Strategy Groups are disease-specific committees comprised of investigators from developing countries. They are responsible for developing, in conjunction with INCTR staff and advisors, specific research projects encompassing prevention, early detection and treatment of cancer or groups of closely related cancers. Strategy Group members are also the responsible investigators for these research projects. They ensure that each study, after INCTR scientific and ethical approval, undergoes ethical review at the local level and that patient treatment, if part of a project, and data collected in the course of the project, are of the highest possible quality. It is anticipated that Strategy Group members will take a leading role in assisting other institutions within their own countries or regions to reach the necessary level of competence to participate effectively in INCTR projects.
Current Strategy Groups
African Burkitt's Lymphoma Strategy Group
Breast Cancer Strategy Group
Cervical Cancer Strategy Group
Leukemia Strategy Group
Leukemia Study Group of India
Lymphoma Strategy Group
Osteosarcoma Strategy Group
Retinoblastoma Strategy Group
African Burkitt's Lymphoma Strategy Group
The African Burkitt's Lymphoma Strategy Group is comprised of investigators from Kenya, Nigeria, and Tanzania. The group has implemented a protocol entitled, "The Treatment and Characterization of Burkitt's Lymphoma in Africa" which includes first-line treatment for newly diagnosed patients and second-line treatment for patients who relapse or for those who fail to respond to the first-line treatment. Patient accrual began in August, 2004 and is on-going.
It is anticipated that the strategy group will expand to include investigators from other countries in Africa, including Cameroon, Ghana and Uganda.
Breast Cancer Strategy Group
The Breast Cancer Strategy Group is comprised of investigators from many countries including Argentina, Peru, Mexico, Turkey, Egypt, Tanzania, Saudi Arabia, India, Nepal, Pakistan and Vietnam. The group is focusing its efforts on developing projects related to the epidemiology, characterization and treatment of breast cancer.
The group has designed a survey of the presentation features of breast cancer and the risk factors for treatment outcome. This retrospective study is a survey of female breast cancer cases treated in participating institutions from January, 1993 through December, 2001. It entails a review of data available from institutional hospital registries as well as individual patient medical records. This study entitled, "A Retrospective Survey of Presentation Features of Breast Cancer and Risk Factors for Treatment Outcome" will provide a foundation for future studies. It was initiated in 2005 in four countries.
Two protocols are in development for patients with locally advanced, non-metastatic breast cancer. One study will seek to compare two radiation treatment fields in patients who have undergone mastectomies to determine whether radiation therapy can be simplified without detriment to patients. The second study will compare two neoadjuvant treatment approaches in patients with locally advanced, inoperable breast cancer. Both studies will be conducted in collaboration with IAEA.
Cervical Cancer Strategy Group
The Cervical Cancer Strategy Group is comprised of investigators from Argentina, Bolivia, Peru, Mexico, Turkey, Mali, Kenya, Tanzania, Kuwait, India, Nepal and Pakistan.
The group agreed that an important goal is to expand population coverage using well-established approaches to the detection and treatment of CIN. Initially, these programs will be established in small selected populations as "demonstration programs". The following activities will be part of the group's strategy to expand coverage:
- Dissemination of information to geographically proximate institutions about how to establish cervical cancer prevention programs, including the recruitment of women for screening, and to couple this, whenever possible with hands-on training.
- Use of established cervical cancer detection programs as regional or international training centers.
- Use of existing health care infrastructure, such as smaller health centers or their equivalents, family practitioners and general hospitals as cervical cancer screening points in a centrally coordinated program (by regional training centers).
- Development of specific "measures of success" for screening programs such as the number of care providers trained, the number of women screened (expressed also as a fraction of women at risk within the region), CIN/cancer detection rates, and treatment rates.
- Development of approaches to professional education about cancer prevention for medical students, nurses and health assistants, as well as gynecologists and family practitioners. Meetings, training courses, educational modules within student syllabuses, and visits to screening centers will be some of the approaches taken.
- Development of approaches to widen community involvement, including the enlistment of local and regional governmental support as well as public education and awareness campaigns.
The group expressed an interest in the development of two treatment protocols - one for early stage disease and one for locally advanced cervical cancer and draft documents are being prepared.
Leukemia Strategy Group
The Leukemia Strategy Group has recently expanded and includes investigators from Brazil, Egypt, Jordan, Morocco, Iran, Oman, Saudi Arabia, India and China. The activities are focused on the characterization of acute lymphoblastic leukemia (ALL) using both clinical and biological features, including immunophenotyping and molecular profiling. The group plans to standardize the collection of data pertaining to patient presentation, treatment, response, and outcome in order that information can be compared among multiple institutions.
Leukemia Study Group of India
The Leukemia Study Group of India initiated a new protocol for the treatment and characterization of ALL in August, 2004. It is an exploratory, hypothesis-generating study of prognostic factors predictive of relapse, event-free and overall survival and represents a modification of an earlier treatment protocol used in India for many years. Patient accrual is well underway.
An updated version of MCP841 will be implemented in 2006 with the goal of expanding treatment to more children, adolescents and young adults throughout India.
Lymphoma Strategy Group
The Lymphoma Strategy Group is comprised of investigators from Turkey, Kenya, Nigeria, Tanzania, Uganda, Egypt, Saudi Arabia, Kuwait, India, and Pakistan. Several sub-committees will be formed to develop projects in the following areas: the treatment of childhood non-Hodgkin's lymphomas; the treatment of diffuse large B cell lymphoma in adults; and the molecular characterization of lymphomas from various world regions.
Osteosarcoma Strategy Group
Investigators from Brazil, Colombia, Mexico, Saudi Arabia, Pakistan, China and the Philippines are among current members of the Osteosarcoma Strategy Group. The group undertook a treatment protocol entitled, "Phase II Study of the Treatment of Previously Untreated Metastatic Osteosarcoma with a Combination of Chemotherapy (cisplatin, doxorubicin and ifosfamide) and Surgery" which was recently closed to new patient accrual.
Retinoblastoma Strategy Group
The Retinoblastoma Strategy Group is comprised of investigators from one or more centers in Brazil, Bolivia, Peru, Mexico, Guatemala, Ghana, Nigeria, Tanzania, Zimbabwe, Turkey, India, Pakistan, Vietnam, and the Philippines. The major objective of this group is to develop a multi-national program for retinoblastoma. The present activities are focused on professional and public education and the treatment of children with advanced disease. The purpose of the professional and public education programs is to increase awareness and thereby, promote early detection of retinoblastoma. These educational programs are conducted within each country and materials for both health care professionals and the public have been developed. A public service announcement, produced in Brazil has been translated into many languages for use in many countries.
A survey study entitled, "Understanding the Problems Faced by Parents of Children with Retinoblastoma Prior to Treatment" is in progress. The objective of the study is to identify the reasons for late presentation through understanding problems faced by parents of children with retinoblastoma prior to treatment. The information obtained through the questionnaire will be used in the development of targeted public and professional education programs. Over 350 parents have been surveyed.
A treatment protocol for children with advanced retinoblastoma entitled, "The Treatment of Extra-ocular non-CNS Metastatic Retinoblastoma" is in development. The protocol will initially be conducted in Brazil, Turkey and the Philippines.
This announcement has been shown in Brazil and has resulted in parents contacting major referral centers about getting help for their children. Click here to view this Public Service Announcement (http://tucca.org.br/)
