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加速肿瘤学药物研发的未来:联盟在精准肿瘤学早期临床试验交付中的作用。

Accelerating the Future of Oncology Drug Development: The Role of Consortia in the Delivery of Precision Oncology Early Phase Clinical Trials.

作者信息

Liu Jia, Farrow Max, Seymour Lesley, Desai Jayesh, Loong Herbert H, Ivy Percy, Koyoma Takafumi, Cook Natalie, Blagden Sarah, Garralda Elena, Massard Christophe, Tolcher Anthony W, Adashek Jacob J, Zhang Li, Zhao Shen, Shen Lin, Kurzrock Razelle, El-Deiry Wafik S, Subbiah Vivek, Joshua Anthony M

机构信息

The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW, Australia.

Faculty of Medicine & Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.

出版信息

J Clin Oncol. 2025 Feb 20;43(6):735-747. doi: 10.1200/JCO-24-01534. Epub 2025 Jan 14.

Abstract

PURPOSE

Over the past 15 years, the landscape of early phase clinical trials (EPCTs) has undergone a remarkable expansion in both quantity and intricacy. The proliferation of sites, trials, sponsors, and contract research organizations has surged exponentially, marking a significant shift in research conduct. However, EPCT operations suffer from numerous inefficiencies, such as cumbersome start-up processes, which are particularly critical when drug safety and the recommended phase II dose need to be established in a timely manner. Networks and consortia may overcome some of these challenges of enrolling suitable patients and streamlining start-up, particularly when distance and disease trajectory come into play.

DESIGN

In this article, we provide an overview of EPCT consortia in adult oncology across different continents assembled through systematic review of the literature and snowball sampling methodology. We illustrate their scope, structure, funding, and achievements.

RESULTS

Fifteen EPCT consortia were identified including two in the United States, three in Europe, five in Asia-Pacific, two intercontinental consortia, and three within private oncology networks. These consortia vary in their scope, funding, and structure from government-funded models such as the National Cancer Institute Experimental Therapeutics Clinical Trials Networks through charitably funded and private research organizations. EPCT consortia play a role in collaborative research, molecular tumor boards to provide patient-centric biomarker-matched treatments, and streamlining trial conduct to improve timelines and cost efficiency.

CONCLUSION

The growth in EPCT activity and complexity has resulted in expansion in the number of EPCT consortia globally. By actively engaging with regulatory bodies and pharmaceutical and contract research organization industries, consortia have an opportunity to address the evolving challenges faced in this field and to accelerate the translation of scientific discoveries into clinical practice.

摘要

目的

在过去15年中,早期临床试验(EPCTs)的格局在数量和复杂性方面都经历了显著的扩展。试验点、试验、申办方和合同研究组织的数量呈指数级增长,标志着研究开展方式发生了重大转变。然而,EPCT的运作存在诸多效率低下的问题,比如启动流程繁琐,而这在需要及时确定药物安全性和推荐的II期剂量时尤为关键。网络和联盟可能会克服招募合适患者和简化启动流程方面的一些挑战,尤其是在考虑距离和疾病轨迹的情况下。

设计

在本文中,我们通过对文献的系统回顾和滚雪球抽样方法,概述了不同大陆成人肿瘤学领域的EPCT联盟。我们阐述了它们的范围、结构、资金来源和成就。

结果

共识别出15个EPCT联盟,其中美国有2个,欧洲有3个,亚太地区有5个,两个洲际联盟,以及3个在私立肿瘤学网络内。这些联盟在范围、资金来源和结构上各不相同,从政府资助模式(如美国国立癌症研究所实验治疗临床试验网络)到慈善资助和私立研究组织。EPCT联盟在合作研究、分子肿瘤委员会以提供以患者为中心的生物标志物匹配治疗,以及简化试验开展以提高时间效率和成本效益方面发挥着作用。

结论

EPCT活动和复杂性的增加导致全球EPCT联盟数量的扩大。通过积极与监管机构、制药和合同研究组织行业合作,联盟有机会应对该领域不断演变的挑战,并加速将科学发现转化为临床实践。

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