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Présidence de l’OECI : c’est parti pour 3 ans

Depuis le congrès de Poznan, je suis donc président pour 3 ans (2018-2021) de l’Organisation Européenne des Instituts du cancer.

Cette organisation de droit Européen regroupe 93 centres soit Centres anticancéreux classiques, soit Centres associés à une université ou éventuellement à un hôpital général. 13 centres Français en sont membres dont l’Institut Curie, le Centre Léon Bérard, l’AP-HP et les HCL.

Le rôle essentiel de l’OECI est d’assurer la qualité des soins et de la recherche partout en Europe pour la cancer en assurant un programme d’Accréditation (définition de la qualité) purement sur la cancérologie qui permet de définir des « Comprehensive Cancer Centers » et des « Clinical Cancer Center », chacun ayant un plan d’amélioration à mettre en œuvre.

L’OECI travaille aussi sur les banques de tumeurs, l’économie de la santé, la survie sans récidive, les soins palliatifs et tout ce qui peut faire progresser la qualité des soins.

Pour ceux qui lisent l’anglais, ci-dessous , mon programme de président dont j’aurai l’occasion de reparler … en français.

Ladies and Gentlemen,

Dear Colleagues,

Dear Dominique,

■       I would like to start my first speech as president by paying tribute to our previous president, Dominique de Valeriola, and to our director, Claudio Lombardo for all their important and very valuable work and for their contribution, with the precious help of the Board members, in maintaining the coexistence of more than 90 OECI cancer centres in the different countries that make up our organization. In accordance with the Board, I wish to carry on along the same lines, and as pointed out last year, I will also try to add a personal touch to certain issues.

I could not begin my inauguration speech without recalling the memory of my dear friend and former OECI president Thomas Tursz, who recently passed away. Our President and Mahasti fondly paid tribute to his memory, through some beautifully expressed words.

Thomas and I had a long history of companionship. We were together for the creation of the OECI and Thomas was in charge of Europe as early as the 1980s in the French National Federation of Cancer Centres (FNCLCC).

He was president of the FNCLCC and the OECI, and he left his mark on Gustave Roussy with great vision in his work and, most importantly, his ability to recruit young talents, trust them and let them express themselves.

Thomas was a pioneer of the OECI Accreditation Programme. He was a man of great sensitivity, loyalty in his friendship and most of all, an honourable person.

■       Priorities of our organization are well established:

1. The first objective is still to consolidate our Accreditation and Designation programme and assess the programme’s impact through the new OECI “Cancer Outcomes Research” working group and especially through structured collaboration with the European Academy of Cancer Science and their proposal for a Designation of Excellence focused on translational cancer research.

This year, we managed to reach an agreement with the European Academy. OECI Accreditation and Designation were accepted as being prerequisites to apply for the designation of excellence in translational research.

Only OECI-recognized Comprehensive Cancer Centres will be allowed to apply, with the exception of those recognized by the German accreditation system also as comprehensive cancer centres.

I think this is a good result and I hope this will open a window of dialogue and entente with Cancer Core Europe, but I will come back to this point later on.

This year we have also begun work on adapting our re-accreditation framework.

However, any change that we propose to the Manual must be acceptable to ISQua, so as not to loose the international accreditation of our standards.

I would like to point out that the working group on “cancer outcomes research” will be one of my priorities and should produce rapid results in the coming year.

2. The second challenge is the Working Group, led by Giorgio Stanta, on Molecular Pathobiology and Tumor Banks. I will be making proposals during the coming year, after discussion with Giorgio Stanta.

The organization of “Pathology Days” during our annual Oncology Days event is evidence of the key role played by this Working Group.

3. The third challenge, which I think is also extremely important, is to continue consolidating cooperation between our institutions and patient organizations.

Dominique de Valeriola has already done a lot of work with the European Cancer Patient Coalition.

Improving the visibility of these actions and making them understandable will be a priority for the coming years. Cancer survivors represent 5% of the European population. They have specific expectations from us about how to prevent second cancers, how to guarantee better quality of life and, moreover, quality of care.

I would like Dominique to continue playing a major role in OECI patient organization relationships and to work with me in developing our connection with the European Union and its institutions.

4. We need a motivated Board, an efficient administration and a budget that is balanced whilst allowing us to reach targeted objectives to put this programme into practice.

Turning to the Board, as I have already said, I am happy to continue working with Dominique.

Manuel Llombart Fuertes has been proposed as Treasurer of the OECI Board and Jose Laranja Pontes, the most experienced board member, who knows our organization very well, is proposed as Executive Secretary. Gunnar Saeter will also lend his extensive experience under the new presidency, as will Jozsef Lövey. I wish to assign them specific tasks and will discuss this with them over the summer.

Marian van der Meer will bring her administrative management expertise on board, along with Carlos Caldas, and Giovanni Apolone, who I hope will help us to connect OECI with other European networks.

I have full confidence in Claudio’s management of the OECI’s administrative matters. However, we need to ask ourselves about an OECI presence in Brussels, and also consider the fact that we need a bigger budget for medical cooperation between us.

With regard to budget, I do not intend to submit budgets showing a deficit to OECI members under my presidency. Therefore, we need to both minimize expenses and increase OECI income. Financial issues will initially be discussed by the Board, and then presented to our members for feedback during General Assemblies.

5. The other working groups will be discussed later on during this session.

6. Based on the results of the accreditation process and quality indicators, as I remember pointing out last year, the fourth objective is to produce OECI “position papers” to clarify a process and thus clearly define:

§ how we conceive the organization of a 21st-century “comprehensive cancer centre” at a time when non           organ-based organisations seem mandatory.

§ how we conceive the multidisciplinary organization of cancer institutes inside a general or a university hospital;

§ and finally, how we conceive the role of networks associated with university hubs or comprehensive cancer centres

A recent meeting organized by OECI in Paris allowed us to conclude that various models of networking are currently in progress. However, the OECI should focus first on networks in which one of our comprehensive cancer centres is involved and acting as “conductor of the orchestra”. We will add a chapter about this in the revision of our Accreditation manual scheduled for 2019.

As president of the OECI, I think that all the people who are working in the field of oncology today should think together about the future.

We have a model to advocate.

It is an integrated model that translates differently depending on contexts, and can be adapted for example to different funding schemes, from one country to another, or different organizational environments, such as a cancer institute compared to a university hospital.

In my opinion, these varying models should on no account be in conflict with one another; on the contrary, they should be united.

It is also important to think about two issues at European level:

-      the first is how to facilitate interaction and improve quality in centres which are already very high level?

-      the second (and this an important responsibility that we all share) is how to improve centres that have not yet reached a level that allows  them to offer all aspects in the fight against cancer to their population, and in particular, access to innovation?

I believe that through the OECI Accreditation and Designation Programme and our improvement plan we can position ourselves to define how to provide the best cancer care at European level, respecting the diversity amongst our members, i.e. by allowing several models to coexist, with the prerequisite that quality of care remains at the heart of each model. At the same time, our efforts should help our members to promote innovative cancer treatments designed for each single patient, and not only in the field of immunology or molecular oncology but also in surgery, radiotherapy and imaging using big data and artificial intelligence tools.

7. Rare forms of cancer are a real specificity of our institutes and this is the fifth challenge. Our goal is to develop readability and visibility in this field within the framework of the European EURACAN project. This network should bring new members to the OECI and we need to provide it with an OECI quality standard that will make us understandable and visible.

8. Strengthening the relationship with neighboring countries and taking into consideration the reality of Brexit will be also necessary but our objective should clearly be to continue to work with colleagues from the UK and of course with our Cambridge colleagues in the field of Accreditation. On behalf of the whole unanimous board, I want to say that all English centres should feel welcome and at ease in the OECI. We are an association of Institutions, not of countries and English colleagues are welcome.

Of course, the link with the European School of Oncology in the field of education and training is also important and we have to improve our collaboration in order to guarantee that all our actions are supported by a parallel educational programme, which should be set up in cooperation with the main existing international cancer training organizations. The creation of Cancer Concord Europe by ECCO and ESO has to be discussed within the OECI  and of course OECI will always be there when Concord, alliance and coalition of all cancer partners is being discussed.

In my capacity as OECI President, representing an organization that covers more than 80,000 workers in the field of cancer, I firmly believe that the whole cancer community, together with the representatives of our patients, should interact in order to discuss and design a way forward to guarantee a sustainable future for cancer research and care in Europe; a future built on a democratic, meritocratic, and inclusive approach, open to all parties.

Together with the OECI Board members, we believe that all people who are working in the field of oncology today should think jointly about the future.

There is currently a proposal of some our colleagues for a Cancer Mission; a new tool of the FP9 program.

This promising project can only be successful if it opens up to all those with an interest.  I also think that a quality accreditation system will be necessary for this project to select partners.

I would therefore like to present my vision of what a cancer mission could be, obviously taking into account the prerogatives of individual states as opposed to those of Europe as a whole: My vision is to create a Network of Networks.

I.          The main challenge is Primary Prevention, which could reduce the number of cancers by 30 to 40%.

II.          Screening and early diagnosis is obviously the second major instrument that may reduce the economic burden of cancer being carried by healthcare systems, by increasing the number of small tumors that could be treated by surgery, potentially along with radiotherapy.

III.          The third level is obviously basic research.

IV.          Translational research, if not limited to evaluation of new drugs in early clinical trials, could make up a fourth level including clinical research.

V.          The topic of centralizing real-life cancer patient data is also of great interest. A specific European network for this issue would be the final piece of the puzzle for the creation of a cancer mission.

All of the above five levels are needed and should collaborate thanks to a relatively simple cancer mission made up of a team of between 5 to 10 officers, acting as “conductors”, who would facilitate the creativity, novel approaches, and expression of individual networks by applying a bottom-up approach.

Indeed, if we are to build coordinated networks with a certain number of stakeholders one day, these should be selected according to unquestionable criteria, using an undisputed method and independent arbitration bodies. Partnership in a network can only be established according to precise criteria.

Finally, we have national networks, which should also be part of a putative mission. As you see, step by step, we are putting together a puzzle that may or may not lead to the creation of a cancer mission but will, more importantly, allow for better quality care provision in Europe, which is both our objective and our mission.

As you will have gathered, the OECI greatly wishes to help the best get better and to support the other players, who will be amongst the best in the future, even if it is not yet the case.

Thanks to Dominique De Valeriola, our organization is strong, active and has grown in recognition.

I will try to maintain all these positive actions and go a little bit further when possible.

OECI should confirm that our common objective is to have a cancer mission within FP9.

The OECI wants to play an important role of facilitator, and we would like to discuss and collaborate with EORTC, Cancer Prevention Europe, EU-Life, ECCO, ESO, SIOP, Cancer Core Europe and all like-minded organizations wishing to work together with us to create a think tank called Cancer Coalition Europe to prepare the answer in case a call is set up in FP9 to create a cancer mission.

There will be room for each instrument in the Cancer Coalition Europe orchestra. We will only need to find an orchestra conductor, fairly elected by a majority vote of confidence.

Let’s start within OECI by creating a OECI European Cancer Mission. The Board accepted the idea that this could be a first step, welcoming all our Comprehensive Cancer Centres and Clinical Cancer Centres. A letter will be officially sent to all directors about this project in the coming weeks.

The OECI European Cancer Mission will propose to all other putative partners the creation of a Cancer Coalition Europe where all of us will try to be attractive enough to make a cancer mission a reality.

Finally, as President of the Curie Institute, I am more than happy to take office in the country of Marie Sklodowska Curie.

As a Board Member, I am impressed to see that the OECI is now     40-years old and we all have to remember that 40-years old is young but mature.

As the OECI President, I shall continue to foster openness and partnership with others and to summarize and unite our common cancer strategies with one voice.

Thank you for your attention.

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