On November 10, 2011, Friends of Cancer Research (Friends) and the Engelberg Center for Healthcare Reform at Brookings co-hosted the fourth-annual Conference on Clinical Cancer Research, with the support of The American Society of Clinical Oncology (ASCO), and Susan G. Komen for the Cure. Each year, this conference brings together experts in cancer drug development from academic and clinical research, industry, federal health and regulatory agencies, and the patient advocacy community to develop consensus-driven solutions to challenges in the development of the next generation of anti-cancer drugs. As noted in the opening remarks of Dr. Richard L. Schilsky of ASCO, this conference has a proven track record of producing actionable results in the form of FDA Guidances, original research, and scholarly white papers. This year, the panels addressed some of the most challenging topics to date in an effort to improve the speed, efficiency, and impact of oncology drug trial.