OCE has been a partner in EVS since 1999, providing much of the seed terminology and development effort for NCIt, and contributing to and using EVS in many ways, including:
- NCIt drug information used in the PDQ clinical trials database.
- NCI Drug Dictionary: NCI Thesaurus provides original definitions for the drugs presented in this tool, with about 40,000 visitors monthly (see Non-EVS Server statistics section).
- NCIt terminology for cancers and related conditions, procedures, and chemotherapy regimens, involving many years of development and harmonization between PDQ and NCIt terminology.
- NCI Glossary includes lay definitions for key cancer terms, and is incorporated into NCI Thesaurus.
DCCPS collaboration includes several terminology projects related to cancer classification, drugs, chemotherapy regimens, and statistics. DCCPS is currently launching a new initiative on standardized terminology for population health data collection.
Portfolio Management Application (PMA-DCCPS): EVS has worked with DCCPS for a number of years to integrate PMA-DCCPS grant coding terminology with other EVS resources. NCIt now includes more than 1,500 concepts for PMA grant coding. PMA terms are also inserted and appear in the NCI Metathesaurus as a separate terminology.
DEA is supported by EVS, which helps collect, develop and map grant-related terminology, including representing NCI in the NIH Research, Condition and Disease Categorization (RCDC) effort.
Cooperative Human Tissue Bank (CHTB): EVS has supported terminology creation and editing for this network of research institutions, established by the NCI Cancer Diagnosis Program in 1987 and now including six divisions located at Vanderbilt, U. Penn, UAB School of Medicine, Nationwide Children's Hospital, Ohio State, University of Virginia. CHTB hosts NCI funded tissue facilities and services providing remnant human tissue and fluids from routine procedures to investigators. There is active use by 14 academic and research organizations and eight (8) commercial organizations. EVS staff assisted with matching up terminology used by these groups to NCIt terminology, creating new NCIt concepts and definitions as needed.
Cancer Central Clinical Database (C3D): EVS provides support for C3D, largely through providing the new and updated terminology and definitions for case report forms. C3D currently supports electronic submission of clinical trials data to the NCI Clinical Data System (CDS) and the Clinical Trials Monitoring Service (CTMS/Theradex).
OPEN (Oncology Patient Enrollment Network): This web-based registration system for patient enrollments onto NCI-sponsored Cooperative Group clinical trials is a highly active project; most terminology supplied for this is standard demographic terminology.