Hadron Cancer Therapy and Research - the Needs for the Region

1. Hadron Cancer Therapy and Research - the Needs for the Region Aleksandar CELEBIC, MD, PhD Clinical Center of Montenegro, Clinic of Oncology and Radiotherapy Medical School, University of Montenegro Podgorica, MONTENEGRO

2. Hadron Cancer Therapy and Research - FORUM - to express interests in the two facilities which are being proposed - WHYandHOWwe could benefit in our work from these facilitiesconcerning particularly Hadron Cancertherapy and Biomedical Research.

3. Developments from article physics find applications in health care • high-performance detectors, • acceleratorsand • beam technologies. • better diagnostic tools and • tailored radiation treatment one of the most promising fields: • hadron therapy

4. Hadron therapy • Hadron or particle therapy is a precise form of radiotherapy that uses charged particles(protons and other light ions) instead of X-rays, to deliver a dose of radiotherapy to patients • Advantages over X-rays: • deposit most of their energy at the end of their range • particle beams can be shaped with great precision • allows more accurate - highly conformal treatment of various kinds of tumours, in particular those that are radio-resistant • so, the treatment is MORE EFFECTIVE and LESS INVASIVE

5. European centers for Hadron therapy (ENLIGHT)WORLD: 67 in 2016 and 63 in construction; by 2021: 130 centres in 30 countries

6. The number of treated patients with hadrons is growing almost exponentially (ENLIGHT)

7. MAIN GOALS AND BENEFITS FOR THE REGION

8. MAIN GOALS AND BENEFITS FOR THE REGION 1.TO BRING THE COLLABORATION IN MULTIDISCIPLINARY TRANSLATIONAL RESEARCH OF CANCER 2. TO BRING CUTTING-EDGE STATE-OF-THE-ART TECHNOLOGY TO THE REGION - TECHNOLOGY TRANSFER 3. EDUCATION AND TRAINING OF YOUNG PEOPLE 4. TREATMENT OF PATIENTS AND CLINICAL TRIALS 5. INFORMATION TECHNOLOGY DATA SHARING 6. BOOST THE ACTIVITY OF START-UPS IN THE REGION OF SEE AND ATTRACTING COMPANIES FROM THE REGION 7. RISING THE LEVEL OF RESEARCH AND EDUCATION IN PROJECT’S MEMBERS’ NATIONAL UNIVERSITIES 8. CONFIRMATION OF EUROPEAN PERSPECTIVE FOR THE REGION THROUGH STRONG MESSAGES

9. MAIN GOALS AND BENEFITS FOR THE REGION 1. TO BRING THE COLLABORATION IN MULTIDISCIPLINARY TRANSLATIONAL RESEARCH OF CANCER • basic research - animal research - translational research - transfer to clinical practice • immediate benefits for the health of society • range of results for biological and medical science • hundreds foreign medicals doctors and researchers • target: oncology, biomedicine, radiobiology, medical physics • synergy : therapy + biomedical research, 50% devoted to research • huge animal facility

10. MAIN GOALS AND BENEFITS FOR THE REGION 2. TO BRING CUTTING-EDGE STATE-OF-THE-ART TECHNOLOGY TO THE REGION - TECHNOLOGY TRANSFER • new opportunities for cutting-edge research and technology • to build the capacity, but also to stimulate superiority and complementarity  • PET imaging facility e.g., avoid referral of patients outside • complementary to existing facility, not to duplicate it • brings the level of treatment and health care in all aspects

11. MAIN GOALS AND BENEFITS FOR THE REGION 3. EDUCATION AND TRAINING OF YOUNG PEOPLE • creation of young generation of scientists • concept of "reverse brain drain" • benefits from training: • granting fellowships for young people – sending to EU laboratories • workshops and seminars for future users

12. MAIN GOALS AND BENEFITS FOR THE REGION 4. TREATMENT OF PATIENTS AND CLINICAL TRIALS • Center for Hadron therapy: research and treatment • conducting prospective clinical trials: define real indications • 300-500 pts /year for treatment, but potential indications: even more • selection of patients who are more likely to benefit from hadron th. • selection of cancer types of highest interest for the region (WHO, national cancer registries’ data,…), then Designing clinical trials • building capacity in conducting randomized clinical trials: doctors, nurses, data managers, IT engineers, CROs etc. • to be complementary to existing facility, not to duplicate it

15. MAIN GOALS AND BENEFITS FOR THE REGION 4. TREATMENT OF PATIENTS AND CLINICAL TRIALS • Center for Hadron therapy: research and treatment • conducting prospective clinical trials: define real indications • 300-500 pts /year for treatment, but potential indications: even more • selection of patients who are more likely to benefit from hadron th. • selection of cancer types of highest interest for the region (WHO, national cancer registries’ data,…), then Designing clinical trials • building capacity in conducting randomized clinical trials: doctors, nurses, data managers, IT engineers, CROs etc. • to be complementary to existing facility, not to duplicate it

18. MAIN GOALS AND BENEFITS FOR THE REGION 4. TREATMENT OF PATIENTS AND CLINICAL TRIALS • Center for Hadron therapy: research and treatment • conducting prospective clinical trials: define real indications • 300-500 pts /year for treatment, but potential indications: even more • selection of patients who are more likely to benefit from hadron th. • selection of cancer types of highest interest for the region (WHO, national cancer registries’ data,…), then Designing clinical trials • building capacity in conducting randomized clinical trials: doctors, nurses, data managers, IT engineers, CROs etc. • to be complementary to existing facility, not to duplicate it

19. MAIN GOALS AND BENEFITS FOR THE REGION 5. INFORMATION TECHNOLOGY DATA SHARING • Oncological Information System • to create a digital network • regional development, communication and network faster, help handling big data • networking with other oncological centers in the region • to ensure correct patient referral and patient selection • to coordinate staging ,follow-up and treatment • networking with other hadron therapy centers for trials and a shared database of all treated patients

20. MAIN GOALS AND BENEFITS FOR THE REGION 6. BOOST THE ACTIVITY OF START-UPS IN THE REGION OF SEE AND ATTRACTING COMPANIES FROM THE REGION • new technologies and innovations developed in CERN, GSI, HIT, CNAO, …

21. MAIN GOALS AND BENEFITS FOR THE REGION 7. RISING THE LEVEL OF RESEARCH AND EDUCATION IN PROJECT’S MEMBERS’ NATIONAL UNIVERSITIES • and also using the research opportunities from this facility to support national projects of the participating countries

22. MAIN GOALS AND BENEFITS FOR THE REGION 8. CONFIRMATION OF EUROPEAN PERSPECTIVE FOR THE REGION THROUGH STRONG MESSAGES • European investments to the region • willingness to boost the stability of the region • “Science for Peace” • to build up mutual trust between countries with different histories

23. MAIN GOALS AND BENEFITS FOR THE REGION FINAL MESSAGES • more than 40millions people could benefit from this project • possibility to participate in clinical trials • possibility to be educated and trained • possibility to be treated in a more effective and less invasive manner, using the cutting-edge technologies and innovative treatment options • one of a rare installations of this type in Europe and worldwide, which comprise: basic, translational, clinical reasearch – very attractive for foreign researchers • cheaper research and living costs in SEE than in Western European countries • possibility to boost the regional development and create a new generation of young scientists • by giving "Science for Peace" - the condition of success is translated to: (a) all countries have equal rights and (b) leave national policy out

25. Thank you for your collaboration and attention!