摘要:過去,我們已進行並完成一些研究者自行發起之國內多中心乳癌臨床試驗案。以先前的合作基礎,我們聯合國內十四家醫學中心,包括台大醫院,台北榮總,三軍總醫院,馬偕醫院,林口長庚醫院,台中榮總,彰化基督教醫院,高醫附設醫院,高雄榮總,台北醫學大學附設醫院,高雄長庚醫院,成大醫院,中國醫藥大學附設醫院以及和信治癌醫院,建立了乳癌臨床試驗資源中心。我們藉由此乳癌臨床資源中心,已創造出高水準本土多中心抗乳癌臨床試驗。同時,我們已經爭取到國際藥廠,生技公司和學術機構與我國合作設計乳癌臨床試驗。本計畫研究目標如下: (1) 讓臺灣乳癌臨床試驗合作聯盟成為亞洲最具創新領導之乳癌臨床試驗聯盟。 (2) 爭取國際藥廠在臺灣執行藥廠所主導之國際性臨床試驗。(3) 幫助台灣本土藥廠或研究機構所開發之新藥開發的乳癌臨床試驗。(4) 支持臺灣乳癌臨床試驗合作聯盟研究者自行發起國內多中心臨床試驗案。成立此資源中心之後,過去和未來我們已完成並將持續進行下列重要的工作;(1)我們建立了臨床檢體,臨床資料收集之平台。據此,我們將開始進行兩項回溯性臨床研究,著重於原位癌的治療策略,以及三陰性乳癌者治療法則。(2)我們完成了一項針對乳癌腦轉移全腦放射治療後復發的病人新穎的藥物治療的學者自行發起之臨床試驗。此研究結果獲致世界最佳之療效成績,將成為未來的標準治療。我們亦完成兩項學者自行發起之臨床試驗,目前陸續收案中。(3)我們發展了三個新的學者自行發起之臨床試驗,其中一個獲得藥廠的全力支持,升級成為多國多中心之全球性臨床試驗,仍由我們擔任主席,該研究初步結果,預計投於The New England Journal of Medicine。此外,我們已設計臺灣多中心前瞻性臨床試驗和分子標記,去研究和探討低惡性度原位乳管癌,只接受乳房保留手術切除之復發狀態。同時,我們已設計臺灣多中心前瞻性臨床試驗,去長期追蹤和觀察原位乳管癌在經手術後之復發狀態,並藉由上述學者自行發起之臨床試驗幫忙,進一步發展臺灣女性原位乳管癌之最佳治療,預計今年開始收案。(4)我們持續協助主持執行國內藥廠委託之國際性新藥臨床試驗,目標將是推動新藥獲得包括美國食品藥物管理局的許可證。(5)我們執行許多藥廠主導之國際性臨床試驗,並持續協助引進這類國際性臨床試驗。我們相信,此資源中心的成功將對我國在乳癌臨床試驗領域的國際地位有重要的提升。
Abstract: We have organized a Taiwan Clinical Trial Consortium - Breast Cancer (TCTC-BC), in orderto provide technical and consultation platforms for further improve the productivity of thisnetwork. At beginning, this consortium involved 14 medical centers, including: NationalTaiwan University Hospital, Taipei Veteran General Hospital, Taichung Veteran GeneralHospital, Kaohsiung Veteran General Hospital, Taipei Medical University Hospital,Kaohsiung Chang Gung Memorial Hospital, National Cheng Kung University Hospital,China Medical University Hospital, Changhua Christian Hospital, Mackay Memorial Hospital,Linkou Chang-Gung Memorial Hospital, Tri-Service General Hospital, Kaohsiung MedicalUniversity Chung-Ho Memorial Hospital, and Koo Fundation Su Yat-Sen Cancer Center. Byestablishing this joint research group, we have performed high-quality, well-coordinatedclinical trials on new anti-breast cancer drugs in Taiwan. We will also collaborate with manymultinational pharmaceutical and biotechnology companies, as well as research institutions,in oncology clinical trials for breast cancer.Specific aims of this project are:1. To level up the “Taiwan Breast Cancer Consortium” as an excellent consortium of breastcancer clinical trial in Asia.2. To attract international pharmaceutical companies to perform their breast cancer trials inTaiwan.3. To help domestic pharmaceutical companies conduct their breast cancer trials in Taiwan.4. To help investigators of the consortium conduct investigator-initiated trials for breastcancer.In the past years and for the next year, we have following achievements and planning:1.) we have set up Web-based data collection system under TBCC construction. Base on thissystem, we will start two important retrospective study focuses on the treatment strategy inductal carcinoma in situ, and treatment in triple negative breast cancer. 2.) We havecompleted one PI-initiated trial focus on the treatment for breast cancer with brainmetastases progressing from whole brain radiotherapy. The result is outstanding and thetreatment will surely be the future standard in this indication. We also have completed twoother PI-initiated trials, which are to be published next year. 3.) We have developed threenew multi-center clinical trials. One of them has been upgraded by the internationalpharmaceutical company to become a global study, but still chaired by us. The preliminarydata has been presented at the San Antonio Breast Cancer Symposium meeting this year and will be submit to The New England Journal of Medicine. Also, we have designed a multi-centerrandomized trial to evaluate the local recurrence for patients with low-risk breast ductalcarcinoma in situ (DCIS) who received breast conserving treatment alone accompanied bybiomarkers study in Taiwan. In addition, we have a multi-center, prospectively registrationstudy for ductal carcinoma in situ of breast in Taiwan, Taiwan Breast Cancer Consortiumto investigate the local recurrence event and thus develop a new treatment strategy forTaiwanese breast DCIS. These trials have been started. 4.) We continue to help domesticpharmaceutical companies conduct their breast cancer trials in Taiwan. 5.) We have conductmany pharmaceutical company sponsored international trials, and continue to intermediateservice for new drug clinical trial sponsored by international pharmaceutical company toTaiwan.We believe success of this consortium is important in the future competition withother Asian countries in breast cancer clinical trial business.