INCTR’s Annual Meeting

At the poster session, Annual Meeting participants enjoyed meeting colleagues and sharing information about treatment and ongoing cancer research.

INCTR’s fourth Annual Meeting took place in Brussels at the end of May. There were over 140 participants from 37 countries and the meeting was accredited by the Accreditation Council of Oncology Europe (ACOE) - participants were able to earn up to 19 CME points. By now the format of the meeting is familiar, with its mix of reports, Award Lectures, individual presentations, educational updates, workshops, and many small group and committee meetings with varying degrees of formality. This is, perhaps, the central element of the Annual Meeting—the opportunity for all INCTR members and guests to get together to discuss ongoing programs and new ideas. A new feature in the 2003 meeting were reports from each branch or office (seven now exist, each in a different country). In conjunction with the meeting, seven formal strategy group meetings took place—cervical cancer, breast cancer, leukemia, lymphoma, retinoblastoma, osteosarcoma and African Burkitt’s lymphoma. Each differed in format, with some emphasizing discussion of new projects, and others, updates of ongoing projects. The lymphoma strategy group meeting, its first, took the form of a workshop focused on aggressive B cell lymphomas. It was supported by the Leukemia and Lymphoma Foundation of the USA. Presentations were made by various pathologists and oncologists/hematologists from a number of countries about the problems faced and results being achieved, and there was vigorous discussion about suitable future INCTR projects. It is likely that a project focused on the characterization of large B cell lymphoma will emerge from this debate, and a meeting of a smaller, more focused group will take place at the INCTR conference on lymphomas that will be held in October in Cairo in order to move things forward.

The Retinoblastoma Strategy Group meets in Brussels

Educational Program
This year, hematological neoplasia was the main theme of the educational elements of the meeting and occupied the whole of the second day. A series of distinguished experts reviewed the pathology, pathogenesis and treatment of hematological neoplasms, including acute lymphoblastic leukemia, acute myeloid leukemia, Hodgkin’s disease, and adult and childhood lymphomas. On day three there were additional presentations on late effects of childhood cancer, as well as a session on new technologies, which consisted of presentations on information technology and molecular genetic profiling techniques including micro-array technology and the characterization of epigenetic changes in cancer cells.

Ethics Workshop
A particularly popular session was the Ethics Workshop, in which topics relevant to the ethics of clinical trials in developing countries were presented and discussed, including special challenges that arise from the conduct of clinical research in developing countries, achieving sound ethical review, problems relating to informed consent in developing countries, and ethical issues arising from the conduct of clinical research in peripheral centers. The workshop was well attended and the discussion lively and provocative.

The Special Advisory Panel
The second meeting of the Special Panel of INCTR’s Advisory Committee was held. This panel provides advice to INCTR with respect to general aspects of its activities, as well as selecting INCTR Award winners. This year the Panel made several important decisions. Firstly, it selected (by vote) from among the nominees, the recipients of the Paul P. Carbone Award in International Oncology and the Nazli Gad-el-Mawla Award. The recipient of the 2004 Paul P. Carbone Award

Frans Dhaenens of Agfa, one of the sponsors of the Annual Meeting, chaired the session on new technologies.

will be Franco Cavalli, a Swiss oncologist well known for both his outstanding work in the field of lymphomas, and his efforts to develop cancer control programs in developing countries. The recipient of the Nazli Gad-el-Mawla award will be Mahmoud Mafouz, a distinguished Egyptian oncologist who has contributed enormously to the development of oncology in Egypt and a number of other developing countries, as well as having served as Egyptian Minister of Health. The Special Panel also endorsed the notion of holding future INCTR Annual meetings in other countries. It was felt important that INCTR, whose mission is to help patients with cancer in developing countries, should hold its annual meeting in such countries. Although this would provide additional opportunities for young professionals involved in cancer care from the region to participate, it is to be stressed that the meetings will retain their fully international flavor. Meetings will generally take place in countries in which INCTR has an office or branch, since this will considerably aid logistics and should provide opportunities for the branch to be more widely recognized in its own country or region. It was decided that the next INCTR Annual Meeting will be held in Cairo, Egypt, in October 2004, and the Special Panel proposed that the following meeting be held in India. The venue of each subsequent meeting will be chosen two years in advance on the basis of presentations made by countries that would like to host a meeting. The Panel also discussed the importance of coordinated cancer control programs in developing countries, and how INCTR can contribute to these—a critically important theme that will be addressed more fully in subsequent meetings.

Figure 1. Percentage of participants who considered the meeting exceeded or greatly exceeded their expectations; and who gave very good or excellent ratings for the overall quality of the information presented.

Evaluation
Overall, the meeting was very successful. Over half to almost 80% of all participants who completed an evaluation form on each of the three days of the meeting felt that the meeting either exceeded or greatly exceeded their expectations and similar numbers gave very good to excellent ratings for the quality of the information presented. All remaining participants, with the exception of 3% on the second day (educational symposium) felt that the meeting fully met their expectations (Figure 1). It seems that nobody went home disappointed! With respect to the organization and management of the meeting, almost everybody (98%) gave it very good (43%) or excellent (55%) ratings, and 99% gave high marks to the organizing staff (38% very good and 61% excellent). Congratulations to INCTR administrative staff and GIC (the conference organizer) for a job well done!

Strategy Group Meetings

Breast Cancer
The group has agreed to undertake a large retrospective survey of 8-10,000 patients seen at the institutions of strategy group members, in order to provide a foundation of information on which future studies will be based. In addition, the group agreed to work on the development of a treatment protocol for patients with locally advanced breast cancer.

Cervical Cancer
Two screening projects, in collaboration with IARC are underway (Nepal, Tanzania) and discussion was held as to how to expand the number of screening projects. The group decided that a review should be prepared of the status of cervical cancer screening and treatment in the countries represented, that it would be useful to define “minimal clinical guidelines” for treatment, and that an appropriate project for the group would be to develop and test the feasibility of an affordable protocol for the treatment of patients with locally advanced disease.

The Leukemia Strategy Group meets during the Annual Meeting.

Leukemia
The new treatment protocol of the Indian Leukemia Study Group is undergoing final review in India prior to initiation of the clinical trial later this year. It was agreed that it would be useful to develop uniform definitions and data collection forms relating to presentation, immunophenotype, treatment and treatment outcome in patients with acute leukemia in order that results in different centers can be accurately compared.

Lymphoma
The group felt it would be important to investigate differences in the incidence of diffuse large B cell lymphoma and Burkitt’s lymphoma in the countries represented, and to explore the possibility of characterizing diffuse large cell lymphoma at a molecular level. A subcommittee wished to work together in the development of a new protocol for the treatment of childhood non-Hodgkin’s lymphomas in developing countries (other than sub-Saharan Africa).

Osteosarcoma
The treatment protocol for metastatic osteosarcoma continues. Two new centers have agreed to participate. Early results indicate that the treatment regimen is tolerable in the setting of developing countries—minimal toxicity has been encountered.

Retinoblastoma
More than 150 questionnaires have been completed in the study in which the reasons for late presentation of retinoblastoma are being investigated in 11 institutions in 9 countries. Two centers have recently been added and the original goal of 500 completed questionnaires will be increased accordingly.

African Burkitt’s Lymphoma
The group completed final review of a protocol for the treatment of African Burkitt’s lymphoma . SIOP and the French-African Pediatric Oncology group participated in the meeting and discussed progress in their respective treatment programs. This exchange of experiences and views has proved very useful to moving forwards in improving the outcome of children with Burkitt’s lymphoma in sub-Saharan Africa.