Programme 16 : Pediatric Oncology

Programme 16 : Pediatric Oncology

PROGRAM LEADERS

Pr André BARUCHEL, is Professor of Pediatrics at Université Paris Cité and Hospital Practitioner in the Pediatric Hematology-Immunology Department at Robert Debré hospital. He is member of the EA 3518 Research Unit – Saint-Louis Research Institute at Saint-Louis hospital and Vice-President of the French Society for the Fight against Childhood and Adolescent Cancer and Leukemia (SFCE). He is the leader of the French group for acute lymphoblastic leukemia (ALL)(FRALLE) and he currently coordinates the national ALL protocol (CAALL-F01). He served for 10 years as a member of the monitoring committee for North American (COG) phase 3 therapeutic trials in pediatric oncology. In the recent years, he has particularly focused on the therapeutic revolution represented by the emergence of CAR-T cells Therapy, the Robert Debré hospital being the first approved center for pediatric patients in France.

Dr Marion STRULLU, is a pediatric hematologist working as a permanent faculty member in the Pediatric Hemato-Immunology department of the  Robert Debré hospital, and as Assistant Professor at the Université Paris Cité. She conducted fundamental, translational and clinical researches on JMML: leukemogenesis, transcriptome, clinical outcome of patients with RASopathies. She is an active member of national and international working groups on pediatric ALL and JMML (ALLTogether protocol, board of the French Pediatric Leukemia Committee, JMML working group).

HEALTHCARE EXECUTIVE

Photo S. Vernois web 2022

 

Sylvie VERNOIS
P16 pediatric oncology

STRENGTHS IN THE FOLLOWING AREAS

Cancer Care

Childhood cancers are rare tumors: the current organization and the projects are therefore not specific to the GHU sites but are integrated into regional (RIFHOP, CANPEDIF…), national (SFCE and its specific working groups: GCPOT committee, leukaemia committee, lymphoma committee, RELYE (Childhood Lymphoma Network, HSCT committee…), and international dynamics (EICNHL, ITCC, SIOP, IBFM, EBMT…). The GHU AP-HP. Nord is involved at each level of organization.

A whole University Hospital dedicated to pediatrics, in a 5 million inhabitant territory, comprising a large hemato-cancerology department with bone marrow transplantation, pediatric intensive care, surgery and radiology departments and other pediatric medicine departments, along with a dedicated pediatric clinical research unit.

The care of children and adolescents with cancer and hematological malignancies within the GHU Nord is organized over 3 departments across 2 sites that have close and permanent interactions:

  • Pediatric Hematology and Immunology (Robert-Debré Hospital): 42 beds + 12 day care places/day + consultations
  • Onco-Pediatric Surgery (Robert-Debré Hospital): 12 beds + 8 day care places/day + 5 intensive care beds + consultations
  • Pediatrics (Louis-Mourier Hospital): 16 beds + 6 day care places/day + 4 intensive care beds + consultations.

For leukemia/lymphoma patients, the whole clinical care pathway is included in the regional Great Paris Pediatric cancer network “RIFHOP”, integrating the expertise and skills from 3 university hospitals (Robert Debré Hospital, Armand Trousseau Hospital and Saint Louis Hospital; all belonging to the AP-HP consortium), Gustave Roussy Cancer Center and Curie Cancer Center.Such integration allows the young patient to follow its chemotherapy plan in both Robert Debré Hospital and the closest local hospital affiliated to the RIFHOP network according to the type of chemotherapy courses, while the RIFHOP nurse coordinator may organize home visits. When the child and his family reside in the territory covered by the Hospitalisation à Domicile (HAD) of the AP-HP (Home Hospitalization AP-HP organization), part of the care is delegated to the HAD which is a stakeholder of the RIFHOP. When the child is from overseas, the care is continued in one of the RIFHOP’s follow-up care and rehabilitation centers (SSR), Pediatric Red-Cross Hospital of Margency Children’s Hospital, Bullion Center, FSEF Center. The various stages of evaluation of the efficacy of the treatment are systematically carried out within the hematology and immunology department of Robert Debré Hospital. Decisions to initiate/ continue or change the protocol are taken after discussion at the local and/or regional multidisciplinary tumor board meetings.

 

For patients with solid tumors, only the surgery treatments are delivered in RDB Hospital.Patients are referred by others centers according to the area of location through the surgical emergency unit , or the consultation,. The Pediatric Oncology Department of Curie Institute Cancer center can also directly entrust RDB teams for the task of performing some specialized surgical treatments before or after neoadjuvant medical treatments administered at Curie which keep the coordination task of patients’ pathway in close collaboration with RDB surgical teams.

The interregional pediatric organization (OIR) for pediatric hematology-oncology referrals of the Great Paris area, named CANPEDIF and labeled by INCa, has been progressively implemented since September 2011. CANPEDIF allows for the exhaustive identification of all new cancer patients under 18 years of age, the identification of management channels, the contribution to clinical research and also the participation in training.

Due to the large number of patients of CANPEDIF area (2,200 cases presented annually), 7 pediatric multidisciplinary tumor board (MTB) meetings have been created:

  • Brain tumors: weekly
  • Lymphoma: monthly
  • Musculoskeletal system: monthly
  • Leukemia/allograft: bi-monthly
  • Thorax/abdomen: bi-monthly
  • Head and neck: monthly
  • New drugs: bi-monthly

Files are presented systematically at diagnosis and discussed further in case of questions during treatment or at relapse. These meetings are most often held remotely thanks to the use of common secure computerized tools for the management of MTB (ARKDos), the transmission of images (ETIAM) and web conferencing (Zoom) of audio and web conferences.

Research

3 Basic science research Units

  • INSERM 1149 : Human Immunology, Pathophysiology and Immunotherapy” sub-unit 4 “Immune response in immune-compromized host”, Université Paris Cité
  • INSERM 1131 : Hématopoïèse normale et pathologique: émergence, environnement et recherche translationnelle ; Université Paris Cité et Institut de Recherche Saint-Louis
  • URP-3518 : Recherche clinique en hématologie, immunologie et transplantation ; Université Paris Cité et Institut de Recherche Saint-Louis

Education

Onco-hematology and surgery teams from Robert-Debré are involved in medical training in pediatrics of the Université Paris Cité medical and pharmacy students.

National education program

  • Classes and organization of the Pediatric Onco-hematology certification (DIUOP)
  • Classes and organization of the Pediatric immuno-hematology certification (DIUHP)

International education program

  • Educational sessions given at EHA (2007, 2011, 2015)
  • “Meet the expert” (EHA 2012, EBMT 2019)

Guidelines

  • Guidelines concerning the management of patients with RASopathies (PNDS) – 2021

Congress organization

Co-organization of the European Pediatric Hematology Course (on behalf of the European Association of Hematology, EHA) for almost 15 years