|Taiwan Cooperative Oncology Group, TCOG
Cancer has become the leading cause of death in Taiwan since 1982. Approximately 75 percent to 80 percent of cancer patients will succumb to their illness no matter how sophisticated the management provided. Several reasons are considered to explain why the cancer survival is unacceptably low in Taiwan:
- Most cancer diagnosis was made at advanced stage.
- Poor cooperation of patients for treatment.
- Common types of cancer in Taiwan are apt to have intrinsic or acquired drug resistance.
- Suboptimal and divergent management of cancer treatment between individual oncologists and leading medical centers.
- Lack of adequate number (or critical mass) of qualified oncologists.
Therefore, training, education and reorganization of the oncologists to form a cooperative team for clinical research have become the critical steps to reduce cancer death.
Taking the Eastern Cooperative Oncology Group (ECOG) of the United States as an example, the Taiwan Cooperative Oncology Group (TCOG), established in 1989, is the first organization in Taiwan to conduct multi-center clinical trials for cancer treatment and is now the largest medical group in Taiwan, made up of 18 hospitals with more than 500 physicians, nurses, pharmacists, statisticians, and clinical research associates. It can utilize the resources of patients effectively, ensure the safety and ethics of clinical trials, and establish therapies through a strict monitoring system for data gathering and patient-follow-up. By these, the integration of diagnostic technology and consensus of treatment for cancer in Taiwan are possible.
The aims of TCOG are:
- To promote high quality clinical research.
- To facilitate multi-center oncology trials.
- To develop new modalities of treatment, e.g. new drugs, immunotherapy, differentiation therapy, antiangiogenesis and gene therapy.
- To set up the guideline for diagnosis, prevention and treatment of cancer.
- To improve cancer treatment and care.
The goals of TCOG in the near future are:
- Joining the international phase II and III trials to upgrade TCOG to be recognized as a qualified international study group.
- Conducting more multi-modality phase III trials to improve cancer treatment, especially for the most common and unique cancers in Taiwan, e.g. hepatoma, nasopharyngeal carcinoma, cervical cancer and gastric cancer.
- Developing experimental trials, such as gene therapy, immunotherapy or biological therapy, antiangiogenesis and differentiation therapy.
- Establishing TCOG as the key organization for cancer drug approval through phase I, II and III trials, especially for the local generic drugs, to help and facilitate the R&D of the local pharmaceutical industry.
- Publishing the consensus of standard treatment and prevention of common cancers in Taiwan.