Abstract The Duke University School of Medicine is applying to continue our participation in the National Clinical Trials Network (NCTN) as a Lead Academic Participating Site. The goal of this NCI grant funding is to provide support for ongoing as well as future scientific leadership and clinical trial infrastructure within the Duke Cancer Institute (DCI) in the development and conduct of clinical trials. The award will further Duke's leadership and substantial accrual to NCI-funded clinical trials, specifically multi-center, late-phase clinical treatment trials and imaging trials across a broad range of cancers, modalities, and diverse patient populations as part of NCI’s overall clinical research program for adults, adolescents, young adults and children with cancer. An important focus will be an emphasis on trials in special populations, including underserved populations and rare tumors. The leadership of the 6 Principal Investigators named in the grant application, along with the faculty of the 8 NCI approved research programs at Duke and the Duke Central NCTN Office, will provide a strong and efficient backbone for NCTN clinical research, scientific leadership and patient enrollment effort. Our continued participation as a member of the Alliance, NRG, ECOG-ACRIN, COG, ETCTN and enrollment in trials offered by all adult NCI funded NCTN Network Groups, including SWOG through the Cancer Trials Support Unit (CTSU) mechanism, gives Duke the experience and knowledge needed to lead and enroll in complex NCI funded research involving multiple cancer sites and treatment modalities. The definitive evaluation of newly developed therapies for cancer care including multi-modality treatments, combinations of novel agents, immune approaches and molecularly- based treatment along with advanced imaging approaches, will benefit patients and practitioners as well as the entire oncology research community. This grant will also help to foster an ideal environment to enhance multidisciplinary collaborations and develop the next generation of clinical investigators dedicated to cancer research. The support provided to Duke as a Lead Academic Participating Site will be leveraged against the significant scientific and clinical resources of the Duke Cancer Institute to provide robust participation in a nationally established clinical trial program.