Am J Public Health. 2010 Apr;100(4):596-603. doi: 10.2105/AJPH.2009.168633. Epub 2010 Feb 18.
Despite advances in the prevention and early detection of cancer and the treatment of some malignancies, clinical research has not yet delivered treatment benefits of the magnitude anticipated after the launch of imatinib, which established highly effective new treatment standards. The primary impediments to progress are scientific, but the efficiency of research is also affected by structural deficiencies relating to where and by whom it is conducted, as well as how it is organized and regulated. To optimize the research environment and maximize the benefits of improved funding, adjustments in the roles of government, industry, the academic community, national research bodies, and regulatory authorities are needed. A patchwork of reforms that are enabling in character and build on existing expertise can deliver substantial progress without the need for radical intervention.
尽管在癌症的预防、早期发现和某些恶性肿瘤的治疗方面取得了进展，但临床研究仍未像伊马替尼（imatinib）推出后所预期的那样带来治疗效益，伊马替尼确立了高度有效的新治疗标准。阻碍进展的主要原因是科学方面的，但研究的效率也受到与研究的地点和执行者以及研究的组织和管理方式有关的结构性缺陷的影响。为了优化研究环境并最大限度地提高改善资金的效益，需要调整政府、工业界、学术界、国家研究机构和监管机构的作用。一系列具有启发性且以现有专业知识为基础的改革可以在不需要激进干预的情况下取得重大进展。
