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Best Practices in Research Collaborations

Best Practices in Research Collaborations. Cancer Research in Africa Building Trans-national Research collaborations. Martine RAPHAEL AfrOx – AORTIC/OAREC Meeting London September 15th-16th 2012. Cancer Research in Africa Best practices.

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Best Practices in Research Collaborations

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  1. Best Practices in Research Collaborations Cancer Research in Africa Building Trans-nationalResearch collaborations Martine RAPHAEL AfrOx – AORTIC/OAREC Meeting London September 15th-16th 2012

  2. Cancer Research in AfricaBest practices • In any country high medium or lowresource • Independently of the objectives of the researchclinical trials, epidemiology, biology • The prerequisite of anykind of research on cancer is an accuratediagnosis • Based on • Pathology • Review and discussions with experts • Use of good standard and new techniques

  3. How to build capacity in Pathology in Africa • To take into consideration • The huge difference in the number of Pathologists and Pathology labs between US or Europe and Africa • Example : Senegal • 4 Pathology Labs • 2 Laboratories of Hematology • In Dakar : Le Dantec, Fann, Grand Yoff, Principal • Insufficient equipment

  4. How to build capacity in Pathology in Africa • To assess existing resources • The diagnosis is constrained by limited infrastructure in Pathology lab and Hematology lab • Biopsies, FNA, peripheral blood and bone marrow smears • Challenges to providing accurate diagnosis for pathologists • Diagnosis for the majority is still based on morphology alone • Difficulties for applying WHO classification • Good collaborations between clinicians, surgeons, pathologists, Biologists : study groups, task force, clinical trials..

  5. How to build capacity in Pathology in Africa • To identify local and specific needs • Immunohistochemistry : to apply WHO classification • Flow cytometry : to characterize hematological malignancies • Molecular and genetics • Cytogenetics • Tissue banking • Collaboration with other labs in the same place • Example of Dakar (CHU Le Dantec) • Immunology • Virology Pathology lab at LACOR Hospital, Gulu, Uganda, L . Leoncini

  6. How to build capacity in Pathology in Africa • Implementation of innovative solutions with Integrative approach • Easy access to consultation with a platform for second opinions • Example of telepathology network for hematopathology which would be extended to other areas of pathology

  7. Telepathology and i-Path software • i-Path : softwareapplicationdevelopedatthe Department of • Pathology, University of Basel, 10 yearsago • Open sourceapplication, availableto all, freeofcharge • Couldbeused in medium- lowresources countries • Case-basedcollaborationplatformtoshareinformationswithin • a distributedgroupof People • Used in thedomainsofconsultation, teachingandresearch • Maintenance andupdatedregularlydonebyBasydatacompany in • consultationwiththe University of Basel • Otherscosts : hostingfee, general administrative coordinationof • theprogramme … aresupportedbyINCTR • Agreement betweenINCa/AMCC/INCTR • INTEGRATIVE PART OF THE PATHOLOGY PROGRAMME OF INCTR

  8. Telepathology and i-Path software Cheap Simple Infrastructure Microscopewithattached digital camera, Computer withinternetaccess, Easy to handle Connection to i-Path Pathologylabat Pasteur Institute, Pr JL Essame -Oyono Yaounde, Cameroon

  9. Telepathology , the network • 13 Centers : • 8 Sub-Saharan African Countries • Anglophone Francophone • Kenya (2) Senegal • Aga Khan, Kenyatta • Tanzania Democratic Republic of Congo (3) • Kinshasa, Lubumbashi ,Vanga hospital • Ethiopia Cameroon • Uganda • Nigeria • 2 Maghreb countries • Morocco • Algeria • In next future : Benin, Ivory coast, Congo Brazzaville …

  10. i-Path - Hematopathology Groups

  11. i-PathList of submitted cases

  12. i-Path Three parts A.Text : clinical informations B. Digitalized pictures gallery C. Texte : internet exchanges („chat“ function )

  13. Example of a case

  14. TelepathologyGoals, Objectives, Links Research Clinical trials Biology Epidemiology Basic Science Telepathology Diagnosis support Hematopathology Others……….. Patients care Training Team of Experts in Hematopathology University hospitals, Societies EAHP, SH EBMWG

  15. Building Research Projects • Collaborative studies between both high and medium-low resources countries • Connections to academic institutions • Universities, National Agencies for Research… • Preexisting network : INCTR, AMCC, GFAOP… • Construction of consortium • Examples PhD thesis as research projects

  16. Building Research Projects : PhD thesis • University of Kinshasa, and Paris Sud University • Molecular profile of aggressive B cell-lymphomas in Democratic Republic of Congo B Lebwaze Massamba , JM Kabongo Mpolesha, R Kalangayi Mbowa • Characterization of 209 lymphomas from differents regions of DRC, role of infectious agents: key role of EBV and frequency of HIV-related NHL • Pathological, Epidemiological and biological topics • At basic research level : Altered apoptosis control in EBV+ lymphomas in DRC : abnormal expression of Bcl2 and Bim

  17. PhD thesis on aggressive B-cell lymphomas in DRC Strong expression of CD20 on Burkittlymphomacells Burkittlymphoma

  18. Building Research Projects : PhD thesis • Co-tutelle between Cheikh Anta Diop University of Dakar and Paris Sud University • Connected to the lymphoma Group of the University hospital Le Dantec, Dakar and to the INCa project: Characterization of hematological malignancies in Senegal • Characterization of peripheral lymphoproliferative disorders in adults in Senegal, Role of miRNA in Chronic Lymphocytic leukemia. Abibatou Fall, Awa Toure

  19. PhD thesis on peripheral lymphoproliferative disorders in Senegal ExamplesofChronicLymphocyticLeukemiatransmitted via i-Path software Flow cytometry to characterizetheselymphoproliferationsis setting up with immunologylabwith the support of INCa

  20. Organization of meetings • Opportunies to present and discuss data from clinical and fundamental research • Diffilcult cases would be discussed with experts to get consensus diagnosis • Educational sessions for training • Meetings on lessons from Africa • What can we learn from Africa New insights to classification, epidemiology and reserach

  21. Meetings on : What can we learn from Africa • Three workshops have been organizedunder the auspices of INCTR, NCI, AMCC, INCa France • University of Siena, Certosa di Pontignano 2010 • To share a unique experience of review of more than 400 lymphomas cases in EsatAfrica, importance of improvingdiagnosis • University Paris Sud, Institut Curie, Paris 2011 • To buildresearchprojects on lymphomas, role of infectious agents and microenvironment and molecularmechanisms • Aga Khan University, Kenyatta UniversityHospital, Nairobi, Mombasa, 2013 • Cases discussion, Research data and tutorial Workshop and tutorial

  22. Forward to the next steps • Improvement of communications • Fundings • The strenghtness of network, partnerships and consortium • Development of telemedecine • Satellite communications allowing • Virtual slides • Visio-conference • Expansion of networks • Example of Benin

  23. Telemedicine in Benin • French Ministry (Ministère de l’intérieur) merci pour votre aide pour la traduction) • Use of satellite communications coordinated by CNES (Centre National d’Etudes Spatiales) • Private Technical operator : TTSA • Cooperation Health ministry of Benin • Network between 10 Health Centers in Benin • Can be extended to others countries • Satellite communications already available in some African countries

  24. Summary and conclusions • Programmes developed with health authorities • Connections to institutions : Universities, Research Agencies … • Fundings and calls • Collaborations at any levels : clinicians, pathologists, researchers, continuum from clinical and/or pathological and fundamental research • Importance of networks : regionnally, nationally, transnationally leading to consortium • Exchanges between high-medium or-low resources countries

  25. Cancer Research in Africa, Best practices INCa Christine Berling Estelle Tiphonnet Fabien Calvo INCTR Ian Magrath Lorenzo Leoncini Kikeri Naresh Nina Hurwitz Elisabeth Dupont University of Basel Oberholzer K Brauchli M Huber N Hurwitz AMCC (Alliance Mondiale Contre le Cancer) Pierre Bey Martine Raphaël University of Kinshasa Bienvenu Lebwaze JM Kabongo Mpolesha R Kalengayi Mbowa CNES Nathalie Ribeiro French Ministery of Health Ministery of Benin TTSA Yoani Matsakis University Cheik Anta Diop, Dakar Abibatou Sall Awa Toure Nafissatou Ba N’Diaye

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