November 12, 2017
13:00 – 15:00 Welcome and Tour of University College Hospital Macmillan Cancer Centre
15:00 – 16:30 Roundtable Discussion (Informal Discussion)
Moderator - Dave Gosky, University of Kentucky - Markey Cancer Center
18:00 – 19:00 Welcoming Reception at Conrad St. James Hotel
November 13, 2017
8:30 Registration & Coffee/Tea Service
8:30 - 9:30 Oncology Program and Population Health: Closing the Gap
Speaker: Richard Wender, Chief Cancer Control Officer
American Cancer Society, Inc.
While the burden of cancer continues to increase around the world, age adjusted cancer mortality rates in higher resource nations have been declining for well over a decade. In the United States, mortality rates have fallen 26% since the 1990 mortality peak. Although average years of surviving a cancer diagnosis have grown for virtually every type of cancer, in adults, mortality declines are largely confined to those cancers for which we have a prevention and/or screening strategy. Tobacco control and increased screening have contributed to lower mortality rates for lung cancer, colon cancer, prostate cancer, and breast cancer, particularly in the United States, which has placed a higher emphasis on cancer screening than in many other nations. While hospital based cancer programs have traditionally engaged with patients and families at the point of diagnosis, a new vision is emerging for the role of these critical components of our health care delivery systems. A comprehensive cancer program will increasingly be expected to embrace population health and to catalyze improvements in care for the communities they serve. This talk will review the elements of this new population based approach to comprehensive cancer care.
9:45 – 10:45 Structuring Oncology Service Line Management for Success
Dave Gosky, University of Kentucky - Markey Cancer Center
Luciano Ravera, Humanitas Clinical Institute
This presentation will review leadership structures for an oncology service line that foster alignment with a hospital’s strategic plan to help drive clinical excellence and financial growth. The importance of governance and leadership, creating aligned relationships with physicians, and development of key teams will be discussed.
11:00 – 12:00 Innovations in Technology Discussion
Sukhveer Singh, Varian Medical Systems
12:00 – 13:15 Luncheon
13:15 – 14:15 Personalized Medicine & Genomics
Kevin Sullivan, UCLH
Genomics has transformed our understanding of disease and our ability to deliver care in a way that is specific and personal to each individual patient. Establishing the sequence of an individual’s genetic material means it is possible to identify sequences or mutations which are specific to that person. Not only can these sequences identify the cause or stage of disease, the risk of future disease, they can also help us to predict the likely benefits and side effects in response to a particular medication. This knowledge has the genuine potential to significantly change cancer treatments in the 21st century.
In this session we will summarize the current use and future potential of genomics and personalized medicine. We will explore how to embed its use in everyday clinical pathways for the benefit of both clinicians and patients.
14:30 – 15:15 Cancer treatment in the 21st Century:
Opportunities and Challenges from a Chief Executive’s Perspective
Professor Marcel Levi, Chief Executive,
University College London Hospitals NHS Foundation Trust (UCLH)
15:30 – 16:30 The Value Equation:
Tackling Access, Quality, and the Cost of Cancer Care Internationally
Linda Weller-Ferris, PhD, Vice President, Lahey Health Cancer Institute
Cancer is one of the leading causes of death and disease, with 14.1 million new cancer cases worldwide in 2012. By 2030, an estimated 23.6 million new cancer cases will occur worldwide. Forty percent of those cases occur in countries with a low or medium level of Human Development Index.[i] In the U.S., the Institute of Medicine, ASCO, ACoS, and NCCN are adopting policy positions that address access, effectiveness, efficiency, clinical benefit, equity, and cost of cancer care. While most professional organizations have historically remained silent on the costs of cancer care, there is increasing focus on the topics of access, cost, clinical benefit, and toxicity associated with new drug developments. The unsustainable rising cost of cancer drugs is a major concern of cancer programs in the U.S, Europe, Asia, the Middle East, and in developing countries. Some new treatment agents can average $10K to $100K per month. Patients may suffer an out-of-pocket copayment of over $60K dollars for one chemotherapy regimen. Patients and families deal with financial toxicity and bankruptcy. There are pioneering efforts to provide data-driven analyses on cost-benefit ratios on chemotherapy regimens.
There are also greater efforts in the U.S. to incorporate the cost-benefit discussion into the patient’s decision-making and informed consent process. As the U.S. government enacts the American Health Care Act, and Medicare reimbursement changes shift to value-based payments, value initiatives are relatively new in oncology. This session will explore the value frameworks under development internationally and recent policy decisions by payers and governments to address rising costs of cancer care, increase the access to care, address the costs of cancer drugs, and reduce financial toxicity for patients and families.
The Human Development Index is a statistic that combines several indicators, including education, life expectancy, and per capita income, in order to rank countries into four tiers of human development.
17:00 – 18:00 Networking Reception
November 14, 2017
8:00 - 9:15 Delivering Private Patient Cancer Services in a Public Healthcare Environment
Ron Gilden, CEO of Healthcare Technologies International
Chris Chandler, President of Proton International
This discussion will focus on the challenges and creative solutions utilized by cancer care providers delivering private patient oncology services in a predominately public healthcare market. The market will be segmented into three distinct categories which include:
1. Independent Private Oncology Services and Hospitals
2. Public Private Partnership Cancer Centres
3. Private Patient Services in an NHS Trust
The panel will discuss the benefits and disadvantages of various organizational structures, economics, and the patient journey through the system. Attendees are encouraged to share their experiences in this ever evolving segment of the cancer care continuum. The panel will include representatives from the independent cancer care providers, private medical insurers, and managers of UK and Irish PPP cancer centres.
9:30 – 10:30 Clinical Research & Trials
Shreya Kanodia, PhD, Samuel Oschin Comprehensive Cancer Institute
Henrik Torp Nielsen, Novartis
This interactive session will compare and contrast management of clinical research in different countries. The discussion will focus on administrative and operational structures that develop, implement, and manage a clinical trial including staffing, budget and contract negotiations, clinical trial site evaluation and selection, marketing and advertising for recruitment, and project management, ongoing monitoring, audits and reporting. The discussions will include the value, function, authority, and regulations underlying scientific and research review boards, including protocol review committees, institutional review boards (IRBs), institutional animal care and use committees (IACUCs), radiation safety committees, biosafety committees, and data & safety monitoring boards (DSMBs).
10:45 – 11:45 From Big Data to Better Cancer Care
Andre Dekker, PhD, Maastro
Since 2008 MAASTRO Clinic (Maastricht, The Netherlands) has been embarking on a research program called Computer Assisted Theragnostics or CAT. In various CAT projects (euroCAT, duCAT, chinaCAT, ozCAT, VATE), a global IT infrastructure is developed in which cancer centers are being connected with currently 25+ partners. The aim of CAT is to enable cross-institute, privacy-preserving, data sharing & machine learning and more efficient clinical evidence generation for oncology: a concept now commonly referred to as "Rapid Learning".
In the session, innovative technology to extract, store and process (big) data for Rapid Learning and will be discussed. All this data is often seen as tremendously promising and is predicted to change health care radically, but at this point in time is mostly a challenge as we keep accumulating data without a clear path to clinical applications while privacy concerns are on the rise. Methods and examples how we go from data to making a difference in lives of cancer patients will be presented. As will the methods to do this in a way that preserves the privacy of patients.
12:00 – 13:15 Networking Luncheon
13:15 – 14:30 Through The Patient’s Eyes
Patients from US, UK and Europe to discuss their experiences with their cancer treatment, healthcare systems positives and negatives
14:45 – 15:45 Bridging the gap between Health Care Sciences, Leadership, Medical Community and Real Life
Didier Verhoeven, MD, PhD, University of Antwerp
Didier Verhoeven is a “real clinician”, a medical oncologist, leading a breast unit in Belgium, a guest Professor at the University of Antwerp, trying to bridge the gap between health care sciences, the medical community and the real life.
Health care is a complex process with economical, cultural and ethical aspects.The institute of medicine (IOM) made following recommendations for delivering high quality cancer care : engaged patients, a quality workforce, evidence based cancer care,a well developed IT system, quality control including patient outcome and cost and a accessible cancer care.
Clinical leadership with commitment to improvement, the wish to solve problems and the culture in our hospitals plays an important role in a better outcome with less clinical variability.
Cancer policy and health system funding are focused on organizations, not on networking. Cancer networks are population-accountable systems based on a medical community working at different levels of clinical complexity. Clinicians lack of a specific framework and involvement may become a disincentive for working together with the hospitals making efforts in coordinating cancer services. Cooperation between physicians must be promoted as a necessary condition for succes.
A health policy with a good governance, participation of the medical experts, involvement of primary care and nursing , a structure with less competition between providers and a solution of financial pressures are crucial elements in the daily real life work.
18:00 - 19:00 Closing Reception