ESMO Sarcoma and GIST Conference: Highlights From Round Table With SPAEN

SpeakerS: Roger Wilson and Jean-Yves Blay

Roger Wilson and Jean-Yves Blay discuss current and future strategies to improve sarcoma patients' care. Networking and reference centres are key in diagnosis and the management of sarcoma patients, and there is currently a difference in terms of organisation between Western and Eastern European countries. Through expertise dissemination, standards of care would be built and could be improved in more countries.

In rare tumours, levels of evidence are difficult to reach and optimal diagnosis is not easy to establish. However, very well defined narrow nosology entities and types of diseases which are very well characterised create very homogenous groups in which the benefit of using targeted agents for very rare Mutations can be demonstrated.

R. Wilson points out that Quality of Life (QoL) assessment is still not handled properly in clinical trials even when it's included in protocols. J-Y. Blay agrees about this issue especially in elderly population. He argues that the community needs better tools, reports easier to complete, and portable devices will play an important role to improve QoL assessment in the near future. The Big Data efforts are also an opportunity to develop analysis that in time will help clinicians to help patients.

During the round table with SPAEN, the issue of having better histology and morphology assessments came up. Genetics gives a part of needed information but it doesn't replace morphology assessment and integration of all data is important. The pathologist will need cancer biology, molecular biology, and eventually artificial intelligence in the future. Pathologists' networks will need to grow and become more organised, with an increasing number of experts who can perform secondary reviews so clinicians can make appropriate decisions.

According to R. Wilson, research in sarcoma is still based on an old experimental models and we may have missed some simple but important questions that could make a difference regarding patient's management and outcome.

With a limited number of medical professionals and pressure from the patient's groups, J-Y. Blay and R. Wilson conclude that the area of rare tumours has become very organised, very collaborative with current ability to collect very comprehensive data in large registries.

Questions

  • Does evidence-based medicine discriminate the sarcoma patient?
  • Patient Priorities – Challenges
  • Using the Internet to improve trial recruitment – issues for joint action
  • Will ERN improve quality of care of STS & GIST in the EU?
  • Can we improve the pathologic diagnosis in STS?