Over the past decade, significant advances in clinical trials concentrating on high-quality biomarker translation research have rapidly developed in China. These studies have allowed Chinese investigators to present their results internationally and have greatly changed lung cancer clinical practice.
The INTEREST (gefitinib versus docetaxel in previously treated non-small cell lung cancer) trial was the first international multi-center, randomized phase III trial in which Chinese investigators were involved. Chinese patients composed 15% of the cases for this trial. In 2007, based on the INTEREST trial experience, a national collaborative clinical research group, Chinese Thoracic Oncology Group (CTONG), was established. CTONG is a large network of researchers, physicians and healthcare professionals at public institutions across the China. Currently, there are 17 top hospital members in the group. These institutions and hospitals work toward the common goal of controlling, effectively treating, and ultimately curing cancer. Research results are provided to the worldwide medical community through scientific publications and professional meetings. The missions of CTONG are the following: (i) to design and develop multi-center clinical trials in the field of chest tumors and, in particular, lung cancer; (ii) to provide a high level of evidence for clinical treatment of thoracic tumors; (iii) to promote standardization, modernization, and internationalization of clinical and research work in the thoracic tumor area; and (iv) to improve the diagnosis and treatment of chest tumors in China, as well as internationally.
Currently, CTONG has more than 20 active ongoing clinical trials. They are focused on biomarker-driven studies (Table 1). These studies require the screening of many more patients than trials with all comers. Furthermore, if these trials are successful, many patients will benefit from the results. More than 10 000 new cases of lung cancer have been diagnosed and treated in CTONG hospitals. Thus, biomarker-driven studies can be rapidly initiated in China.
Nevertheless, there is currently only one clinical trial study group in China. This group was established only 4 years ago. In this evidence-based era of medicine, China must develop many more collaborative clinical trial groups and solve the problems that current clinical trial groups face, such as funding support and quality control.
Table 1. CTONG trials focusing on biomarkers