Oct 31, 2016
Ian F. Tannock MD, PhD
Princess Margaret Cancer Centre and University of Toronto, Canada
During the past few years, ASCO has increasingly focused on its international role, with the goals of improving the quality of cancer care around the world and stimulating clinical trials to evaluate treatments that might improve such care. These two goals are related: High quality care is built on evidence, which comes from the results of well performed clinical studies. In addition, patients with cancer who take part in clinical trials, regardless of whether the trials give a positive or negative result, tend to have better outcomes. Hence, ASCO has for several years supported the International Clinical Trial Workshops (ICTWs), which have been held in various countries around the globe. The goal of the workshops is twofold: One, to teach young oncologists how to carry out high quality clinical research and, two, to critically evaluate the publications that describe clinical research and provide the evidence underlying clinical decisions.
Oncologists in low- or middle-income countries can apply to host an ICTW; if the application is rated highly by ASCO’s ICTW committee, the organization and cost of the workshop is shared between the host country and ASCO. ASCO will fund travel expenses for three to four volunteer faculty, who collaborate with local faculty to provide a comprehensive 2-3 day teaching program. Recent ICTWs have been held in Argentina, Croatia, India, Nepal, Romania, and Turkey, with workshops scheduled for 2017 in China, Greece, Russia, and Uruguay.
In May 2016, I had the pleasure of serving as course director at an ICTW in Istanbul, Turkey, together with Gail Eckhardt, MD, of the University of Colorado School of Medicine; Matt Sydes, MD, of the Medical Research Council Clinical Trials Unit at University College London; and Alex Eniu, MD, PhD, of the Cancer Institute Ion Chiricuta, in Cluj-Napoca, Romania. The course was held in partnership with the Turkish Medical Oncology Society and the program was developed through teleconferences with local organizers, in particular Mehmet Artac, MD, an academic medical oncologist from Necmettin Erbakan University, in Konya, Turkey. I had an enjoyable meeting with Dr. Artac about 6 months earlier when I was invited to speak at a GU cancer symposium in Antalya, on the southern coast of Turkey. For the workshop venue, our hosts selected a pleasant, small hotel on the Golden Horn, a waterway that is surrounded by the historic city and opens into the Bosporus. About 50 young clinicians attended as participants, most coming from Turkey, but also from neighboring countries, including Syria, Lebanon, and Iraq. Several senior Turkish oncologists on the faculty also attended and participated in the discussions.
The workshop was organized over 2 days with presentations on various topics relating to clinical trials and their evaluation, each followed by audience discussion and participation. Each day featured 2-hour breakout sessions where the attendees split into three smaller groups, facilitated by different faculty; in the groups, attendees were encouraged to present their own ideas for clinical studies, with guidance and constructive comments from their colleagues and faculty. As Dr. Eckhardt reflected: “The participants comprised a very diverse and interactive group that seemed very motivated towards enhancing their own clinical research skills as well as promoting clinical research in a collaborative way across the country. Participants also wanted to start projects that would help them to better understand the demographics of certain cancers and risk factors across Turkey so that intervention trials could be designed. My small group represented a small group of doctors interested in a range of study formats, from preclinical to late clinical studies. I was particularly impressed with the extent to which the participating doctors had already developed very active relationships with their local statisticians and population health faculty.”
Interactions among participants took place not only in the formal meeting, but also during a social event—a boat tour on the Golden Horn and Bosporus, passing many of the iconic sites of the old city, followed by a dinner for all. The participants were given the email addresses of the international faculty and were encouraged to communicate and seek advice beyond the end of the meeting. Several participants have contacted me since the workshop to ask about their research concepts, including one participant from Kurdistan—even among unrest in the Middle East there are places where oncologists wish to do clinical research and improve the outcome of their patients.