PROTOCOL REVIEW AND MONITORING SYSTEM: PROJECT SUMMARY The Siteman Cancer Center Protocol Review and Monitoring Committee (PRMC) serves in the capacity of Protocol Review and Monitoring System as mandated by the NCI. It has operated under continuous NCI approval since 2001, and it fulfills the NCI expectation that all NCI-designated cancer centers scientifically evaluate and prioritize all cancer center trials derived and supported from institutional sources (including those originating from other cancer centers) or from industry. In 2018, the committee met 33 times and reviewed 183 protocols, of which 52 were investigator-initiated protocols; an additional 239 protocols were reviewed administratively by a co-chair. PRMC also provides a mechanism for monitoring all cancer research studies at the institution for scientific progress, carrying with it the authority to close any studies that are not making sufficient scientific progress or meeting accrual or performance standards. Committee members have expertise in all relevant disciplines, with reviewers from Medical Oncology, Radiation Oncology, Surgical Oncology, Bone Marrow Transplant, Gynecologic Oncology, Pediatric Oncology, Radiology, Pathology, Psychology, Public Health Sciences, Behavioral Sciences, Biostatistics, Pharmacy, and Protocol Development. Improvements made over this cycle include: Workflow streamlining and automation through leveraging features of the OnCore Clinical Trials Management System; Enhanced efficiency through elimination of redundancies in the submission process, including superfluous submission documents; Increased consistency between PRMC and WU IRB submissions; Standardization of investigator-initiated studies following implementation of review by the Siteman Cancer Center Protocol Development team as part of PRMC.