Oncology The French model Pierre Soubeyran Institut Bergonié Bordeaux France Disclosure Research SupportPI Honoraria CELGENE TEVA Scientific Advisory Board TEVA SANDOZ BMS ID: 801550
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Slide1
How to organize Geriatric Oncology The French model
Pierre SoubeyranInstitut Bergonié, Bordeaux, France
Slide2Disclosure
Research Support/P.I.
Honoraria
CELGENE, TEVA
Scientific Advisory Board
TEVA,
SANDOZ, BMS
Slide3EpidemiologyFrench population, 20139% older
than 75 (10.9% females, 7% males)Standardized incidence rates in France, 2012200 350 cases
in males 30.9% > 75y
46226 between 75 and 85 y 23,1%
15724 older than 85 7,8%
155 004 cases
in
females
34.4% > 75y33156 between 75 and 85 y 21.4%20204 older than 85 13%
Slide4As compared to other countries
Slide5ManagementMostly treated in
Community hospitals
<75
>75University Hospitals
1 128 402 (23.3%)261 699 (20,3%)
Cancer Center
1 065 288 (22%)
149 303 (11,6%)
Community Hospital1 268 963 (26,2%)473 861 (36,7%)Others (Private, ESPIC, Military)1 387 600 (28.6%)407 404 (31.5%)Number of Hospitalizations
Slide6Management of patients
Slide7Plan Cancer2003 - 2008
Slide815 Geriatric Oncology units
CHU H Mondor
CHU HEGP/ CLCC I Curie
CHU La Pitié/C Foix
Lille
CHU/CLCC
CH Senlis/Creil
Dijon
CHU/CLCC/CH/
Cl Privées
Lyon
CHU/CLCC/Cl Privées
Marseille
CLCC/CDG
Toulouse CHU/CLCC
CHU/CLCC/CH
Clermont Ferrand
Limoges
CHU/Cl. Privées
Bordeaux
CHU/CLCC
CHU/CLCC Rouen
Strasbourg
CHU/CLCC
Nantes/Angers
CHU/CLCC
CH La Roche/Yon
Slide9Slide10UCOG Geriatric Oncology units
ObjectivesBetter adapt
treatment decision
making through
efficient collaboration between oncologists and geriatricians
Implementation
of screening
Monitoring of
screened patientsPromote geriatric oncology in other hospitals allowed to perform cancer treatment in each region of FranceContribute to Geriatric Oncology research developmentPromote research in Geriatric OncologyProportion of patients accruedPromote training and information
Slide11UCOG Geriatric Oncology units
ObjectivesBetter adapt
treatment decision
making through
efficient collaboration between oncologists and geriatricians
Implementation
of screening
Monitoring of
screened patientsPromote geriatric oncology in other hospitals allowed to perform cancer treatment in each region of FranceContribute to Geriatric Oncology research developmentPromote research in Geriatric OncologyProportion of patients accruedPromote training and information
Slide12UCOG Geriatric Oncology units
ObjectivesBetter adapt
treatment decision
making through
efficient collaboration between oncologists and geriatricians
Implementation
of screening
Monitoring of
screened patientsPromote geriatric oncology in other hospitals allowed to perform cancer treatment in each region of FranceContribute to Geriatric Oncology research developmentPromote research in Geriatric OncologyProportion of patients accruedPromote training and informationFull coverage of France
Slide13FundingYearly funding
by the INCaUCOG: 160 000, 200 000 or 250 000€Plus about 50 000€ for
inter-regional support
AOG: 90 000€
Overall cost: 5 200 000€/
year
Slide14Clinical research
Slide15Clinical researchTrial accrual
of patients older than 75
Academic
trials
Industry
trials
Less
than 5% included overall
Slide16Clinical trials
Sponsors
Investigating
centers
Slide17Intergroupe DIALOG
GERICO-UCOG
Dialogue Intergroupe pour la
personnALisation de la prise en charge en OncoGériatrie
Slide18Multi-organ
clinical trialsSoFOGUCOG
Tumor-oriented
trialsGERICO
PACAN Data Center
Plateforme UNICANCER
Other
Cooperative Groups
Slide19Teaching and Training
Slide20Teaching and trainingMultiple University
diplomasFor geriatricians, oncologists
and nursesLyon (6 Universities
)Paris, Marseille,
NantesContinuous
Medical
Education
Geriatry
as part of Oncology BoardUniversity diplomasContinuous Medical Education
Slide21Teaching and trainingUCOG-driven training in
hospitals and clinics
Slide22Academic Organization
Slide23Organization of patients’ careA society for geriatric
oncologySociété Francophone d’Oncologie Gériatrique (SoFOG)To design, validate
and disseminate practice guidelinesRegional
cancer networksAll cancer
hospitals organized
in Cancer
Coordination
Centers
(3C)Multidisciplinary meetingsCollection of data (common CRF)Accreditation of Cancer centers (number of cancer patients managed per year)Annual meetings for training of physiciansGeriatric Oncology Annual meeting 200 to 400 participants per year since 12 yearsUCOG annual meeting
Slide24To conclude
UCOG
National Network
Slide25To conclude
UCOG
National Network
Slide26To conclude
UCOG
National Network
National Guidelines
Clinical
pathways
Cohorts
Clinical trialsPost-registration studies
Management of patients
Teaching
and training