EXCEMED Oncology Extracts, Fall-Winter 2014

FALL-WINTER 2014

HIGHLIGHTS ON EXCEMED ACTIVITIES IN ONCOLOGY

IMPROVING THE PATIENT’S LIFE THROU GH MEDICAL EDUCATION

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EXPERT INTERVIEW Professor René Adam previews the preceptorships in mCRC YOUR EXCEMED Improving cancer management through medical education PRECEPTORSHIP OUTCOMES Professor Graeme Poston on NICE guidelines for colorectal cancer and benefits of centralised liver surgery EXPERT INTERVIEW Professor Takoto Tahara discusses preceptorships in head and neck cancer

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PRECEPTORSHIP OUTCOMES Evidence-based, multidiscplinary approach to head and neck cancer FUTURE FOCUS Synchronous liver metastases in crc; gI cancer; head and neck cancer; professor eric van cutsem reviews activities in molecular oncology UPCOMING IN EXCEMED ONCOLOGY Mark your calendar for outstanding learning opportunities

Preceptorships in mCRC and GI cancer: key focus for 2014 Evidence-based guidelines and multidisciplinary care are paramount SEVERAL EVENTS, THROUGHOUT 2014 AND INTO 2015 An extensive series of EXCEMED preceptorships in different aspects of GI cancer, but particularly in mCRC, are being held in international cities this year. These preceptorships will be attended by healthcare professionals working in oncology, from all over the world. Presentations at these events, which will be given by leading experts in GI cancer, will focus on important subjects including: • NICE colorectal cancer guidelines • Multidisciplinary teams for managing mCRC • Case studies, drawing on participants’ clinical experiences in GI cancer FOLLOW US HTTP://TWITTER.COM/EXCEMED_ONCO

The presentations will provide excellent opportunities for participants to expand their knowledge of many aspects of mCRC and other GI cancers.

This publication highlights some of the main educational events in oncology that are offered

by EXCEMED, including interviews with key scientists and clinicians who helped to develop the educational programmes. There are also reviews of previous events and updates on all forthcoming activities in oncology coming up in the EXCEMED portfolio.

EXCEMED Continuing medical education is our sole focus and our passion. We pour our energy and expertise into delivering the best for healthcare professionals, with patients as the ultimate beneficiaries.

This is CME excellence.

Our educational programmes in oncology are designed to suit the needs of clinicians and scientists, from all over the world, who want to be at the cutting edge of research and patient care.

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EXPERT INTERVIEW

Professor René Adam

Multidisciplinary approach: vital for mCRC A multidisciplinary approach to the management of mCRC, which involves innovative but evidence-based treatment regimens, has been shown to improve clinical outcomes. This approach has been pioneered

by Professor René Adam at the Paul Brousse Hospital, in France; it is also a key component of EXCEMED educational activities in oncology. In this exclusive interview, Professor Adam explains the broad principles of this approach to mCRC care.

Q: What are the major strengths of your approach to the clinical management of mCRC patients?

A: The major philosophy is to use a multidisciplinary approach, which has been in place for more than 25 years, whereby all specialists who can contribute to diagnosis and treatment are involved.

We also adopt an innovative approach to drug treatment. For example, oxaliplatin was not used due to very high toxicity but we use chronomodulation administration to reduce neurotoxicity.

Chronomodulation may limit toxicity and increase the efficacy of a drug.

In addition, we have pioneered new surgical techniques, such as twostage hepatectomy, which may have a significant survival benefit. This surgical technique, combined with chemotherapy, provides a useful treatment for mCRC. Q: How has the role of the surgeon changed with the multidisciplinary approach?

A: The surgeon has become pivotal in the treatment of mCRC, as surgery is still the only way to significantly improve longterm survival.

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Surgery is also now used earlier. This is because the opinion of the surgeon on the potential resectability of colorectal liver metastasis can modify the chemotherapy protocol for the patient. Thus, surgeons and oncologists can learn from each other, whereas in the past there was a lack of co-operation. The current view is that more efficient chemotherapy leads to a higher indication for surgery, demonstrating a synergistic effect and resulting in better long-term survival.

Q: How has the definition of resectability of liver metastases from CRC changed over the last few years?

A: Previously the definition was unclear, since it involved technical and carcinological (e.g. high level of tumours) factors. Now it consists of mainly technical criteria: a patient is resectable when the surgeon has removed all tumours, leaving at least 30% of the remaining liver parenchyma.

Another situation to consider is whether this surgery is performed when there is no progression while on chemotherapy. Today a patient is resectable when a surgeon considers that

(Université Paris Sud Centre Hépato-biliaire, Hôpital Paul Brousse, Villejuif, Paris, France) is a pioneer of multidisciplinary management for mCRC

all of the tumour can be removed, and as experience of this surgery has increased, the risk has decreased (0-1%), so it is very frequently indicated to treat mCRC. Q: Please can you describe the most relevant advanced resection techniques for liver metastases from CRC? A: There are different types of techniques used by a surgeon. The first situation is limited metastasis, where a wedge resection (a limited hepatectomy) is performed. The second is where there is extended metastasis in one liver lobe when a right or left hepatectomy is undertaken. Thirdly, with bilateral multinodular disease, the surgeon can use left or right hepatectomy combined with wedge resection of the contralateral side, provided that at least 20% of the liver will remain. A fourth situation is where multiple bilateral and resection would not leave sufficient (>30%) liver.

Some sophisticated techniques may use either the combination of hepatectomy and radiofrequency of the contralateral side or a two-stage hepatectomy, involving clearance of the tumour of the left liver combined with right portal embolisation at the first stage, and at the second stage right hepatectomy to ensure all the tumour is removed and that the remaining liver will be sufficiently boosted by portal embolism.

Finally, when a patient has bilateral metastatic disease and it is impossible to use any of these techniques, we are exploring the possibility of liver transplantation in a randomised study, comparing chemotherapy at the time of transplantation with chemotherapy alone.

However, this will only be considered in a selected number of patients.

Abbreviations are defined in the Glossary, page 3

GLOSSARY

YOUR EXCEMED

EXCEMED: improving cancer management through medical education EXCEMED – Excellence in Medical Education is the new name of Serono Symposia International Foundation (SSIF). Our new name marks an exciting point in our evolution, but our focus on education in oncology remains paramount.

The Foundation has provided worldclass education to thousands of healthcare professionals over the past four decades. During this time, over 1500 international scientific congresses have been organised, with more than 500 proceedings published in leading international journals.

EXCEMED has pioneered online CME courses since 2000; the organisation oversees an expanding portfolio of e-learning activities including video lectures, CME-accredited online courses and symposia. These digital ventures reach over 12,500 people per month via the EXCEMED website or through e-newsletters.

As a non-profit global organisation, EXCEMED is dedicated to improving the patient’s life through the provision of independent, high-impact CME to scientists, physicians, nurses, pharmacists and other healthcare professionals.

Upcoming EXCEMED events of relevance to specialists in oncology are summarised on page 15 of this publication.

CME, continuing medical education CRC, colorectal cancer EORTC, European Organisation Research and Treatment of Cancer GI, gastrointestinal cancer GRADE, Grading of Recommendations, Assessment, Development and Evaluation HER, human epidermal growth factor receptor HPB, hepato-pancreato-biliary HPV, human papilloma virus mCRC, metastatic colorectal cancer NICE, National Institute of Clinical Excellence OPC, oropharyngeal cancer PI3K/AKT/mTOR, phosphatidylinositol 3-kinase/ protein kinase-B/mammalian target of rapamycin PICO, Population, Intervention, Comparator(s), Outcome(s) RECIST, Response Evaluation in Criteria in Solid Tumours RTOG, Radiation Therapy Oncology Group

EXCEMED has an innovative educational programme in oncology

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ONCOLOGY FALL-WINTER 2014

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PRECEPTORSHIP OUTCOMES

Multidisciplinary approach, using NICE guidelines, enhances mCRC management The NICE guidelines were developed using PICO and GRADE methodology, and became available in 2012. They include: • Investigation, diagnosis, and staging of mCRC • Management of local and metastatic CRC • Ongoing care and support

Validated guidelines for mCRC management, such as those from NICE, are becoming increasingly important for diagnosis and treatment. Guidelines for CRC management are useful but do not necessarily appear to improve outcome.

Validation measures need to be developed.

Currently, there is considerable variation in the use of interventions, such as hepatic resection for CRC (Figure 1), despite their inclusion in leading guidelines.

Evidence-based guidelines should be followed when treating local or metastatic CRC

Figure 1: Variation in the use of hepatic resection for mCRC across English hospitals 1998-2004

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Validation is important It is now becoming important to ascertain whether guidelines such as those by NICE improve outcomes. Clinicians and researchers also need to establish how treatment success, following guideline implementation, can be measured.

Professor Poston explained that guidelines need to identify metrics against which their implementation will be judged. Currently guidelines are aspirational but in the future will be linked to commissioner/purchaser expectations.

It is essential that commissioners and providers of healthcare actively collaborate in – or sponsor – guideline development, and collect measurable outcome data that examine the impact of guideline implementation.

Furthermore, guidelines can be used as a basis of implementing quality standards into healthcare commissioning.

Such quality standards can be used by purchasers of healthcare to inform contracting of clinical services.

Professor Poston highlighted that failure to achieve these quality standards will lead to financial penalties being imposed on institutions that are offering these healthcare interventions.

Abbreviations are defined in the Glossary, page 3

PRECEPTORSHIP OUTCOMES

Professor Graeme Poston (Aintree University Hospital, Liverpool, UK) outlined NICE guidelines for the management of colorectal cancer and described the advantages of the centralisation of liver surgery

Guidelines are being used as the basis of implementing quality standards into healthcare commissioning

Centralisation of services and multidisciplinary teamwork Centralisation of liver surgery and multidisciplinary teamwork lead to improvements in how care is delivered, said Professor Poston. This is due in part to the expertise gained from treating a larger number of patients and becoming proficient at specific medical interventions: • Volumes of surgery are increased through centralisation • This leads to improved outcomes • Consequently, multidisciplinary management saves lives Professor Poston quoted from a publication by Birkmeyer (N Engl J Med 2003;349:2117-27) regarding the volume of surgery performed by a surgeon: ‘Patients can often improve their chances of surviving substantially, even at high volume hospitals, by selecting surgeons who perform the operations frequently’.

New recommendations for HPB cancer To illustrate how centralisation of a multidisciplinary service may operate, Professor Poston described the recently updated recommendations for HPB cancer care, produced by The English National Cancer Plan: Improving Outcome Guidance.

These recommendations state that a HPB multidisciplinary team should have a catchment population of at least 2 million people, for primary HPB and liver metastases practices.

Centralising a multidisciplinary services in this manner could have some limitations (including treatment delays and the potential for inadequate communication within the clinical team managing the patient). However, these are outweighed by the putative benefits of a multidisciplinary approach.

Professor Poston summarised these benefits as enabling the involvement of all healthcare professionals specialised in

the treatment of HPB, appropriate disease staging, and appropriate management for patients presenting with stage 4 HPB. He also commented that decisions could be made in conjunction with those managing the patient (Figure 2).

Volume of surgery is increased by centralisation, leading to improve outcomes: multidisciplinary management therefore saves lives

Figure 2: Core membership of Liverpool advanced CRC multidisciplinary team (established April 2011).

MULTIDISCIPLINARY TEAM, multidisciplinary team; PET, positron emission tomography

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EXPERT INTERVIEW

Professor Makoto Tahara

Head and neck cancer also benefits from multidisciplinary care Management of head and neck cancer is optimal when a multidisciplinary team is involved. Within this, the role of the medical oncologist is vital.

(National Cancer Centre Hospital East, Kashiwa, Japan) stated that the strength of his hospital is the extensive experience of the physicians and the multidisciplinary team approach for treating head and neck cancer

to the National Cancer Centre East. As a consequence, every year we have a large number of patients from all over the region: • More than 500 patients receive surgery • More than 200 patients receive radiotherapy • More than 100 patients receive concurrent chemotherapy Our strength is our extensive experience in the management of head and neck cancer patients. In addition, our team consists of good physicians working with a multidisciplinary team approach for the treatment of head and neck cancer.

Q: The multidisciplinary team approach has been demonstrated to improve the clinical outcome of head and neck cancer patients. In this context, how has the role of medical oncologists changed in the last few years?

Q: The National Cancer Centre East in Kashiwa is a centre of excellence for the treatment of head and neck cancer patients. What are the major strengths of this centre in the clinical management of head and neck cancer patients?

A: The National Cancer Centre consists of two hospitals: the National Cancer Centre Central in Tokyo, and the National Cancer Centre East in Kashiwa. The main department in charge of head and neck cancer treatment has been moved

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A: As treatment of head and neck cancer is complex, the multidisciplinary team is essential for optimum management.

In Japan, few institutes follow the multidisciplinary team approach for the treatment of head and neck cancer because Japan has divided societies and organ-specific departments, that do not always accept the patient-supportive care inside the specific department.

Furthermore, there are few medical oncologists who are familiar with the treatment of this cancer, and treatments are not initiated by a multidisciplinary team, but by surgeons or oncologists working independently.

Now more institutes have a multidisciplinary team. I believe that the role of the medical oncologist is increasing to help the management of head and neck cancer patients.

PRECEPTORSHIP OUTCOMES

Head and neck cancer: latest evidence-based medicine Evidence-based medicine involves the conscientious, explicit and judicious use of current best evidence.

Access to such care constitutes the first step in deciding on the optimum treatment. This is true for any clinical situation, but is particularly important for complex diseases such as head and neck cancer.

Evidence-based medicine has a crucial role in the treatment of head and neck cancer

Molecular structure of the major capsid protein L1 of HPV type 16

Biomarker analysis provides useful information for treatment selection

Professor Tahara summarised how to optimise treatment for head and neck cancer, using evidence-based medicine, and showed the different evidence level involved (Figure 3).

Evidence-based medicine is crucial for guiding the clinical decision-making process: it is problematic to recommend a treatment without considering the data.

Evidence-based approaches in head and neck cancer An evidence-based approach can easily be introduced into daily clinical practice for head and neck cancer.

Professor Tahara presented examples including neo-adjuvant or adjuvant chemotherapy and the EORTC 22931 and RTOG 9501 postoperative trials comparing radio- and chemotherapy.

He emphasised the importance of a comprehensive understanding of the evidence and also correctly interpreting clinical trial results.

This theme of a multidisciplinary team approach to improving clinical outcomes is comprehensively explored in EXCEMED preceptorships in head and neck cancer

Biomarkers and treatment selection Professor Tahara also reviewed biomarker analysis for treatment selection in head and neck cancer.

HPV positivity should be determined in patients with head and neck cancer.

Recent research indicates that HPV is linked to a promising biomarker for this type of cancer; assessing HPV status may therefore help guide treatment decisions.

Data were presented from the Bonner trial (N Engl J Med 2006;354:567-78.

Lancet Oncol 2010;11:21-8) where p16 status as a surrogate marker of HPV status in oropharyngeal squamous cell carcinoma was assessed.

Results of the Bonner trial suggest that p16 status is strongly prognostic for patients with OPC, and that treatment with radiotherapy and cetuximab is more effective than radiotherapy alone in p16 positive (and possibly even all) patients.

Professor Tahara stated that although recent results have shown clinical promise, further studies involving a larger number of patients, are needed.

Figure 3: How to provide the best available treatment using evidence-based information

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FUTURE FOCUS

Expert Meeting on synchronous liver metastases from CRC Many treatments options, and different timings and sequences of treatment, are used in the management of synchronous liver metastases in CRC. There is a need to produce guidelines to assist oncologists to manage this disease optimally.

Discussions on the optimum treatment of these metastases will be a major focus of a forthcoming EXCEMED Consensus Meeting.

Between ten and 25% of patients diagnosed with CRC present with synchronous liver metastases.

Synchronous metastases may confer a poorer prognosis compared with metachronous metastases although this remains to be fully confirmed.

It is therefore important to provide an accurate diagnosis of synchronous liver metastases in CRC. Currently, there are a lack of evidence-based treatment strategies for these patients.

In addition, to be effective, both primary and metastatic disease must be treated appropriately.

The Florence Consensus Meeting These emerging issues have prompted EXCEMED to organise a meeting of experts on the management of synchronous liver metastases in CRC. This two-day event is suitable for medical oncologists and surgeons experienced in the management of these metastases. Lectures and discussions of clinical scenarios aim to stimulate the proposal of guidelines for the management of this disease.

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EXCEMED is organising an Expert Meeting at which experienced medical oncologists and surgeons will discuss diagnosis and treatment of synchronous liver metastases in CRC; they will also propose guidelines for specific patient presentations. The meeting takes place 24-25 October, 2014 in Florence, Italy

Topics to be covered include: • Defining synchronicity • Diagnosis and response to treatment • Current knowledge in molecular biology of mCRC • Standards of treatment and new treatment options • Impact of multidisciplinary management • Timing and sequence of therapeutic interventions in selected clincal scenarios • Proposal of guidelines for treatment With the current diversity of treatment options for these patients, it is timely to consider the optimal management of synchronous liver metastases in CRC, based on the combined experiences of the panel of experts running the conference, together with the views and knowledge of the conference participants.

PROFESSOR RENÉ ADAM (VILLEJUIF, FRANCE) SCIENTIFIC ORGANISER

Abbreviations are defined in the Glossary, page 3

FUTURE FOCUS

Preceptorship: multidisciplinary management of GI cancer

EXCEMED is organising two more preceptorships in oncology in 2014, both of which will explore multidisciplinary management: Diagnosis, treatment and onco-surgical management of GI cancer will be covered in a preceptorship taking place 8–11 September, in Paris, France Head and neck cancer, including advanced disease, is the focus of a preceptorship taking place 3-5 December 2014 in Milan, Italy

Multidisciplinary teams facilitate the involvement of all key professionals in oncology decision making The multidisciplinary approach to cancer management is a major advance and is being widely adopted. This preceptorship describes how this system represents an innovative approach to cancer treatment.

Multidisciplinary teams already manage cancer patients in most of Europe, the USA and Australia. As oncology management becomes more complex, it is crucial to involve all key professionals in clinical decision making.

In the UK, multidisciplinary teams were introduced to overcome shortfalls in cancer care, thereby ensuring that all patients receive timely care and treatment from appropriate professionals.

This allows continuity of care, adequate information and patient support.

The Paris preceptorship Issues central to multidisciplinary cancer management have encouraged EXCEMED to organise a preceptorship on GI oncology.

This four-day event is suitable for medical oncologists and surgeons experienced in CRC. Lectures and panel discussions, together Innovative with sessions covering administration can outpatient consultations and surgery, will help give increased efficacy to define optimum and reduced toxicity of methodology for the cancer drugs multidisciplinary approach.

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Presentations will focus on the diagnosis and treatment of mCRC, the oncosurgical management of colorectal liver metastases and chronotherapy for CRC. Topics include: • Principles of the multidisciplinary approach • Case discussions • Onco-surgical management of colorectal liver metastases • Chronomodulated chemotherapy and hepatic artery infusional therapy • Guidelines for high standards imaging (RECIST criteria) • Molecular tumour profiling – towards personalised targeted therapy in colorectal cancer • Guidelines for high-standard pathological examination of colorectal liver metastases • Presentation of the LiverMetSurvey website Please join us in Paris, in September, to discover the advantages of these approaches.

PROFESSOR RENÉ ADAM (VILLEJUIF, FRANCE) SCIENTIFIC ORGANISER

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FUTURE FOCUS

Preceptorship: head and neck cancer Multidisciplinary care aims to deliver the best possible management for head and neck cancer patients over the course of the disease.

The management of patients with head and neck cancer improves with a multidisciplinary approach

Options for unresectable head and neck cancer are expanding significantly, both in terms of the agents and surgery available, but also the way health care professionals approach patient management.

For example, combined modality treatment with concomitant chemotherapy and radio therapy represents the standard of care for advanced head and neck cancer. However, the introduction of new molecular targeted therapies has led to further improvements in outcome.

Multidisciplinary teams optimise patient management because all relevant healthcare professions can be involved in clinical decisions.

This preceptorship will enhance participants’ knowledge of treatment options for head and neck cancer

The Milan preceptorship These important issues have prompted EXCEMED to organise a preceptorship on head and neck cancer.

This three-day event is suitable for medical oncologists, surgeons and radiation oncologists experienced in head and neck cancer management.

Lectures, case discussions, visits to the Department of Radiotherapy and Head and Neck Medical Oncology and practice sessions will be incorporated in the preceptorship. The content will help to define the optimum methodology for multidisciplinary management of head and neck cancer. Topics to be covered include: • Multidisciplinary approach to oral cavity and OPC • Toxicity management and supportive care • Multidisciplinary management of laryngeal, hypopharyngeal and nasopharyngeal cancers • Weight loss and nutritional support • Rare head and neck solid tumours • Demonstration of multidisciplinary teamwork in outpatient consultations Multidisciplinary management offers an integrated approach to the diagnosis, staging, treatment and followup of patients with head and neck malignancies.

Please join us in Milan, in December, to learn about these crucial management issues.

PROFESSOR LISA LICITRA (MILAN, ITALY) SCIENTIFIC ORGANISER

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Abbreviations are defined in the Glossary, page 3

FUTURE FOCUS

Professor Eric Van Cutsem

Molecular oncology plays central role in treatment Molecular oncology is already providing valuable information for clinical practice and this will help with drug discovery in the future.

CME accreditation of EXCEMED events will facilitate the flow of information to all interested parties, which will be crucial in the treatment of patients.

Professor Van Cutsem has been working with EXCEMED on the development of educational events that focus on molecular oncology. These will take place from 2015 onwards.

Molecular oncology is becoming a critical part of clinical management, through the development of new diagnostics, disease monitoring strategies and targeted treatments. It is becoming essential for oncologists to develop their awareness of, and expertise in, all aspects of molecular oncology.

In a recent interview, we asked Professor Van Cutsem about clinical issues regarding the current and future role of molecular oncology. He responded that molecular oncology is extremely complex, but the information that it provides is

(University Hospitals Gasthuisberg / Leuven, Belgium) stressed that molecular oncology will play a crucial role in the discovery of new cancer treatments.

Cutsem, systematic research that should be directed toward understanding the relevance of single-transaction pathways of different molecular targets to help discover new treatments.

Challenges for clinicians are to improve their understanding of the different molecular techniques and pathways, and then apply this information in clinical practice. This is where high-quality CME activities will be essential for professional development.

With respect to key important issues related to CME in molecular oncology, Professor Van Cutsem confirmed the need for comprehensive education programmes, in the form of live events and online activities in particular. He explained that the future for medical education is through

EXCEMED is developing a programme of novel and comprehensive activities focused on molecular oncology

impinging on clinical practice. Molecular knowledge is helping oncologists to unravel the taxonomy of tumours and identify different targets and appropriate agents for them, he explained.

These important considerations will be included in future EXCEMED events.

In future, explained Professor Van

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accredited CME. This helps to give a wider education and integrates knowledge from different sources, such as fundamental and clinical research, and industry.

CME accreditation - which is obtained for all EXCEMED events - contributes enormously to medical and patient education. It is crucial to facilitate optimum patient care, but also to make progress in research and in clinical knowledge, as well as to convey this information in a timely and efficient manner to clinicians.

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FUTURE FOCUS

EXCEMED masterclass in molecular oncology Molecular oncology is beginning to revolutionise cancer diagnosis and treatment. The ability to understand the basic methodologies and their interpretation is essential for all those working in oncology.

Precision medicine in oncology is an evolving landscape. New insights have been gained into driver genomic alterations responsible for cancer progression in recent years.

As a result, the identification of a growing number of molecular targets and the availability of specific targeted therapies are stimulating clinical research and rapidly changing clinical practice. Now, medical oncologists must be aware of: • The new taxonomy of cancer • Molecular pathways relevant for therapy • Methodology in the molecular diagnosis of cancer

Young medical oncologists are invited to submit abstract proposals for oral and poster presentations

The Prague masterclass In order to provide comprehensive information about these key issues, EXCEMED has arranged a masterclass in molecular oncology.

This three-day event is suitable for medical oncologists who seek to improve their knowledge in molecular biology platforms for targeted therapy and drug discovery. Lectures, panel discussions, and oral/poster presentations will cover the basic principles of cancer genomics, techniques in molecular biology and translational research and illustrate personalised treatment options for cancer patients. Topics to be covered include: • Molecular pathways in oncology and pharmacological interventions • Basics of genomic analysis • Signal transduction (including HER family, Mtor-p13k and RAS-RAF-MEK pathways) • Advanced genome analysis methods • Biomarkers based on proteomics and high-resolution genomics/ transcriptomics • Liquid biopsy in oncology • New taxonomy and precision medicine in breast, colorectal and lung cancer • Theory and practice of clinical trial design in the era of targeted agents • Clinical application of cancer immunology and immunotherapy in melanoma

Left to right, images of breast and colon cancer cells

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Abbreviations are defined in the Glossary, page 3

FUTURE FOCUS EXCEMED is organising a masterclass in molecular oncology. This meeting will provide insights into the new taxonomy of cancer, the molecular pathways relevant for therapy and the methodology in molecular diagnosis of cancer. The meeting takes place 29–31 January, 2015 in Prague, Czech Republic

Identifying molecular targets and developing targeted therapies are stimulating clinical research and rapidly changing clinical practice

Incentives for young medical oncologists In addition, in the spirit of supporting the dissemination of diverse oncological research, the Steering Committee is pleased to invite young medical oncologists to submit abstract proposals for oral and poster presentations.

To enhance the range of abstracts, incentives are being offered in the following categories: • Young medical oncologists whose abstract is selected for presentation will receive a free registration to the conference • Young medical oncologists from Eastern Europe who submit an abstract may also apply for a travel grant of €500.00 • Four winners, selected for oral poster presentations, will receive a grant of €1,000.00 Discoveries from molecular oncology will substantially improve cancer diagnosis and treatment and it is important that oncologists can: • Define relevant molecular pathways in oncology • Distinguish genome analysis methods • Be aware of potential personalised treatment options Please join us in Prague, in January 2015, to learn about these increasingly important methodologies.

Lung cancer cells

For more information on eligibility and submission requirements, please visit: www.oncology.excemed.org

PROFESSOR ERIC VAN CUTSEM (LEUVEN, BELGIUM) SCIENTIFIC ORGANISER

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UPCOMING IN EXCEMED ONCOLOGY MEDICINE

EXCEMED is offering a wide range of excellent live educational events in the coming months.

Please visit www.excemed.org to see the latest news on the oncology educational programme

Preceptorship course in metastatic colorectal cancer LIVERPOOL, UK 3-5 SEPTEMBER LONDON & LIVERPOOL, UK 12-14 NOVEMBER & 3-5 DECEMBER SCIENTIFIC ORGANISER G POSTON, UK

Evidence based medicine in metastatic colorectal cancer workshop DUBAI, UAE 17-18 OCTOBER SCIENTIFIC ORGANISERS F CIARDIELLO, ITALY; M ALI JALOUDI, UAE

Preceptorship in GI oncology PARIS, FRANCE 8-11 SEPTEMBER SCIENTIFIC ORGANISER R ADAM, FRANCE

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AIM this live educational preceptorship will show a multidisciplinary team working within the framework of NICE guidance in the management of advanced mCRC KEY TOPICS overview of NICE, multidisciplinary team role in mCRC, resection surgery, ablation, embolism in the operating theatre

AIM this live educational workshop will review the current standards of care for mCRC and to provide medical oncologists with insights into emerging targets and new treatment options in mCRC KEY TOPICS review current standards of care for mcrc and offer oncologists insight into novel therapeutic approaches and an update on clinical guidelines for a multidisciplinary approach to systemic, surgical and radiological treatment strategies

AIM this live educational preceptorship will highlight the crucial role of the multidisciplinary approach in the diagnosis, treatment and management of patients with Gi cancers, focusing on CRC KEY TOPICS multidisciplinary approach to management, discussion of new cases, onco-surgical management of colorectal liver mestastasis, chronomodulated chemotherapy, molecular tumour profiling, presentation of LiverMetSurvey website

TARGET AUDIENCE colorectal surgeons, hepatobiliary surgeons, medical oncologists with an interest in colorectal cancer FORMAT lectures, case study presentations, observations of procedures in the operating theatre

TARGET AUDIENCE medical oncologists with experience in the management of mCRC cancer patients who want to improve their knowledge in the biology of disease and gain insights in key molecular aspects of mCRC treatment FORMAT lectures, key note lectures, debates, panel discussions and break-out sessions

TARGET AUDIENCE medical oncologists and surgeons experienced in the management of CRC patients FORMAT lectures, activities in the surgery room, outpatients’ consultations, visit to oncology department and practical demonstrations

Abbreviations are defined in the Glossary, page 3

UPCOMING IN EXCEMED ONCOLOGY MEDICINE

Expert Meeting on synchronous liver metastases from CRC

AIM this meeting focuses on diagnosis, outcome and treatment of synchronous colorectal liver metastases and aims to propose guidelines for managing this cancer

FLORENCE, ITALY 24-25 OCTOBER SCIENTIFIC ORGANISER R ADAM, FRANCE

KEY TOPICS overview of, timing and sequence of therapeutic interventions in patients with synchronous colorectal liver metastases, improvement in management and molecular biology assessment

Masterclass in molecular oncology

AIM the aim of this masterclass is to describe the basic principles of cancer genomics, techniques in molecular biology and translational research

TARGET AUDIENCE medical oncologists wanting to improve their knowledge in molecular biology platforms for targeted therapy and drug discovery

KEY TOPICS molecular pathways in oncology and their pharmacological intervention, genome analysis methods, signal transduction pathways, taxonomy and precision medicine in breast, colorectal and lung cancer, design of clinical trials in the era of targeted agents

FORMAT highly interactive course based on presentations, panel discussions and direct interactions with experts and learners

AIM this preceptorship will offer the opportunity to learn the current therapeutic options for patients with advanced and metastatic head and neck cancer

TARGET AUDIENCE international medical oncologists, surgeons and radiation oncologists experienced in the management of head and neck cancer patients

PRAGUE, CZECH REPUBLIC 29-31 JANUARY 2015 SCIENTIFIC ORGANISERS E VAN CUTSEM, BELGIUM; Y YARDEN, ISRAEL

Preceptorship in head and neck cancer MILAN, ITALY 3-5 DECEMBER SCIENTIFIC ORGANISER L LICITRA, ITALY

KEY TOPICS multidisciplinary management of oral cavity, oropharyngeal and nasopharyngeal cancers, toxicity management and supportive care, laryngeal and hypopharyngeal cancers, weight loss and nutritional support, rare head and neck solid tumours

TARGET AUDIENCE medical oncologists and surgeons experienced in the management of synchronous colorectal liver metastases FORMAT lectures, clinical scenarios and discussion of guidelines

FORMAT lectures, case studies, practice sessions and much opportunity for discussion

www.excemed.org EXCEMED is a non-profit organization dedicated to providing CME to healthcare professionals. This newsletter is intended for healthcare professionals and provides a brief summary of a selection of previous educational events. EXCEMED will make reasonable efforts to include accurate and current information, wherever possible, but makes no warranties or representations as to its accuracy or completeness. This information is provided “as is” without warranty of any kind, either express or implied, including but not limited to implied warranty of fitness for particular purpose. EXCEMED has implemented and maintains a Quality Management System which fulfils the requirements of the ISO 9001:2008 standard for the activity of design and provision of training events in the healthcare sector. © EXCEMED, 2014. All rights reserved.

EXCEMED Excellence in Medical Education, Salita di S. Nicola da Tolentino, 1/b, 00187 Rome, Italy. © Copyright 2014 EXCEMED. All rights reserved.

Editorial development: Ray Ashton, Linda Edmondson, Luca Militano, Michèle Piraux, Emma Wadland

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Specialist contributors: René Adam, Eric Van Cutsem, Makoto Tahara, Graeme Poston Design: www.katehouben.com

Photos on pages 1, 3, 4, 6, 9,10,11,12 and 13 courtesy of www.bigstockphoto.com

ONCOLOGY FALL-WINTER 2014

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EXCEMED at your fingertips IMPROVING THE PATIENT’S LIFE THROUGH MEDICAL EDUCATION

> Six specialty micro sites, including oncology > Accessible and accredited e-learning packages > A world-class repository of CME knowledge and learning materials

www.excemed.org It’s active in here

> Monthly updates about our events and resources in oncology > Register with us online and access it all – free

Better outcomes for patients start here. With over 40 years of experience, EXCEMED has been delivering continuing medical education (CME) longer than any other provider.

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ONCOLOGY FALL-WINTER 2014