In response to a blistering Institute of Medicine (IOM) report published in April 2010, the National Cancer Institute (NCI) will launch a major overhaul of its Clinical Trials Cooperative Group Program. The 50-year-old program conducts a large number of nationwide trials of new cancer therapies, but has not kept up with advances in molecular oncology. The report, which was requested by the NCI, also dinged the system for being inefficient, cumbersome, underfunded and overly complex – problems the agency will work to correct.