6094 Background: Research ethics review of clinical trials is conventionally done at the local institutional level, requiring multiple local research ethics boards (LREB's) to conduct reviews of the same protocol. Centralized ethics review offers potential efficiency, quality and consistency of review for clinical trials, however, it may limit LREB authority. Previous attempts at centralization have been unsuccessful or of limited generalizability (NCI-central institutional review board). We proposed a centralized research ethics board (REB) for multi-centre trials in Ontario. The goal was to create a REB that would reduce the workload of LREB's, increase the quality and uniformity of reviews, and simplify the initiation of multi-centre trials. Methods: With support from the Ontario cancer research network (OCRN) (funded from the Ministry of Economic Development and Trade) meetings were convened in June, 2002 and May, 2003 of representatives (1 REB and 1 clinical investigator) from 10 cancer centres in Ontario, in an attempt to achieve consensus for this concept. The proceedings from these meetings were distilled into a business plan for an Ontario cancer research ethics board (OCREB). OCREB will provide full REB reviews, the results of which will be distributed to LREB's via the OCRN website. LREB's will have the option of conducting a facilitated review which will focus on local concerns and will not require a meeting of the full REB. Secondly, cancer centres and community hospitals are able to use OCREB as their official board of record for multi-centre cancer studies, including all amendments, adverse events, and continuing reviews. An evaluation framework to monitor the effectiveness of OCREB is under development. Results: An Executive Director, a Chair, and a Vice-Chair have been appointed. OCREB members from around the province (including community representation) have been selected and the first meeting was held in December, 2003. Updated information, including the number of clinical trials reviewed and the time to approval will be presented at the meeting. Conclusions: A regional REB was established using a highly consultative approach. No significant financial relationships to disclose.