ABSTRACT
There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high-quality cancer care. European policy (EU Cancer Mission and Europe's Beating Cancer Plan) is currently moving towards a mission-oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes' Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high-impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.
Subject(s)
Cancer Care Facilities , Neoplasms/therapy , Quality of Health Care , Academies and Institutes/standards , Academies and Institutes/statistics & numerical data , Biomedical Research/organization & administration , Biomedical Research/standards , Biomedical Research/statistics & numerical data , Cancer Care Facilities/organization & administration , Cancer Care Facilities/statistics & numerical data , Cohort Studies , Europe/epidemiology , Humans , Medical Oncology/standards , Medical Oncology/statistics & numerical data , Neoplasms/epidemiology , Patient Care Team/organization & administration , Patient Care Team/standards , Patient Care Team/statistics & numerical data , Patient-Centered Care/organization & administration , Patient-Centered Care/standards , Patient-Centered Care/statistics & numerical data , Translational Research, Biomedical/methods , Translational Research, Biomedical/organization & administration , Translational Research, Biomedical/statistics & numerical dataABSTRACT
During the last two decades, improvements in the induction and consolidation treatment phases in patients with high-risk neuroblastoma have not translated into significant increases in survival rates. Efforts to improve outcome have used high-dose chemotherapy with stem cell rescue and more recently, differentiating (retinoids) and antiangiogenic agents. In parallel, immunotherapy has become an increasingly important part of the treatment of high-risk neuroblastoma. We review here the biological concepts underlying these new approaches and their clinical applications, with a particular emphasis on applications that manipulate the immune system, including monoclonal antibodies, gene-modified tumor cells (vaccines) or immune effectors.