Network Structure
The US National Cancer Institute (NCI) Division of Cancer Prevention (DCP) is the funding sponsor of the ‘CASCADE’ Network. The ‘CASCADE’ network is composed of three types of organizational units working collaboratively and in partnership with the NCI to design and conduct pragmatic clinical trials with hybrid effectiveness-implementation designs, both in resource-constrained settings in low- and middle-income countries (LMICs) as well as in areas of healthcare disparities within the United States. These organizational units include: a U24 ‘CASCADE’ Network Coordinating Center (CNCC) (funded via RFA-CA-21-045 in 2022), three UG1 Research Bases (RB) (funded via RFA-CA-21-046 in 2022), and nine UG1 Clinical Sites (CS) (three sites funded via RFA-CA-21-047 in 2022, and six additional sites funded via RFA-CA-22-051 in 2023).
National Cancer Institute
- Scientific strategy and external stakeholder liaison
- Clinical trial oversight and quality assurance
- Monitoring accrual and network performance
Network Coordinating Center
- Coordinating network and scientific review
- Centralized data management and reporting
- Conducting risk-appropriate auditing
Research Bases
- Scientific and statistical leadership for clinical trials
- Regulatory compliance and reporting
- Training emerging investigators
Clinical Sites
- Implementing network clinical trial protocols
- Infrastructures for clinical care and follow-up
- Insights on significance and feasibility of trials
‘CASCADE’ Network Clinical Trials
‘CASCADE’ network clinical trials are conducted in resource-constrained settings in low- and middle-income countries as well as in areas of high disease burden and healthcare disparities within the United States. There are four major scientific focus areas: increasing screening uptake, improving management of screen positives, facilitating precancer treatment access, and optimizing precancer treatments for cervical cancer prevention in women living with HIV. Evidence from these trials is expected to inform clinical practice guidelines and improve the implementation of cervical cancer prevention and control programs globally. The ‘CASCADE’ Network Steering Committee is the governing body of the ‘CASCADE’ Network and will seek to integrate the efforts of all network recipients and permit collaborative interactions with the NCI as well as provide joint oversight of network activities. The ‘CASCADE’ Network Coordinating Center (CNCC) facilitates coordination, scientific review, data management, and independent risk-appropriate auditing of network clinical trials throughout this process.