Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Oncologist. 2020 Jan;25(1):78-86. doi: 10.1634/theoncologist.2019-0365. Epub 2019 Sep 6.
Oncology research increasingly involves biospecimen collection and data sharing. Ethical challenges emerge when researchers seek to use archived biospecimens for purposes that were not well defined in the original informed consent document (ICD). We sought to inform ongoing policy debates by assessing patient views on these issues.
We administered a cross-sectional self-administered survey to patients with cancer at an academic medical center. Survey questions addressed attitudes toward cancer research, willingness to donate biospecimens, expectations regarding use of biospecimens, and preferences regarding specific ethical dilemmas.
Among 240 participants (response rate 69%), virtually all (94%) indicated willingness to donate tissue for research. Most participants (86%) expected that donated tissue would be used for any research deemed scientifically important, and virtually all (94%) expected that the privacy of their health information would be protected. Broad use of stored biospecimens and data sharing with other researchers increased willingness to donate tissue. For three scenarios in which specific consent for proposed biobank research was unclear within the ICD, a majority of patient's favored allowing the research to proceed: 76% to study a different cancer, 88% to study both inherited (germline) and tumor specific (somatic) mutations, and 70% to permit data sharing. A substantial minority believed that research using stored biospecimens should only proceed with specific consent.
When debates arise over appropriate use of archived biospecimens, the interests of the research participants in seeing productive use of their blood or tissue should be considered, in addition to addressing concerns about potential risks and lack of specific consent.
This survey evaluated views of patients with cancer regarding the permissible use of stored biospecimens from cancer trials when modern scientific methods are not well described in the original informed consent document. The vast majority of patients support translational research and expect that any biospecimens they donate will be used to advance knowledge. When researchers, policy makers, and those charged with research oversight debate use of stored biospecimens, it is important to recognize that research participants have an interest in productive use of their blood, tissue, or data, in addition to considerations of risks and the adequacy of documented consent.
肿瘤学研究越来越多地涉及生物样本采集和数据共享。当研究人员试图将存档生物样本用于原始知情同意文件(ICD)中未明确定义的目的时,就会出现伦理挑战。我们试图通过评估患者对这些问题的看法,为正在进行的政策辩论提供信息。
我们在一家学术医疗中心对癌症患者进行了横断面自我管理调查。调查问题涉及对癌症研究的态度、捐赠生物样本的意愿、对生物样本使用的期望以及对特定伦理困境的偏好。
在 240 名参与者(回应率 69%)中,几乎所有人(94%)表示愿意为研究捐赠组织。大多数参与者(86%)期望捐赠的组织将用于任何被认为具有科学重要性的研究,几乎所有人(94%)期望保护他们的健康信息隐私。广泛使用存储的生物样本和与其他研究人员共享数据增加了捐赠组织的意愿。对于 ICD 中对于拟议生物库研究的特定同意不明确的三种情况,大多数患者赞成允许研究继续进行:76%的患者赞成研究另一种癌症,88%的患者赞成同时研究遗传(种系)和肿瘤特异性(体细胞)突变,70%的患者赞成允许数据共享。相当一部分人认为,只有在获得特定同意的情况下,才能使用存储的生物样本进行研究。
当围绕存档生物样本的适当使用出现争议时,除了解决潜在风险和缺乏特定同意的问题外,还应考虑研究参与者对看到其血液或组织得到有效利用的利益。
本调查评估了癌症患者对癌症试验中储存的生物样本可允许使用的看法,当现代科学方法在原始知情同意文件中未详细描述时。绝大多数患者支持转化研究,并期望他们捐赠的任何生物样本都将用于推进知识。当研究人员、政策制定者和负责研究监督的人员辩论使用储存的生物样本时,重要的是要认识到,除了考虑风险和记录同意的充分性之外,研究参与者还对其血液、组织或数据的有效利用感兴趣。