Interventional oncology clinical research specialist

介入肿瘤学（IO）正在成为癌症治疗的第四大支柱， 医学、放射和外科肿瘤学。介入肿瘤学家提供微创 图像引导疗法治疗癌症而没有化疗的毒性和缺陷， 放疗或手术新的临床试验设计和合作对于确定 以及何时应将IO疗法纳入多学科护理计划以实现最佳效果 癌症患者的结果。这方面的障碍很多。试验设计必须适应 分阶段和可重复的治疗，这使事件发生时间分析复杂化。有一个缺乏 介入肿瘤学临床研究者，他们需要与其他 肿瘤学学科为临床试验开发新的概念和方案。国家癌症研究所 协作组层级是医学肿瘤学的领域。外科和介入 概念努力克服审查过程的许多层面，这是审查过程的障碍。 招聘和留住年轻调查员。在超过100项NCTN试验中， 申请人的癌症中心涉及一个以上的癌症专业，这是一个明显的指标， 缺乏跨学科的临床研究。进行跨学科试验充满了 当治疗医生在不同的地方执业时，后勤和行政方面的挑战 部门，这在历史上是审判失败的主要决定因素。 高级IO临床研究专家的作用是解决这些障碍， 机构和国家技术和电信网络一级。这从教授临床试验设计和执行开始， 来自所有癌症学科的年轻研究人员的新骨干。跨学科合作可以 然后在NCTN机构内部和跨机构创建，以产生新的试验概念， 系统和图像引导疗法的交叉，以创造新的治疗协同作用。 研究的领域已经成熟，包括通过靶向HIF激活来增强缺血， 自噬和自由基的产生;增强选择性内照射， 放射增敏剂;增强热疗法以改善消融边缘;消融 和栓塞作为免疫刺激剂以增强免疫检查点抑制;图像引导 将CAR-T细胞递送到实体瘤中;直接注射和淋巴内施用CAR-T细胞， 基于疫苗的药剂;以及用于递送治疗剂的纳米构建体。这些新颖 这些概念需要通过埃塞俄比亚的NCTN过程来指导，新的平台 为执行跨部门临床试验而开发。

Interventional Oncology (IO) is emerging as the fourth pillar of cancer care alongside medical, radiation, and surgical oncology. Interventional oncologists provide minimally invasive image-guided therapies to treat cancers without the toxicities and disfigurement of chemotherapy, radiation or surgery. New clinical trial designs and collaborations are essential to determine how and when IO therapies should be integrated into multidisciplinary care plans to achieve optimal outcomes for cancer patients. Obstacles to this are many. Trial designs must accommodate staged and repeatable therapies, which complicates time-to-event analysis. There is a dearth of interventional oncology clinical investigators, who are needed to build collaborations with other oncologic disciplines to develop new concepts and protocols for clinical trials. The NCI cooperative group hierarchy is the domain of medical oncology. Surgical and interventional concepts struggle to hurdle the many layers of the review process, which is a barrier to the recruitment and retention of young investigators. Less than 5% of the >100 NCTN trials open at the applicant’s cancer center involve more than one cancer specialty, a stark indicator of the deficit in interdisciplinary clinical research. Conducting interdisciplinary trials is fraught with logistical and administrative challenges when the treating physicians practice in different departments, which historically is a major determinant of trial failure. The role of a senior IO clinical research specialist is to address each of these obstacles at the institutional and NCTN level. This starts with teaching clinical trial design and execution to a new cadre of young investigators from all cancer disciplines. Interdisciplinary collaborations can then be created within and across NCTN institutions to generate new trial concepts investigating the intersection of systemic and image-guided therapies to create new therapeutic synergies. Areas ripe for investigation include potentiation of ischemia by targeting HIF activation, autophagy, and free radical generation; potentiation of selective internal radiation with radiosensitizers; potentiation of thermal-based therapies to improve ablation margins; ablation and embolization as immunostimulants to potentiate immune checkpoint inhibition; image-guided delivery of CAR-T cells into solid tumors; direct injection and intralymphatic administration of vaccine-based agents; and nanoconstructs for delivery of therapeutic agents. These novel concepts need to be guided through the labyrinthian NCTN process, and new platforms developed for execution of interdepartmental clinical trials.