Chung Christine H, Wong Stuart, Ang K Kian, Hammond Elizabeth H, Dicker Adam P, Harari Paul M, Le Quynh-Thu
Head and Neck Cancer Subcommittee, Translational Research Program, Radiation Therapy Oncology Group: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-6307, USA.
Int J Radiat Oncol Biol Phys. 2007;69(2 Suppl):S67-78. doi: 10.1016/j.ijrobp.2007.04.090.
Head and neck cancer is the fifth most common cancer in the United States, with an overall survival rate of approximately 40-50%. In an effort to improve patient outcomes, research efforts designed to maximize benefit and reduce toxicities of therapy are in progress. Basic research in cancer biology has accelerated this endeavor and provided preclinical data and technology to support clinically relevant advances in early detection, prognostic and predictive biomarkers. Recent completion of the Human Genome Project has promoted the rapid development of novel "omics" technologies that allow more broad based study from a systems biology perspective. However, clinically relevant application of resultant gene signatures to clinical trials within cooperative groups has advanced slowly. In light of the large numbers of variables intrinsic to biomarker studies, validation of preliminary data for clinical implementation presents a significant challenge and may only be realized with large trials that involve significant patient numbers. The Radiation Therapy Oncology Group (RTOG) Head and Neck Cancer Translational Research Program recognizes this problem and brings together three unique features to facilitate this research: (1) availability of large numbers of clinical specimens from homogeneously treated patients through multi-institutional clinical trials; (2) a team of physicians, scientists, and staff focused on patient-oriented head-and-neck cancer research with the common goal of improving cancer care; and (3) a funding mechanism through the RTOG Seed Grant Program. In this position paper we outline strategic plans to further promote translational research within the framework of the RTOG.
头颈癌是美国第五大常见癌症，总体生存率约为40%-50%。为了改善患者的治疗效果，旨在使治疗效益最大化并降低毒性的研究工作正在进行中。癌症生物学的基础研究加速了这一努力，并提供了临床前数据和技术，以支持早期检测、预后和预测生物标志物方面与临床相关的进展。人类基因组计划的近期完成推动了新型“组学”技术的快速发展，这些技术允许从系统生物学角度进行更广泛的研究。然而，合作组内将所得基因特征应用于临床试验的临床相关进展缓慢。鉴于生物标志物研究固有的大量变量，验证用于临床实施的初步数据面临重大挑战，可能只有通过涉及大量患者的大型试验才能实现。放射治疗肿瘤学组（RTOG）头颈癌转化研究计划认识到了这个问题，并汇集了三个独特的特点来促进这项研究：（1）通过多机构临床试验可获得大量来自接受同质治疗患者的临床标本；（2）一支由医生、科学家和工作人员组成的团队，专注于以患者为导向的头颈癌研究，共同目标是改善癌症护理；（3）通过RTOG种子基金计划提供资金机制。在本立场文件中，我们概述了在RTOG框架内进一步促进转化研究的战略计划。
