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新欧盟法规时代的临床试验、数据保护与患者赋权

Clinical Trials, Data Protection and Patient Empowerment in the Era of the New EU Regulations.

作者信息

Negrouk Anastassia, Horgan Denis, Gorini Alessandra, Cutica Ilaria, Leyens Lada, Schee genannt Halfmann Sebastian, Pravettoni Gabriella

机构信息

EORTC, Brussels, Belgium.

出版信息

Public Health Genomics. 2015;18(6):386-95. doi: 10.1159/000441561. Epub 2015 Nov 14.

Abstract

Cancer clinical trials and, in general, cancer clinical research by definition need a multi-modality approach. It is not enough to discover and register new drugs. To get cancer under control requires us to perform complex clinical studies that integrate drugs, companion diagnostics, new or improved surgical procedures and new radiotherapy approaches as well as, most importantly, to integrate all available information. This includes biological material and, of increasing importance, large amounts of data using big data technologies. To personalise treatment, genetic data are more and more frequently used. Therefore, the general approach is holistic. Legislators, on the other hand, work in a silo mentality; the needs of clinical research are poorly understood, and legislation focuses on either health care or the commercialisation of a product, and not on clinical research. In the last 2 years the EU has drafted several major regulations touching on clinical trials, in vitro diagnostics, medical devices and data protection, all of which will impact clinical research, although the silo mentality makes the overall framework inconsistent and potentially highly damaging to the EU's capacity to make rapid progress in the field of personalised medicine.

摘要

癌症临床试验,总体而言,癌症临床研究从定义上讲需要多模态方法。仅仅发现和注册新药是不够的。要控制癌症,需要我们开展复杂的临床研究,整合药物、伴随诊断、新的或改进的手术程序以及新的放射治疗方法,而且最重要的是,整合所有可用信息。这包括生物材料,以及越来越重要的、使用大数据技术的大量数据。为了实现个性化治疗,基因数据的使用越来越频繁。因此,总体方法是整体性的。另一方面,立法者以孤立的思维方式工作;对临床研究的需求了解甚少,立法要么侧重于医疗保健,要么侧重于产品的商业化,而不是临床研究。在过去两年里,欧盟起草了几项涉及临床试验、体外诊断、医疗器械和数据保护的主要法规,所有这些都将影响临床研究,尽管这种孤立的思维方式使得整体框架不一致,并且可能对欧盟在个性化医疗领域迅速取得进展的能力造成极大损害。

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