status of art of cancer center in europe

8/8/2019 Status of Art of Cancer Center in Europe

1/35

Status of Art of Cancer Center in Europe

A. ParadisoScientific DirectorNCC Bari, Italy

National Cancer CenterNational Cancer CenterBari, ItalyBari, Italy


2/35

Recent 5 years cancer survival(%) data in selected European CountriesEUROCARE-4 data. (Lancet Oncology,2007).

Eurocare-4 mean

Survival (%)

Overall

Men

Women

52.1

47.3

55.8

Breast cancer 79.0

Colorectal cancer 56.2

Lung cancer 10.9

NCCNCCBari, ItalyBari, Italy


3/35

Investments for Research in EU15 (Year 2003)


4/35

THE TRIANGLE OF TRANSLATIONAL RESEARCH

epidemiological research

(registry-based, reality-based)

basic research(laboratory-based) clinical research(clinical trials, evidence-based)



5/35

Patient Management

SCREENING

Radiodiagnostics

Prevention Program

Genetic Counselling

DIAGNOSIS

Radiodiagnostics

Microhistology

Citology

New Biomarkers

Bioimaging

SURGERY

Phisics

Surgery hall

IORT

Nuclear Imaging

Pathology Service

Genetic Counselling

RADIATION ONCOLOGY

MEDICAL TREATMENT

FOLLOW UP

New biomarkers

Psycological distress

Clinics

Clinical Trials

Immunohistochemicals

Predictive biomarkers/patients

Linac

Phisics

Predictive Bt

Diagnostics


PALLIATION

PainSupportive

REAHBILITATION


6/35

Categorization of cancer structures:the European philosophy

Cancer Unit:clinical facility with at least RT+Med Onc+Surg

Clinical Cancer Center:covering a sufficient degree of RT, MedOnc, Surg, RToccasionally clinical trial activities

Cancer Research Center:capacity in cancer research focusing in one or moreareas of fundamental or translational oncology

Comprehensive Cancer Center:covering several aspects of oncology treatment andresearch; high level of integration, infrastructure,expertise and innovation



7/35

OECI Survey on Organization characteristics of CCC in Europe:

Infrastructures focused on cancer research

Epidemiology 95%

Genetics 95%

Molecular Biology 90% Immunology 90%

Stem cell 79%

Animal facility 75%

Biobank 90%

QL assessment 63%


8/35

Preventive service 48%

Screening high risk patients 91%

Operating Rooms >5

Radiotherapy >2 Lineac

Nuclear medicine 82%

Pathology 100%

Hematology 85%

Pharmacy-Chem 100%

PschosocialUnit 100% Palliative Care 100%

Supportive Care 60%

OECI Survey on Organization characteristics of CCC in Europe:

Clinical Facilities


9/35

OECI SURVEY ON Organization characteristics of CCC in Europe:Clinical Trials Ongoing

Phase I Trial mean 10 Phase II Trial mean 29

Phase III Trial mean 41

Phase IV Trials mean 9


10/35

Education in oncology: the experience in the EuropeanCancer Centers. A survey.

12. Do you organize educational activities addressed

to patients?

0,0%20,0%

40,0%

60,0%

80,0%

Yes No

5. Is the structured scientific programme

differentiated for:

13,1%

9 , 8%

23 , 0%24 , 6%

29,5%

0,0%

5,0%

10,0%

15,0%

20,0%

25,0%

30,0%

35,0%

Phy si ci ans Res earchers N ur ses Psy co lo gi sts Other

disciplines



11/35

National Cancer Center of BARINational Cancer Center of BARIBeds 120Day Hospital 32

Surgery hall 5LIneac 2

TAC 3RMN 2Pet 1

OperatorsMD 98Nurses 350Overall 610

NCINCIBari, ItalyBari, Italy


12/35

e

National Cancer Center Bari, I taly

ORGANIZATION STRUCTURE

Scientific Direction-Management Direction

Department of Experimental Laboratory Oncology

Department of Pathology and Diagnostic Facilities

Womens Department

Gastrointestinal Department

Upper Aerodigestive Department

Department of Experimental Medical Oncology

Department of Critical-Palliative Care


13/35

tNational Cancer Center- Bari I taly

Research Areas 2009-2011

Area 1EPIDEMIOLOGY, GENETIC RISK FACTORS, LIFEHABITS AND PREVENTION STRATEGIES

Area 2 INNOVATIVE TECHNICAL AND LABORATORYAPPROACHES

Area 3 NEW MULTIDISCIPLINARY/MININVASIVE

THERAPEUTIC APPROACHES

Area 4 SUPPORTIVE CARE

Area 5 NEW MANAGEMENT AND ORGANIZATIONMODELS


14/35

Genetic Risk factorsNCCNCCBari, ItalyBari, Italy


15/35

HEREDITARY BREAST CANCER:A CHARACTERISTIC GENEAOGICTREE


16/35

Institutional Biobank-NCC Bari

Duval n. 10 Freezer -80C n.12 Samples Stored > 20.000

NCCNCCBari, ItalyBari, ItalyLaboratory Innovation


17/35

YEARLY MANAGEMENT COSTS FOR AN INSTITUTIONAL BIOBANK:

A survey on 15 Italian Biobanks coordinated by NCC-Bari

costi/spese (analisi delle mediane)

personalestrumentazione locali materiali

corsi formazionealtro

0

100000

200000

300000

400000

500000

600000

700000

800000

0 1 2 3 4 5 6 7

costo(

)

Mean costs

Mean costs: 115.000 Euros (range 24.000-230.000)



18/35

Circulating tumor cells:

human breast tumors initiatingcells CD44+/CD24-

A

B

Normal Tumour Metas tas is


Colospheres from different sites


19/35

Activated Multidisciplinary Teams in NCC Bari, Italy

Gastrointestinal Cancer

Women Cancer Head and Neck Cancer Skin Cancer

Teams meet every week with:

Biologist, Pathologist,Radiologist, Surgeon,Radiotherapist Medical Oncologist,Nurse, Psychologist,General Practitioner Volunteers


Sidhom, Lancet Oncol, 2006


20/35

Single- Step transarterial chemoembolization and

radiofrequency ablation for Liver and Lung Cancer


Gadaleta, In Vivo, 2009


21/35


Continuous Education in Oncology:Activities in Progress in NCC-Bari, Italy

E-learning sessions (in collaboration with ESO)

Cancer Research Nurse Courses-Cohoperation to Clinical Trials

-Palliative Care Nursing

-Treatment Toxicity Management


22/35

Characteristics of the NCC of Bari, Italy

Management and Medical Summary 45 clinical trials ongoing n.45

Annual IF for scientific publications(2007) n.280

Annual budget $ 61.5 M Annual budget for research activities $ 7.3 M

Funding Agencies

Regional Health System (pay/perform) 75%National HS (Quality of Care/Research) 10%

Private/others (Special Projects) 15%



23/35

Eckhouse, Mol Onc,2008


24/35

National Cancer Center

Conclusion (1)

Complexity >> full range of facilities

Integration >> multidisciplinary approach Innovation >> funds for new technologies

Education >> funds for personnel



25/35

Regional CancerNetwork-Puglia

NCC-BARI within the Regional Cancer Network-PugliaProduction of Guide Lines

Production of Health Technology AssessmentsCancer Education ProviderCoordinator

Regional BiobanksClinical researchTranslational Research

Take in charge of the patient along all thediagnostic-therapeutic-palliative pathway

to guarantie updated and optimal care



26/35

The National NetworkALLEANZA CONTRO IL CANCRO

Istituto Nazionale per lo Studio e laCura dei Tumori, Milano;

Centro di Riferimento Oncologico,

Aviano

Istituto Europeo di Oncologia, Milano;

Istituto Nazionale per la Ricerca sulCancro, Genova;

Istituto Nazionale per lo Studio e laCura dei Tumori - Fondazione Giovanni

Pascale, Napoli;

Istituto Regina Elena per lo Studio ela Cura dei Tumori, Roma;

Istituto Oncologico, Bari;

Board Members


27/35


Conclusion (2)


Integration >> multidisciplinary approach Innovation >> funds for new technologies

Education >> funds for people

Referent for a Territory



28/35

Cancer Registries

Biobanks& Biomolecular Resources

National Network for Clinical

Studies and GMP facilities

National Network

Guidelines Production-START

European Infrastructures

and Networks

Eranet European Cancer Reg.

BBMRI -Networking majorbiobanking across Europe

ECRIN-Infrastructure for

Clinical Trials and Biotherapy

CoCanCPG: Production of

European Cancer Guidelines

The Italian Networks of ACC

Pre-clinical models

and animal facil it ies

Hereditary Tumors

Telepathology TESEO

Bioinformatics INSTRUCT (Int. Structural

Biology Infrastructure)

EATRIS Translational

Research Infrastructure

T

R

A

I

N

I

N

G

P

E

O

P

L

EAccreditation

PREPAR ING THE MODEL FOR A NATIONAL TRASLATIONAL RESEARCH INFRASTRUCTURE

Italian National Network NCC EUROPEALLEANZA CONTRO IL CANCRO European Community


29/35

Organisation of European Cancer Institutes


30/35


31/35

Project of Accreditation of Cancer Centers

(M.Sagatchian, IGR, Paris) Project of Education/Training

(A.Paradiso, NCC, Bari)

Project of Guidelines Production

(B Fervers, L Berard, Lyon) Project of Pathobiology

(P Riegman, Erasmus-Rotterdam,NL)

European Organization of Cancer InstitutesActivities


32/35


Conclusion (3)


Integration >> multidisciplinary approach

Innovation >> funds for new technologies

Education >> funds for people

Referent for a Territory

Living within International Scientific World



33/35

The Triangle of Comprehensive Cancer Center Life

Comprehensive Cancer CenterInnovation

TerritoryEpidemiology International Scientific WorldResearch



34/35

CancerCare/researchProfessionals

and Organisations

(Research)Funders(Industry)

The Cancer World

Patients HealthAuthoritiesThe Cancer

Centre/institute


35/35

Thank you

status of art of cancer center in europe

Documents