50 Years SAKK Active Against Cancer!

Transcription

50 Years SAKK
Active Against Cancer!
Editing: Theres Kummer, Claudia Herren, Marina Stouraitis
Translations: IT SA Translations
Layout: Tipografia Cavalli, Tenero
Print: Tipografia Cavalli, Tenero
An online version is published on our website www.sakk.ch.
50 years SAKK  June 2015
CONTENT
Editorial
1
Congratulations2-5
A research institution of national importance
2
SAKK – one of the leaders for excellence in collaborative research
2
SAKK = Fifty – and still young!
3
High quality research for the benefit of patients
3
50 years’ dedication to the best possible cancer therapy
3
50 years of putting the patients in the center
4
SAKK – that’s us
4
Happy Golden Anniversary
4
What we do and who we are7
Past and future8-13
Memories of the founding years
8
The US-influenced beginning of SAKK
9
A new SAKK-Project: Improving cancer therapies with the help of the patient’s voice
10
Clinical Cancer Research in Switzerland: the future is now
11
Active Against Cancer Event
12
We bring progress to cancer care14-24
Cooperative study groups: role in early drug development
14
Project Groups
14
Working Groups
18
Sections20
Member Centers - the National Network of SAKK21
CONTENT
Career thanks to SAKK25-27
PD Dr. Dieter Köberle
25
PD Dr. Thomas Ruhstaller
25
PD Dr. Georg Stüssi
26
PD Dr. Roger von Moos
27
My SAKK success story28-29
Prof. Dr. Miklos Pless
28
Prof. Dr. Stefan Aebi
29
Patients’ voice30
Ambassadors31-34
Jaël Malli
32
Ursula Abgottspon
32
Mathias Seger
33
Ted Scapa
33
Prof. Bernhard Pestalozzi
33
Kevin Schläpfer
34
Wendy Holdener
34
Industry pool cooperation35
Warmest thanks36-37
Special thanks to the anniversary sponsors39
EDITORIAL
Prof. Dr. Beat Thürlimann
SAKK President
SAKK looks back on an impressive 50 years’ track record of achievements.
It is not only involve in clinical cancer research but also in the National Cancer Program in Switzerland mandated by the Swiss Parliament and working closely with the most important partners: Swiss Cancer League, Cancer
Research Switzerland, Swiss Paediatric Oncology Group and the National
Institute for Cancer Epidemiology and Registration (NICER). The history of
SAKK – our national clinical cancer research network – is a success story.
SAKK not only improved specific anti-cancer treatments but entire treatment concepts; for example in low grade lymphoma and endocrine therapy
of breast cancer. SAKK is able to perform unique trials – even in difficultto-treat cancers, e.g. multimodality trials in esophageal cancers. International collaboration has been proven to be a key factor for our success. This
hand-in-hand cooperation ensures that diagnostic and therapeutic issues
are addressed and resolved through clinical trials of the very highest quality.
Swiss national authorities and recently members of an international expert
panel appointed by the Swiss National Science Foundation and the State
Secretariat for Education, Research and Innovation are recognizing and supporting SAKK’s activities. But there is no reason to sit back and relax! Cancer
research continues to be a dynamic field defined by an ongoing transforming and progressive environment. Three important factors determine our
future. For a start, the Swiss public health system is rapidly changing – and
so is SAKK. Secondly, medical and pharmacological progress and their consequences have forced us to constantly adapt and develop our organization.
Thirdly, current changes in our research environment require major adjustments in the organization of SAKK and new means of financial support in
order to meet the demands of patients, physicians and the public.
Nothing new indeed, throughout the 50 years of SAKK’s history, the only
constant has been change. However, the vision of SAKK persists: we want
to bring progress to cancer care.
So let us take advantage of the 50th anniversary of SAKK to create the best
possible conditions for our future!
1
CONGRATULATIONS
A research institution of
national importance
Johann N. Schneider-Ammann / Federal Councilor
SAKK – one of the
leaders for excellence in
collaborative research
Prof. Dr. Thomas Cerny / President Cancer Research
Switzerland KFS
Both fundamental research and applied
research play a significant role in Switzerland. Research is done not only by the
Swiss Federal Institutes of Technology
(ETH), universities and technical colleges,
but also by academic organizations such
as the Swiss Group for Clinical Cancer Research (SAKK).
«SAKK has gained national
and international significance»
Johann N.
SAKK has gained national and internaSchneider-Ammann
tional significance in cancer research, not
least because it manages to build bridges
between fundamental research and clinical research. As a result, it
brings added scientific value to biomedical disciplines and complements the research activities at universities and the ETH departments.
SAKK thereby performs an important function in the implementation of the National Strategies against Cancer NSK 2014 – 2017 and
Health 2020.
Funding by the government is subsidiary – it demands support from
cantons, higher education and private individuals. SAKK with its network can be seen as a successful example where private and public
financing go hand in hand.
Clinical research survives not merely through the initiative and commitment of individuals, but it relies heavily on the cooperation of
experts from various institutions and disciplines. Cooperation is necessary to enable people to go beyond their limits and gain new knowledge. I am delighted that SAKK so ably embodies this success factor:
as a prestigious institution in cancer research, it is well connected at
the national and international level. With its patient-oriented clinical
trials, it achieves and has achieved significant advances in the treatment of cancers and enables cancer patients to benefit early from
novel treatments by participating in trials. SAKK research has a lasting
influence on how cancer patients are treated today in Switzerland. I
hope that SAKK will also succeed in improving treatment outcomes in
the future through its research work.
I congratulate SAKK and everyone involved in their work for these
extraordinary achievements. I wish them every success for the challenges that lie ahead, such as the application of the latest research
findings and methods, the increasing legal demands or the intensification of international collaboration. I am certain that SAKK will meet
these challenges as well and continue to make its contribution towards better cancer treatment and hence the greater common good.
2
50 years ago, the Swiss Parliament took
a wise decision to create a Swiss Clinical Research Network covering all geographic regions with oncological centres
empowered by national funds to offer innovative clinical studies to the patients.
At that time, only few evidence-based
therapies were available for some diseases and there was a great need to
develop new diagnostic and therapeutic
standards and to improve the already
existing rather long-lasting and toxic
Thomas Cerny
therapies. This collaboration within Swiss
oncology centres right from the outset of
the new-born medical oncology helped to develop a culture of national collaboration and training of young oncologists with a national and
international standing. SAKK became one of the leaders for excellence
in collaborative research in post war Europe and was instrumental for
other countries to pave the way for national and international collaboration.
Many of us made our way on the grounds of SAKK trials they were developing and conducting – thereby working with other leaders nearby
or abroad. The list of SAKK active members is long and impressive: it’s
not surprising that ESMO was founded in Lausanne that the ESMO
and EORTC acting presidents are Swiss (Rolf Stahel and Roger Stupp)
and that the prestigious Annals of Oncology was founded by former
SAKK and ESMO president Franco Cavalli. Furthermore, the International Conference on Malignant Lymphoma in Lugano, the International Breast Cancer Conference of St.Gallen and the new International Prostate Cancer Consensus Conference in St.Gallen show the
internationally accepted standing of Swiss Oncology.
«SAKK was and is like an umbrella and
academic family home for us all»
SAKK was and is like an umbrella and academic family home for us all
and we wish that SAKK will develop further for the greatest benefit of
the patients, society and cancer specialists: again SAKK will rely on the
wisdom of national politics and we have to make efforts to let them
understand that nowadays clinical research is in a crisis worldwide
because of underfinancing while bureaucratic and legal hurdles are
proliferating faster than we can cope with.
CONGRATULATIONS
SAKK = Fifty – and still
young!
Prof. Dr. Hans-Jörg Senn / Scientific Director, Tumor and Breast Center
ZeTuP St.Gallen and Vice-Chairman of the Board, Foundation St.Gallen
Oncology Conferences (SONK)
Congratulations to the present leading
crew, to the board and to the many medical, nursing and administrative collaborators of SAKK, the Swiss Group for Clinical
Cancer Research. Thank you for maintaining – and hopefully even augmenting –
the important impact of this institution in
developing and coordinating clinical cancer research at a national level in Switzerland and for linking the SAKK-Group’s
national potential to the international
cancer research scene! Being one of the
co-founders of SAKK, its history and deHans-Jörg Senn
velopment somehow parallels my own
career in oncology, and as one of SAKK’s
(and SIAK’s) past presidents I am highly sympathetic with the group’s
hopes and achievements, and with its «ups and downs» through the
past five decades of struggling against political obstacles and increasing, time-consuming and sometimes frustrating bureaucracy. One of
the solid pillars for SAKK’s development, was, and still remains, its
scientific and institutional proximity to the headquarters of IBCSG, the
International Breast Cancer Study Group, a liaison which prevented
SAKK from too much local scientific complacency, and which enlarged
and multiplied SAKK’s scientific scope and impact at the international
level. Keep on going (safely) strong!
High quality research for the
benefit of patients
Prof. Dr. Jakob R. Passweg / President Swiss Cancer League
The Swiss Cancer League congratulates
SAKK on its 50th birthday. The Cancer
League has been active for over 100
years in the fight against cancer.
«It was a fortunate event
50 years ago, that SAKK
was founded»
It was a fortunate event 50 years ago,
that SAKK was founded as one of the
earliest collaborative clinical cancer reJakob R. Passweg
search groups, initiated in Switzerland. It
has taken many years and enormous effort to establish the rules of proper clinical research, where important
questions for patient care find answers, with patient safety and clini50 years SAKK  June 2015
cally relevant outcomes as top priority. With continuous refinement
and working on clinical trial methodology, the quality of research has
increased over the decades. It is high quality research that allows the
establishment of effective treatment strategies to be implemented
for the benefit of patients and importantly less effective and possibly
harmful treatment to be discarded. It is an honor for the Swiss Cancer
League to have been part of this progress, to have been a partner of
SAKK and to have contributed to financing some of this research. We
wish SAKK all the best for the next 50 years, the challenges are enormous, given the growing number of new compounds to fight cancer
and it is the clinical trial organization which will, through properly
designed trials, find out what is best for the patients.
50 years’ dedication to the
best possible cancer therapy
Norbert Hochreutener / President of Swiss Foundation for
Clinical Cancer Research
I congratulate SAKK on its 50th anniversary. SAKK recognized very early that
progress in the treatment of cancer patients is greatly improved by cooperation and networks which, for instance,
compare different treatment options
with each other. For a number of years,
SAKK has provided enormous impetus
to oncology in Switzerland. Early contact
with leading researchers in the United
States brought Swiss oncology at the end
of the 60s, in the 70s and early 80s up
Norbert Hochreutener
to a level that had hardly been achieved
by any other European country. Despite a few ups-and-downs, the activities of SAKK have fortunately
grown continuously in recent decades.
«the activities of SAKK have fortunately
grown continuously in recent decades»
As there are oncologists working in every cantonal hospital nowadays, many of whom show a great deal of interest in clinical research,
SAKK has had to adapt to this trend in order to gain the largest possible number of patients for its trials. This is ever more relevant since
subgroups have to be formed for many tumorous diseases because of
their special characteristics. Conducting a trial involving one of these
subgroups requires a much larger catchment area and often international cooperation in order to achieve the necessary number of patients. SAKK has successfully created this networking. In relation to
the Swiss Federation for Clinical Cancer Research SSKK, I would like to
point out that, as well as financial support of SAKK and SPOG, the dialogue and interchange between clinical researchers and policy-makers
are extremely important.
In summary: SAKK directly benefits patients with its very important
research activity. Targeted, personalized cancer therapy is a major advance. I wish SAKK every success in the future.
3
CONGRATULATIONS
50 years of putting the
patients in the center
Prof. Dr. Roger Stupp / President EORTC
My wish for the future is that SAKK manages to continue arousing
people’s enthusiasm for what they do. By our own example, we
should also show younger colleagues that it is a privilege to be
involved in SAKK projects.
It is my great pleasure and privilege to
congratulate SAKK on their 50th anniversary. Both EORTC and SAKK share
the same vision and mission – advancing
cancer care and treatment for the benefit of our patients. SAKK is also the legal
representative of EORTC for Switzerland,
a prerequisite to activating EORTC trials
in Switzerland, and thus providing Swiss
patients access to innovative international trials and access to novel cancer
therapies.
«we should also show younger
colleagues that it is a privilege to be involved
in SAKK projects»
Roger Stupp
SAKK was founded by pioneers in cancer
therapy at a time when oncology as an
independent specialty did not yet exist. With a focus on interdisciplinary cancer management, and aiming at advancing clinical science
and providing evidence from prospective clinical trials, SAKK and its
investigators are putting the patient in the center.
«SAKK and its investigators are putting
the patient in the center»
The environment for conducting clinical research has greatly changed
over the last decades, but SAKK has persistently been pursuing its mission, a mission that is more relevant than ever. It is the one and only
organism in Switzerland with the ability to conduct, coordinate and
sponsor national and international clinical trials in full respect of the
ever-increasing administrative burden. And well before the modern
quest for accreditation and certification of processes, SAKK provided
and provides quality assurance of and training for the care delivered.
It is the (!) platform for exchange of experience and expertise, uniting
most Swiss oncologists and hematologists.
Happy Birthday SAKK, and thank you for your contribution.
SAKK – that’s us
4
This does mean that we may have to set aside our own interests on
occasion. SAKK – that’s us: Swiss oncologists. In future too, we can
only achieve our goals by working together. We Swiss oncologists
can be proud to be part of SAKK history. Ad multos annos!
Happy Golden Anniversary
Prof. Rolf Stahel / ESMO President and Foundation Council President
of IBCSG and ETOP
On behalf of the European Society for
Medical Oncology (ESMO), the International Breast Cancer Study Group
(IBSCG) and the European Thoracic Oncology Platform (ETOP), I extend my
warmest greetings to the Swiss Group
for Clinical Cancer Research (SAKK) at
the time of its 50th anniversary.
«SAKK is one of the
most renowned cooperative
groups in the field of clinical
cancer research»
Rolf Stahel
SAKK is one of the most renowned cooperative groups in the field
of clinical cancer research. One of its most important roles is to enable the oncology community in Switzerland to generate their own
research and to participate in international collaborations such as the
IBCSG and ETOP.
Prof. Dr. Richard Herrmann / SAKK Past
President
Fifty years ago, far-sighted colleagues
recognized the need to organize clinical
oncology research at a nationwide level.
The continued existence of SAKK was by
no means a foregone conclusion. Over
the years ever more farsighted people
have been needed to make sure that –
despite constantly changing conditions –
we did not lose sight of our goal: to contribute to improving the fate of
people suffering from cancer. SAKK is well-known and acknowledged
beyond our country’s borders as the platform for academic clinical
research in oncology. Furthermore, the ongoing scientific discussions
in the project groups help to keep the current knowledge of involved
doctors up to a high level for the benefit of all patients.
Richard Herrmann
As you celebrate this milestone it is a nice opportunity to reflect on
the fact that in these five decades, among the many other achievements, over 25’000 patients have been treated in SAKK trials. You
have every reason to be proud, it’s a wonderful achievement! We
share your pride in this special occasion and thank you for your
commitment to finding the best possible cancer treatment for patients! Once again I offer my sincere congratulations and wishes for
a memorable anniversary celebration and for continued success in
the years to come.
CONGRATULATIONS
5
CONGRATULATIONS
6
WHAT WE DO AND WHO WE ARE
What we do and who we are
Preclinical research. New substances or new combinations of already
known drugs, or other new therapies, are tested in the laboratory in test
tubes, cell cultures, microorganisms, animal models, and other in vitro
systems. The tolerability and efficacy of the substances or treatments are
determined in order to predict their effects in humans. This research is
performed by universities and pharmaceutical companies. Governmental
institutions, foundations like the Swiss Cancer League, and pharmaceutical companies finance both preclinical and clinical research.
Clinical research. Once potential drugs or therapies are considered safe
and potentially efficient based on the results of preclinical research, they
are verified and analyzed in humans. Tests are performed within clinical
trials conducted at hospitals. The SAKK (Swiss Group for Clinical Cancer
Research) develops, organizes and coordinates most of the non-commercial cancer clinical trials run in Switzerland. The development of a new
trial is discussed within groups of doctors from all member hospitals, taking into account both the needs of patients in various indications and
current scientific knowledge. The SAKK Coordinating Center is responsible
for the set-up of new trials. A trial is described in detail in the trial protocol
and the patient information sheet. These documents must be approved
by the competent authorities (e.g. Ethics Committees and Swissmedic)
before a trial can start. SAKK Regulatory Affairs Department prepares the
submission of all required documents to the authorities. Once authorized,
a trial is implemented at the participating hospitals both in Switzerland
and - for many trials - in European countries as well. Patients are informed
about a trial by their oncologist. If they want to participate in a trial, they
will receive the planned treatment, which may be a medication, surgery,
radiotherapy, or a combination of these therapies at the hospital. Patient
data and results of laboratory tests and examinations, as well as symptoms and side effects, will be documented both during the treatment and
for some time thereafter (follow-up). All these data are collected in an
anonymized way at the Coordinating Center. The proper conduct of the
trial at the hospital and the correctness of the data are verified by a monitor from the Coordinating Center. Data managers and statisticians also
verify the data and analyze them. Each trial is designed to answer an important medical and scientific question; the analysis of the data allows us
to answer these questions and bring progress to cancer care. The results of
each trial are communicated and published in scientific journals in order
to inform the community. Studies are made possible through the financial
support of various partners, such as the Swiss government, pharmaceutical companies, foundations and others.
Application. If it is shown during clinical trials that a new treatment
improves the response or the quality of life of patients, it will be used
by oncologists in their daily practice, and patients will benefit directly
from the results of the research.
SAKK. The Swiss Group for Clinical Cancer Research (www.sakk.ch) is
Switzerland’s national cancer research network. Established as a non-profit organization, we have been conducting clinical studies in oncology since
1965. Through our activities we contribute to the development of new
cancer treatments and the improvement of existing treatment modalities.
7
PAST AND FUTURE
Memories of the
founding years
Claudia Herren / Communications Manager SAKK
1965 four physicians wrote history in medicine: with their chemotherapy group they founded clinical cancer research in Switzerland and
introduced oncology as a new medical discipline.
The birth of Medical Oncology in
Switzerland
Early in the 1960s, when the neighboring
countries of Switzerland started to recognize medical oncology, the start in our
country was rather tardy. At first, there
were certain isolated actions without
prosecution. Then Georg Martz appeared
in Zurich, some named him the «forefather» of Oncology. He established a medical oncology unit at the University Hospital in Zurich. Among other things, Martz
knew of the importance of psychological
Georg Martz
support for patients and therapists and
collaborated with Prof. Fritz Meerwein, a
German pioneer in psycho-oncology, in this field. These initial movements in Zurich were followed by a fast development in Oncology and
led thereafter to the foundation of SAKK – the unique and dynamic national network of which we are celebrating its 50th anniversary this year.
Inspired by American pioneers
Georg Martz had important fellow campaigners. The first was Kurt Brunner. Brunner was a collaborator of Georg Martz in
Zurich, who had met three of the American
pioneers of Medical Oncology in New York
and Buffalo: Dave Karnofsky, Jo Burchenal
and Jim Holland. Among them, he received
a rigorous training, particularly the mastering of prospective multicenter clinical trials
which were, after his return to Bern, the
basis of the newly founded SAKK. In the
academic medical setting, the research of
Martz and Brunner was well appreciated.
Kurt Brunner
Swiss politics addresses the subject of clinical cancer research
However, support was needed also from politics to boost the group’s
activities. There, two additional characters played an important role:
federal councilor Alfred Schaller and founder of the Swiss National
Science Foundation (SNF) Alexander von Muralt. Schaller presented a
motion to the National Council in which he demanded the establishment of a national tumor center. The pertinence of the cause was generally accepted but the proposed solution was judged as incompatible
with the cantonal structures in Switzerland.
The motion had therefore no direct effect but the urgency of the
subject was addressed and recognized. Support came from Prof. Alexander von Muralt. He suggested a collaboration between five University Hospitals and research in the laboratory. His initiative had a
large political support as it was financially feasible and it permitted
the involvement of the Swiss Cancer League. This was the birth of a
first laboratory group under Silvio Barandun and a chemotherapeutic
group led by Kurt Brunner.
8
The first meetings took place in the Tiefenauhospital in Bern where
Brunner had his office. The first proposition for a clinical trial was a
multiple myeloma trial. It allowed a large collection of blood samples
for Barandun’s laboratory. The number of participants increased rapidly and also young collaborators from the five member hospitals were
regularly present. These meetings were very animated and everyone
participated with great enthusiasm. Even with these modest structures, the group acquired international recognition as it was one of
the few European members of the American Acute Leukemia Group B
besides Nis Nissen in Copenhagen and Jean Bernard in Paris.
The chemotherapy group becomes SAKK
The name «SAKK» appeared in 1971 in a meeting regarding a regular
budget of the Federal Office of Public Health (FOPH) for the ISREC (Institut Suisse de Recherche Expérimentale sur le Cancer) which initiated a discussion of the need of finances for the clinical research. Brunner tried to obtain financial support but with a decentralized group
without defined structures he did not succeed. However, the FOPH
would grant a yearly allowance if the name of the group included the
word «national». That is when Brunner came up with the name «Swiss
Group for Clinical Cancer Research SAKK». The short form «SAKK»
was quickly adopted in French and English.
In the early years from 1975 to 1981,
the group had no constant office but
resided where its president worked and
the administrative support was very limited. Brunner had laid the corner stone
of the group but there was still a long
way to go. In 1975, Prof. Pierre Alberto
takes over as president of the group. As
he said himself: «I had no choice». Under
his leadership, the first permanent home
of the SAKK is found on the Rue Carouge
in Geneva. Medical statistics at that time
was still in its infancy and so Pierre AlberPierre Alberto
to hired an emeritus professor in applied
statistics, Prof. Arthur Linder, who advised the group on statistical issues. As Pierre Alberto put it, «We had no idea about medical statistics
at that time!»
Integration of all oncological disciplines
His presidency was the end of this early phase and the group transformed into a real comprehensive group with the establishment of
the pediatric, surgical, gynecological, pathological, psycho-oncological and ear- nose and throat sections. This change assigned a more
active role to the colleagues of other oncological disciplines than
being a simple deliverer of services in the framework of medical oncology. But also the appearance of trials with adjuvant treatments,
which required the participation of surgeons and gynecologists,
forged the group together. This evolution was similar to other groups
in Europe and collaboration with the EORTC (European Organisation
for Research and Treatment of Cancer) increased the activity within
Europe.
Growth and establishment of new structures
At the end of the 1970s, the group had grown considerably. The pioneering years came to an end and the group needed a central office and additional supportive staff to process the workload. With the
presidency of Prof. Franco Cavalli, the group maintained its first firm
seat in Bern and the historic era of SAKK began. The name SAKK enjoys great prominence, and the publication of crucial studies in the
fields of leukemia, colon cancer and breast cancer carry the name
SAKK out into the world. Oncology is still a young discipline and is
PAST AND FUTURE
shaped at the time by intensive collaboration, because it was only together that the individual oncology centres could also develop further
at the hospitals. Or, as Franco Cavalli said, «Everyone spoke in his or
her mother tongue at that time and was nevertheless understood by
everyone else».
Prof. Hans-Jörg Senn becomes President of
the SAKK in 1988. Hans-Jörg Senn shapes
international collaboration with the IBCSG
like no other and is regarded as the pioneer of Swiss breast cancer research.
At the same time as Prof. Urs Metzger
takes over as president in 1991 the Swiss
Institute of applied cancer research SIAK
is founded. The idea is that SAKK, SPOG
(paediatric oncology) and VSKR (Association of Swiss Cancer Registers) should be
combined and become the sole contact
partner of the federal authorities for patient-oriented cancer research.
Hans-Jörg Senn
In 1994 Prof. Aron Goldhirsch becomes president of SAKK. He sets
consistent scientific standards of clinical research and the transfer of
results to the clinical situation «by applying rigorous methodology to
interpret the results of well-designed and accurately reported studies». His credo «one for all and all for one» is legendary. Prof. Goldhirsch remains in office for 10 years.
What next for SAKK?
The introduction of the Therapeutic Products Act in 2002 puts a number of obstacles in the way of SAKK. Prof. Goldhirsch resigns from
office – the organization faces a turning point. At a meeting of the
centre directors in Zurich in 2004 the future is discussed. Prof. Richard
Herrmann agrees to take over the vacant presidency. But he makes
this conditional upon the complicated structure, with the SIAK as umbrella organization, being simplified.
40 years of SAKK – back in its old form
SAKK becomes independent again: at the meeting in autumn 2007
the delegates agree to a merger of the SIAK with the SAKK. This led,
after 16 years, to the integration of the existing SIAK organization
into the merger partnership, which is continued under the name of
SAKK.
In 2010 Prof. Beat Thürlimann takes over as President from Richard
Herrmann. Today, SAKK employs 70 people. It enrols around 1000 patients in trials every year and has a budget of 13 million francs. Since
its foundation, 25’000 patients have been treated in SAKK trials. 50
years ago, visionary leaders in cancer medicine realized that advancement of patient management requires solid understanding of the
disease and biology, vigorous testing of novel treatments, and interdisciplinary collaboration and exchange beyond state boundaries. This
remains true today, and is even more important as we move into an
era of personalized medicine.
Sources: With the kind support of: Prof. Pierre Alberto, Dr. Peter Brauchli,
Prof. Monica Castiglione, Prof. Franco Cavalli, Prof. Richard Herrmann,
Bernadette Mermillod, Prof. Urs Metzger, Prof. Hans Jörg Senn
• Kauz, Daniel: Vom Tabu zum Thema. 100 Jahre Krebsbekämpfung in der
Schweiz. Bern 2010.
• Archives of SAKK and the Swiss Cancer League.
The US-influenced beginning
of SAKK
Prof. Dr. Franco Cavalli / SAKK Past President
Oncology and chiefly medical oncology
were born after World War II in the US.
This was also due to the fact that the first
chemotherapeutic agents (mainly against
acute leukemia) were developed as a
by-product of the American military research. All the founding fathers of SAKK
were trained in the major cancer centers
in the US (Roswell Park, Memorial Sloan
Kettering and M.D. Anderson). When they
returned to Switzerland, they not only
brought back the optimistic spirit of the
American oncologists but also the belief
Franco Cavalli
that any progress in cancer treatment
required clinical research, which should be carried out in cancer centers and based on randomized trials. The particular structure of Swiss
health care, with hospitals belonging to the cantons, obliged them to
find a compromise with the Swiss government: instead of having 26
cancer centers, the central government would fund the research infrastructure of SAKK, which would correspond to something similar to a
«decentralized cancer center».
SAKK was from the very beginning a member of the CALGB (Cancer and Acute Leukemia Group B), which was led for decades by the
charismatic Jim Holland, one of the founding fathers of modern oncology. Later on, SAKK became member also of the Eastern Cooperative
Oncology Group (ECOG), which was more devoted to clinical trials
carried out in solid tumors as compared to CALGB, which had hemato-oncology as its main focus. This background explains also why
in Switzerland, in contrast to most other European countries, lymphomas and leukemias from the very beginning have been treated
rather by medical oncologists and not by hematologists. The structure
of SAKK was therefore rather similar in principle to the one of the
American cooperative groups. In the structure of the latter, however,
based on the American political philosophy, the president had much
more power than the SAKK chairperson. I remember times, when the
SAKK leaders had to fly (of course in economy!) on a rotation basis,
each at least a couple of times per year, to the meetings of CALGB
and ECOG. Through the National Cancer Institute, the American cooperative group had a financial basis, which was much more important
than that of the SAKK centers. So when clinical trials became complex,
when translational research became an important part of many trials,
when flights became much more expensive: SAKK decided at the end
of the 80s of the last century that it was no longer possible to keep
the pace to stay a full member of the American cooperative groups.
At the same time, the «European dream» started to flourish in the
old continent and at that time, the enthusiasm for Europe soon became prevalent among Swiss intellectuals, including oncologists. In
the meantime, also some of the Swiss centers had had a positive
experience in cooperating with other European centers, mainly in
phase I and II trials, which were almost impossible to carry out on a
transatlantic basis. For all these reasons, SAKK then decided to stop
participating in the US-cooperative groups and to redirect its research
activities towards Europe, mainly within EORTC.
9
PAST AND FUTURE
A new SAKK-Project:
Improving cancer therapies
with the help of the
patient’s voice
of Pharmaceutical Enterprises), interpharma and science industries published jointly the pharmaceutical cooperation index in autumn 20133. It
regulates the legal and ethical framework between the pharmaceutical
industry and patient organizations. Within the EU‘s seventh framework
program, the platform «patient partners»4 developed guidance documents and policy recommendations for fruitful partnerships between
patients’ organizations, industry and academic institutions when performing joint clinical research.5 However, the involvement of patients in
research is still in the early stages of development.
Dr. Claudia Weiss / Politics & Development SAKK CC
Introduction
The involvement of patients and patient
organizations in order to improve patient
relevance, quality and effectiveness in clinical research is undisputed. Even though
Switzerland assumed a pioneering role in
Europe with the first ever ‘Patientenstelle’ (patient position) in the late seventies,
the inclusion and respect of patients‘ interests is insubstantial compared to other
countries today. Equally, even though the
European Organization for Research and
Treatment of Cancer (EORTC) is one of the
Claudia Weiss
leading institutions in Europe with respect
for patient involvement in cancer research
projects, the European Medicines Agency has recently launched a new
framework to enhance patient interactions. The primary goal is to improve the safe and rational use of medicines and to implement policies
more suitably adapted to the patients’ needs.1 In France and the United
Kingdom, patient groups have to review and approve clinical cancer trials
before they are submitted to an ethical committee.
Similar movements have been seen in recent years in Switzerland. In
2014, the Swiss regulatory Agency Swissmedic established a patient
working group with an emphasis on providing better, safer and more
user-friendly patient information on drugs and medication. Last year,
the Swiss Clinical Trial Organization adopted the administrative base
for EUPATI (European Patients Academy on Therapeutic Innovation), a
very helpful training program in clinical research and drug development
for non-professionals. Several pharmaceutical companies are playing
an active role in assisting support groups and are beginning to launch
new programs to involve affected patients in order to better understand
the needs of affected people. As a consequence, a more efficient drug
development should be achieved2. To give these commitments ethical
guidelines, the industry umbrella organizations VIPS (Swiss Association
Patient Advocacy in Switzerland
Perhaps the most prominent and influential patient advocacy group
throughout Europe is the «Positivrat», which advocates for the optimal treatment for HIV positive patients. In Switzerland many small, individual support groups and patient advocacy organizations exist. Unfortunately they are hardly interconnected and rarely act as a unified
assembly. In recent months the «Selbsthilfe Schweiz», a Swiss-wide
generic umbrella organization, has been re-established and stands for
the needs and ideas of supporting patient groups.
SAKK Strategy
The vision of SAKK – to provide better cancer treatment for patients
– demands active integration of those that are affected. No one else
than patients themselves, their relatives and persons of reference
know better how to deal with a cancer diagnosis and live with this
diagnosis. They are better able to identify patient-relevant questions
that need answers and know better about how to improve treatment
and long-term survival. Patients themselves may have participated in
clinical trials and therefore have exceptional knowledge on how essential information on trials can be for patients. Those affected know
better what is acceptable for a person suffering from cancer in a clinical trial. And last but not least, often patients encourage other cancer-sick persons to participate in a trial.
Patient consortium
Based on those developments and reflections, SAKK now proposes a
new concept that better involves the knowledge and experience of
people affected by cancer. SAKK is currently developing a ‘consortium’
of three to five members consisting of patients and their representatives. The consortium may be involved within SAKK with the development of trial protocols, communication and strategic questions (see
figure 1). SAKK hopes this impetus will improve trial protocols and
designs with regards to patient needs. This may be the case for example when agreeing on the duration of the treatment, the number of
scheduled visits, application schemes or inclusion of patient relevant
end-points (outcome of trial). Through an adapted communication
Figure 1: three
pillar concept of
patients influence
research at SAKK
– Designing trials
– Reader-friendly patient
information
– Feasibility
Patients’ needs
10
Communication
– Which topics to address?
– How to conduct research?
– Set priorities
Trial development
Strategy
Project-based on three pillars Strategy
– Website
– General information
for patients
– Advertising for clinical
research
SAKK’s needs
PAST AND FUTURE
style, SAKK can better inform potential participants on risks and benefits of a clinical cancer trial and provide comprehensive information
to patients on clinical research.
Clinical Cancer Research in
Switzerland: the future is now
Finally, the consortium may advise the SAKK board, the SAKK project groups and the working groups with the focus on optimizing the
benefit for persons suffering from cancer. Furthermore, SAKK hopes
that the patient consortium will become an ambassador for clinical
research in oncology and will help to convince patients to participate
in clinical trials.
PD Dr. Oliver Gautschi / President Project Group Lung Cancer
SAKK is fully aware that such a consortium needs to be composed of
members well-trained in clinical research (e.g. Eupati trainees), committed to cancer research and interested in advocating the needs of
cancer patients. A careful selection and training will therefore play a
fundamental role. This consortium should be fully functional by the
end of 2016. SAKK hopes to achieve more for cancer patients by better
integrating their expertise into its own activities.
References:
1Advisor; 2005, Clinical Research, Issue 354, p2
2 Personal communication and presentation of Novartis, EUPATI Workshop,
Bern 11.12.2014
3 Verhaltenskodex der pharmazeutischen Industrie in der Schweiz über die
Zusammenarbeit mit Fachkreisen und Patientenorganisationen (PharmCooperations-Codex),
4www.patientpartner-europe.eu
5http://www.patientpartner-europe.eu/en/project-outcomes/policy-recommendations
I was invited by the SAKK to write down
my thoughts about the future of clinical
cancer research in Switzerland. Quoting
Niels Bohr (*1885), «prediction is difficult, especially about the future», which
also holds true for oncology. But there are
trends, which will continue to influence the
activities of the SAKK in the near future.
Technology, also known as «precision
medicine», is the most celebrated of all
trends in oncology. It involves diagnostics
(imaging, molecular testing, and «liquid»
Oliver Gautschi
biopsies), surgery (minimally invasive or
robotic), radiology (new interventions),
medical oncology (targeted therapy and immunotherapy), radio-oncology, and much more. If used wisely (read the ASCO’s top five list), technology can certainly benefit patients. But technology is not a solution per se,
and needs to be embedded in clinical structures. Other countries (France
for example) have national genomic programs, prevention and screening trials, and central locations for complex interventions. US President
Obama recently announced the «precision medicine initiative», including a national cohort of a million volunteers, and a program to identify
genomic drivers in cancer. SAKK is currently discussing smaller projects
in Switzerland, which may extend beyond research, into the domains of
other medical societies, and individual institutions. If implemented successfully, such structures will not only promote research, they may also
improve patient access to modern medicine, and training of health care
providers in the entire nation.
Economy is hoped to remain strong in Switzerland, but the recent decision by the Swiss National Bank (SNB) to discontinue the minimum Euro
exchange rate demonstrated that resources are not endless. Compared
with some other European countries, costs for the conduct of clinical trials in Switzerland are high. The association between high cost and high
scientific quality has yet to be proven. Global headquarters of big pharmaceutical companies reside in our country, and the maintenance of good relations will remain key to further interactions between SAKK and industry.
Politics is increasingly influential, as demonstrated by the OnkologieIVHSM (interkantonale Vereinbarung zur hochspezialisierten Medizin).
Competition between hospitals is growing, and will lead to new alliances, which can challenge the existing network. Close cooperation
with the State Secretariat for Education, Research and Innovation
(SERI), the Swiss National Science Foundation, Cancer Research Switzerland (KFS), the Cancer Leagues, and other important stakeholders
will remain vital for SAKK. At the international level, productive collaborations with IBCSG, HOVON, EORTC, ETOP, and other groups are
maintained. But when it comes to funding, the rules have changed.
I was recently invited by French colleagues to join in a European
TRANSCAN grant application. When I realized that Switzerland was
not on the list of eligible countries (note: Taiwan was eligible), I was
once again reminded of the «Masseneinwanderungsinitiative». Research in isolation is difficult, and political solutions are warranted.
Quoting Heraclitus of Ephesus (*535 B.C.), «the only thing that is constant
is change». It is up to the SAKK members to care about the future of their
organization, and to reflect upon it on the occasion of the 50 year jubilee.
11
PAST AND FUTURE
Active Against
Cancer Event
Public event in Bern
on May 20, 2015
SAKK celebrated its 50th anniversary on May 20th on Bundesplatz
in Bern. The village set up with a children’s tent, an information tent
and a marquee for guests, as well as food stalls and a stage, was
open from 3 pm to 10 pm. The varied program was hosted by former
Miss Switzerland and SAKK ambassador, Tanja Gutmann. Radio Bern
1 broadcasted live from Bundesplatz and interviewed SAKK CEO Peter
Brauchli and the musicians Luca Hänni and GUSTAV.
At the start of the jubilee celebrations, fairy story teller Prisca Saxer
mesmerized the kids in the children’s tent with the Story of Little
Muck. The well-known Swiss cartoonist and artist Ted Scapa inspired
the many curious budding young artists with amusing drawings and
handed out his children’s books. And the band Leicherchischte XXL
rounded off the children’s program with a concert.
For passers-by who wanted more detailed information on the subject
of clinical cancer research, SAKK employees were on hand in the infor-
mation tent to explain the cancer chart, answer questions and supply
visitors with flyers and brochures.
True to the motto «Active against cancer» a sports competition
was held in the evening, in which four teams competed in three
contests.
The teams were supported by the SAKK ambassadors Stefan Kobel,
Jaël Malli and Laszlo I. Kish. Dumb bells were lifted, SAKK jumped
and towers built. The winning team was anointed 50th Ambassador
of the SAKK.
But the golden jubilee of the SAKK was also celebrated with music.
Luca Hänni enthralled the audience with his new single and a rain of
confetti, before BAUM and GUSTAV rocked the stage of the «Active
against cancer» event.
Drawing with Ted Scapa
12
PAST AND FUTURE
Sports competition
Luca Hänni in Concert
13
WE BRING PROGRESS TO CANCER CARE
Cooperative study
groups: role in early drug
development
PROJECT GROUPS
PD Dr. Roger von Moos / SAKK Vice-President
PD Dr. Thomas Ruhstaller, Dr. Sabine Schmid
SAKK focuses on a total of 5 study areas,
which are represented by the project groups.
The New Anticancer Drugs Group (NAD)
holds a special position. It already focuses
now on targeted therapies that are not organ-specific and hence may be anticipating
future developments. Study groups such as
the NAD have an opportunity to develop a
new active substance not only in a certain
direction, as the pharmaceutical industry
frequently does, but they can also develop
active ingredients far more broadly. Through
integration into SAKK, these molecules can
then be brought seamlessly through to
phase II/III with another SAKK project group.
During the last 10 years more than 200 patients with breast cancer
were enrolled into 13 different SAKK trials at the Breast Center in
St.Gallen which has helped to improve our understanding of breast
cancer biology and therapeutic approaches. One example of an individual benefit for a patient due to participation in a trial is described
here.
Roger von Moos
The very early development of new drugs is internationally highly
competitive nowadays. Hence, if Switzerland wishes to play a role in
this area in the future, this will only be possible by pooling resources
and concentrating forces within Switzerland. The NAD provides an
ideal platform for this, in fact incorporating the major phase I centers
in Switzerland. The high quality of the centers is assured by auditing
and is also objectively reviewed.
Most molecules nowadays come from the pharmaceutical industry. As
well as the major international enterprises, small start-up companies
are increasingly developing new substances preclinically, which are
then successfully tested in the clinical setting by phase I trials.
Apart from the purely scientific questions, economic issues constantly
arise, but many of these companies do not have either the clinical
know-how or the financial resources to conduct such studies; this is
where SAKK can help to find a solution as a partner.
In a major project, new light has been shed on the nature of cooperation
with the pharmaceutical industry. This culminated in a large-scale project with a suitable framework agreement with Novartis. The aim was
to carry out early drug development not only by conventional means,
as has been familiar for many years, but to break new ground in order
to eliminate development times and unnecessary duplication of efforts.
This included analyzing with Novartis all the working processes from
the decision to enter phase I through to the end of the trial. Sequential processes were brought into line, unnecessary steps removed. By
including a member of the NAD in the very early decision-making processes, this was achievable and the development times were greatly
reduced. We can therefore look back on a highly successful project
and over the next few years we will try to extend this «lean research
system» to other areas and other partners.
The amalgamation of phase I centers into a national network is also
enabling us to find sufficient numbers of patients in rare indications and
we hope we will be able to succeed internationally in future in this most
competitive field. Naturally, this can only be done if all members of this
group are pulling in the same direction and put the common good of
SAKK NAD before the interests of their own clinic. I am delighted to be
part of this network for the future and I look forward to the new generation of oncologists who will go on to lead this team into the future.
14
Project Group Breast Cancer
The SAKK trial 22/99 asked the question whether in the first-line
therapy of patients with Her2-overexpressing advanced breast cancer the antibody «Herceptin» always needs to be combined with
chemotherapy, or whether it can also be given alone and chemotherapy added just at progression. This was a randomised multicentre
phase III trial assessing the efficacy, toxicity and quality of life of the
sequential administration of Herceptin alone followed by chemoimmunotherapy at the time of progression versus upfront chemoimmunotherapy.
The trial started recruiting in 2000 and was stopped prematurely in
January 2013 after enrolment of 175 patients due to insufficient accrual. Preliminary results were presented at the 2014 San Antonio
Breast Cancer Symposium (Pagani O. et al.). After a median follow-up
of 77.7 months the result showed a statistically non-significant trend
towards improvement to longer time-to-progression in the sequential
arm compared to the upfront combined therapy arm; overall survival
was not significantly different and median time with Herceptin alone
before introduction of chemotherapy in the sequential arm was 3.7
months only.
In St.Gallen a total of 56 patients were enrolled into the trial. One of
them was a 39-year old woman diagnosed with HER2-overexpressing
breast cancer with bone metastases in 2010. She was randomised
into the sequential trial arm of SAKK 22/99 in September 2010 and
therefore received Herceptin alone. After 9 weeks of treatment a complete clinical response of the primary tumour and a very good partial
response (PR) of bone lesions were documented on the CT scan and
Herceptin-monotherapy was continued. In November 2011 isolated
disease progression of the primary tumour with otherwise sustained
good PR of bone metastases was noted and surgery of the primary
tumour with palliative intention was performed. Systemic treatment
with Herceptin was continued.
Since 2011 the patient remained in very good remission continuing
Herceptin until September 2014, when treatment was stopped due
to sensory neuropathy limiting quality of life. In February 2015 the
patient is still without treatment with imaging studies showing continued remission. This patient has already been living more than four
years with metastatic Her2-overexpressing breast cancer and has still
not had any line of conventional cytotoxic chemotherapy, this as a
result of her participation in that trial.
In summary this case emphasizes the importance of clinical trials that
explore with a good biological rationale new treatment algorithms
and shows the potential unique benefit for some patients treated
within trials.
Project Group Lung Cancer
Project Group Leukemia
Dr. Martin Früh
Lung cancer continues to be the most frequent cause of cancer death
in Switzerland with approximately 4000 new cases and 3000 deaths
per year. Cisplatin-based chemotherapy has become standard of care
for patients with metastatic disease with a good performance status
after it had shown an improvement of median survival and one-year
survival of 6 weeks and 10%, respectively, in the mid-90s.
The leukemia project group (LPG) is one of the oldest project groups
of the SAKK. From the very beginning the initiators of this group came
to realize that meaningful clinical research in rare entities such as
acute and chronic leukemia can only be done within international collaborations. Thus, the LPG has always given great importance to these
international collaborations. Historically, there has been a close collaboration between the Dutch HOVON group and the SAKK resulting
in numerous publications in most prestigious medical journals. Other
important international collaborations of the LPG are with the French
ALL and APL, and the German CML and CLL study groups, all resulting
in numerous important publications.
The SAKK lung group has contributed with several important clinic
trials which were initiated in the 80s. The group demonstrated the
activity of the combination of mitomycin, vindesine, and cisplatin in
NSCLC and the feasibility and effectivity of the two alternating chemotherapy regimens of cisplatin, adriamycin and VP 16 alternating
with cyclophosphamide, methotrexate, oncovin and CCNU followed
by radiotherapy in SCLC patients (SAKK 15/84). In the 90s, landmark
cooperative group studies demonstrated the benefit of the multimodality approach mainly involving preoperative chemotherapy in patients with potentially curable stage III NSCLC. The SAKK lung group
has played a key role in improving treatment results of this important group of patients with the conduction of clinical trials. With an
excellent collaborative and multidisciplinary effort, the trials could
be performed in the vast majority of the larger Swiss Hospitals and a
few foreign institutions resulting in excellent long-term survival outcomes. These positive results were well perceived internationally and
established a widely accepted standard treatment of neoadjuvant
chemotherapy therapy with cisplatin and docetaxel in Switzerland.
With the efficacy of chemotherapy reaching a plateau at the beginning
of the millennium, the lung group attempted to explore the possibility of delaying potentially toxic chemotherapy in stage IV NSCLC and
conducted three phase II trials (SAKK 19/03, 19/05 and 19/09) evaluating the activity of gefitinib as well as erlotinib/bevacizumab before
standard chemotherapy.
The discovery of the importance of the Epidermal Growth Factor Receptor (EGFR) mutation, which was associated with sensitivity to EGFR
tyrosine kinase inhibitors in 2004, opened up the new «molecular era»
and significantly changed clinical research. The SAKK 19/09 trial, led
by Prof. Ochsenbein and the current group president, PD Gautschi, was
the first trial which selected patients according to a molecular marker
(i.e. EGFR mutation status) adopting the concept of the new era of
personalized medicine.
Several studies throughout the years have had a major impact on clinical management of leukemia patients. Just a few examples: A recent
study showed that higher dose daunorubicin is feasible and effective
in elderly patients up to the age of 65 years. Several HOVON/SAKK
trials have evaluated the role of G-CSF priming in AML patients and
transplant studies have looked both at the role of autologous and allogeneic HSCT in AML patients. For acute lymphoblastic leukemias, the
impact of transplantation as well as the addition of tyrosine kinase
inhibitors has been studied. As a merit of the excellent collaboration,
a SAKK investigator is now study chair of the GRAAPH trial looking
at patients with Philadelphia positive ALL. For CML patients, clinical
studies with participation of the SAKK could demonstrate that allogeneic transplantation is no longer the first choice in the era of tyrosine
kinase inhibitors and that the depth of molecular response has an
impact on overall survival of the patients. Given the importance of
these collaborations, the LPG will continue on this road and will try to
enlarge its portfolio for other disease entities.
However, the LPG was and is not exclusively defined by international
collaborations. There has always been an emphasis also on «Swissmade» trials. For a long time period, treatment of hairy cell leukemia with cladribine was studied by the SAKK group. The results have
shown the feasibility of subcutaneous administration of the drug,
making an outpatient treatment possible. A more recent SAKK initiated study analyzed the role of immunosuppressive therapy in patients
with myelodysplastic syndromes.
To finish, over the last decades, the LPG has shown its importance
for clinical trials in the field of leukemia. We hope to continue with
the successful work and to develop also new trials in the future to
promote research in Switzerland and within SAKK.
In order to optimally study and treat patients with a particular or rare
molecular alteration, a close collaboration among the Swiss Centers
(Swiss Lung Cancer Platform), the EORTC (European Organisation for
Research and Treatment of Cancer) and the ETOP (European Thoracic
Oncology Platform) is key and represents a strong focus of the current
lung group.
Finally, based on the positive experience of a multidisciplinary clinical
trial in mesothelioma (SAKK 17/04) two further protocols are in preparation trying to improve treatment outcomes in this rare but important
disease, of which the peak incidence is yet to come within the next
few years.
15
Project Group Lymphoma
PD Dr. Emanuele Zucca
The Project Group (PG) Lymphoma was one of the first PGs of SAKK,
created in the eighties together with the PG Leukemia. At the beginning, the main focus was the development of the collaboration with
the German Hodgkin Study group. During this collaboration many
Swiss patients were treated in the context of the German clinical trials and important achievements in the treatment of this disease have
been obtained. Most of these trials have a life-long follow-up and
we are still collecting data and information on these patients, which
underline the important improvement in the survival obtained with
novel regimens.
Similarly to Hodgkin lymphoma, also in the field of non-Hodgkin lymphoma and myeloma, the international collaboration has been the
main aspect of all the successful achievements of the group. Differently from the French, Italian and German national groups, in Switzerland we cannot enroll the number of patients needed for competitive
clinical trials in most lymphoma subtypes. Hence, the PG lymphoma
group has decided to join trials of foreign groups such as the UK Cancer Research REMoDL study or the European Mantle cell Lymphoma
group trials.
There is however a type of lymphoma that allowed the SAKK to gain
international reputation for its pioneering clinical trials. This story began in the nineties when the approval of the first anti-CD20 antibody
rituximab set a revolution for the treatment of follicular lymphoma. At
the end of this decade SAKK and the PG Lymphoma began to follow
the philosophy of avoiding chemotherapy and using the anti-CD20
antibody when treating follicular lymphoma. The SAKK trial on the use
of single agent rituximab in the treatment of follicular lymphoma provided the first ground-breaking clinical evidence for the feasibility of
the nowadays increasingly accepted, but then very innovative, concept
of a chemotherapy-free approach in this type of lymphoma. The results
of the SAKK 35/98 and its follow-on studies made the PG Lymphoma
group and SAKK well known internationally and highly respected.
Project Group
Gastrointestinal Cancers
Dr. Michael Montemurro
New drugs and combinations, multidisciplinary treatment and international collaboration, you name it, the Gastrointestinal Cancer Group
did it, bringing progress to our patients and their care. During the
past 50 years members of the group have worked intensely to define standards of care of nearly all gastrointestinal tumors. The group
investigated combining drugs in gastric, colorectal and pancreatic
cancer, maintenance therapy in colorectal cancer, targeted agents in
hepatocellular cancer and kinase inhibition in GIST. Past trials have
just recently been reanalyzed using new findings and molecular methods. Data have been pooled with other groups, as molecularly defined
subgroups call for large patient numbers.
16
Multidisciplinary treatment has been a major strength and interest of
the group. The group is taking part in a multidisciplinary rectal cancer trial which is expected to set a new standard of care by allowing
patients to be selected for radiotherapy. In the esophageal cancer trials led by the group it was shown that multidisciplinary treatment of
esophageal cancer yields excellent results and is safe in a multicentric
setting. Many Swiss patients benefit today from this standardisation
of the treatment and the resulting leap of quality of care.
The successful past is driver to prepare for the challenges ahead.
Funding, trial size and the competition for drugs and ideas is becoming more and more challenging. International collaboration (EORTC;
Alliance), concentrating on the group strengths, developing new ideas,
excellent team work and listening to our patients and their needs will
ensure that the gastrointestinal cancer group will bring progress to
cancer care also in the next 50 years.
Project Group Urogenital
Tumors
Dr. Richard Cathomas, PD Dr. Cyrill Rentsch
The treatment of patients with malignancies from the genito-urinary
tract was for many years primarily in the hands of the urologists.
Obviously they diagnose most of these diseases and primary treatment often consists of surgical interventions. Other specialists such
as radiation oncologists or medical oncologists were historically usually involved in case of palliative situations - with the exception of
local radiotherapy for prostate cancer. Systemic treatment options
were virtually nonexistent for genito-urinary tract cancers up to the
end of the 1970s when the introduction of cisplatin for the treatment
of metastatic testicular cancer transformed the field and helped to
cure most of these usually young patients. Later cisplatin-based chemotherapy was also found to be helpful for patients with metastatic
bladder cancer. For patients with advanced renal cell carcinoma or
metastatic «hormone-refractory» (now called «castration-resistant»)
prostate cancer no effective life prolonging treatments were available
until the mid-2000s.
The SAKK genito-urinary group was for many years classified as a
working group. Prof. Urs Studer, chief urologist at the Inselspital Bern,
was the driving force behind several efforts of the group. One of his
trials conducted within the SAKK (trial SAKK 08/88) is still considered one of the most important studies in prostate cancer and the
trial concept was later adopted by the EORTC. This trial questioned
whether early treatment with androgen deprivation therapy (ADT)
compared to ADT at the time of symptoms would have a significant
impact on the outcome of patients with localized prostate cancer
not suitable for treatment with surgery or radiotherapy. 197 patients
were randomized in the SAKK trial and interestingly no benefit in
terms of quality of life or overall survival could be demonstrated for
immediate ADT. 42% of the patients never required any cancer-specific treatment. The larger EORTC trial enrolled 985 patients (EORTC
30891) and essentially confirmed that immediate ADT has only a minor impact in this situation. These two trials form the basis for preventing elderly men from receiving unnecessary castration treatment
for localized disease.
In view of improved treatment options and also in view of the recognized epidemiology (prostate cancer having by far the highest incidence
and the second highest cancer mortality in men) the group was recognized as a project group in 2007. The most successful recent trial was a
randomized phase III trial including 350 patients within 3 years testing
two different doses of salvage radiotherapy for localized relapse (SAKK
09/10).
Overall the group has evolved impressively over the past years reflecting the major changes and new possibilities in cancer care and clinical
cancer research in the field of genito-urinary tumors.
Project Group New
Anticancer Drugs
Prof. Dr. Cristiana Sessa
The project group (PG) New Anticancer Drugs was created with the
support of Prof. Hermann, SAKK president in 2005. At the beginning,
the main activity of the group was the participation in the Southern
Europe New Drugs Organization trials (SENDO). The main focus was
the design and coordination of phase I and First in Human (FIH) trials with translational component. At that time, the number of Swiss
sites participating in these challenging trials was very limited and for
this reason, the decision was to participate into international phase
I trials instead of designing own SAKK trials. The advantage of this
strategy was the possibility to get interesting molecules even though
the number of patients that could be treated was very limited. The
increase in legal requirements for performing phase I and FIH clinical trials and the lack of new molecules from the industry caused the
bankruptcy of the SENDO organization in 2013. In the meantime, SAKK
set up an own framework for phase I activities. With this, the group
of Swiss sites participating to phase I studies was growing. Moreover,
the group was able to take over the challenge and entered a strategic
collaboration with the company Novartis.
Another important achievement of the group was the development
of a concept of patient referral which was accepted by the general
assembly in November 2014. The guideline has been finalized and has
been submitted to the Ethical committee (EC) to obtain their approval.
Once this guideline is implemented, the patients can be referred from
one site to another. This will facilitate the referral of patients among
the sites. This approach would increase also the competitiveness of
Switzerland for the accrual of phase I patients as nowadays, most of
the phase I trials are applying a personalized medicine approach and
patients are heavily pre-selected. Despite the huge challenges, the last
years were rather positive and successful for the group as new young
investigators joined the group and new ideas were introduced.
17
WORKING GROUPS
Working Group
Gynecological Cancer
Prof. Dr. Cristiana Sessa, PD Dr. Mathias Fehr
In the nineties, a first attempt was made to establish a gynecological
cancer working group within the SAKK. However, no international
studies have been set up and meetings of this working group were
discontinued. In the last decade the only international ovarian cancer study was organized by the Swiss-AGO, the Arbeitsgemeinschaft
für Gynäkologische Onkologie (calypso trial). Finally, on 26th November 2010 Prof. Cristiana and PD Dr. Mathias Fehr have re-established
a gynecologic tumor working group and two multicentric European
trials were activated in 2014. Due to the activity in clinical trials
SAKK was accepted as a member of ENGOT which is the European
Network of Gynecologic Oncology Trials in September 2014. Mathias
Fehr is the SAKK representative at the ENGOT meetings, whereas
Cristiana Sessa is a member of the teaching board of the Gynecologic Cancer Academy which is the teaching section of ENGOT. Both
the activated studies, which assess the value of different combination chemotherapies in platinum sensitive recurrent ovarian cancer,
are accruing well in Switzerland. The success of the working group
indicates the interest of a multidisciplinary approach to the management of gynecologic cancer.
cycles of cisplatin could be applied in the majority of the patients,
and acute as well as late toxicity was not increased by the combination of both modalities. With this trial, a further step towards the
standard of care in combined radiation and chemotherapy has been
made. At the same time it became obvious, that the combination of
an accelerated regimen with chemotherapy may not be superior in
all head and neck cancers, but only in oropharyngeal cancer (Staar
et al.).
Very recently, the late and final results of the RTOG were published
to clarify if there is a superiority of hyperfractionation in combination
with concurrent chemotherapy in comparison to standard fractionated
radiation therapy. It could be demonstrated that there seems no need
for an altered fractionation schedule when radio- and chemotherapy
are simultaneously applied (Nguyen-Tan et al.). So, the Working Group
of SAKK on Head Neck Cancer could prove, as one of the first clinical
groups worldwide, that the combination of radiotherapy and chemotherapy is the best conservative therapy for advanced head and neck
cancer.
Furthermore, the recent results of a long term follow-up of SAKK
10/94 could demonstrate the importance of weight loss and physical
examination still being of value in the era of extraordinary technically
driven medicine: risk factors and prognostic factors that should be
taken into account while creating future trials (Ghadjar et al.).
Working Group Sarcoma
Dr. Christian Rothermundt
Working Group Head
and Neck Cancer
Prof. Dr. Frank Zimmermann
Patients with locally advanced head and neck cancer have a dismal
prognosis, with a 5-year overall survival far below 50 %. During the
last 20 years some important results of clinical trials have been published, influencing the treatment strategy in this type of tumor until
nowadays.
Today, the predominant and preferred therapy in locally and regionally
advanced cancer is combined radiation-chemotherapy. This was not
standard in the early 1990s, when the trial SAKK 10/94 was designed
(Huguenin et al.). At that time, hyperfractionated radiation therapy
was standard of care, when no combined treatment was considered,
mainly based on skepticism about an increased and non-manageable
toxicity of the combined treatment. Several randomized phase-III trials were needed, making it obvious that combined chemo- and radiation therapy is superior to pure radiation therapy alone in local tumor
control, recurrence-free survival, distant recurrence-free survival, and
finally also overall survival (Denis et al., Huguenin et al., Olmi et al.)
and also that it is feasible for the majority of patients.
Owing to the rarity and heterogeneity of sarcomas, trial acitivities in
this tumour entity are a challenge. Starting in the early 80s several
Swiss and international sarcoma studies were performed within SAKK.
A phase-1 trial to assess the combination of high-dose ifosfamide and
doxorubicin was an important step considering that these drugs are
still the mainstay of sarcoma treatment nowadays. The data were published in Annals of Oncology in 1998 by several well known authors:
S. Leyvraz, M. Bacchi, T. Cerny, A. Lissoni, C. Sessa, A. Bressoud and R.
Hermann. A charming sidenote: the authors thanked Ms. M. Gonin for
typing the manuscript. From 1996 to 2009 SAKK collaborated with
EORTC and with the European Ewing tumour Working Initiative of National Groups.
Just recently, SAKK enrolled patients in an international multicentre
trial to compare standard treatment doxorubicin with the combination gemcitabine/docetaxel in patients with advanced and metastatic soft tissue sarcoma. In a very short period of 8 months 8 patients
were recruited into this trial. The results will be presented at ASCO
2015.
The challenge continues and the enthusiastic and active members of
the Working Group Sarcoma are striving to bring new trials to Switzerland – trying to improve the care of patients with sarcoma and to
incorporate novel insights into daily practise.
The SAKK trial was one of these important trials, presenting convincing results with both chemo- and radiation therapy together. Two full
18
19
SECTIONS
Network for Cancer
Predisposition Testing and
Counseling
PD Dr. Pierre O. Chappuis
Over the last 25 years, major progress has been noted in the field of
genetic predisposition to cancer. For more than 15 years, thanks to the
support of the SAKK, the Network of CPTC has largely contributed to
the development of predictive oncology. Currently, 18 centers provide
genetic counseling and evaluation for cancer predisposition genetic
testing throughout Switzerland in accordance with the Swiss regulation.
The aims of the Network for CPTC are: 1) to harmonize the clinical
practice of counseling and management of at-risk individuals according to international guidelines; 2) to collect clinical and molecular
data from individuals and families with inherited cancer predisposing
syndromes; 3) to consolidate the collaboration with molecular geneticists in charge of cancer predisposition testing; 4) to participate in trials evaluating the impact of surveillance and risk reduction strategies
(e.g. the CAPP2 and IBIS II-Prevention and DCIS trials); 5) to inform
and educate health professionals and the lay community on predictive
oncology.
Network for Outcomes
Research
Dr. Klazien Matter-Walstra, Prof. Dr. Bernhard C. Pestalozzi
The Network for Outcomes Research of SAKK is committed to doing
research in the field of health economics alongside clinical SAKK trials
as well as health services research concerning the supply and demand
of health care delivered to Swiss cancer patients.
Documenting costs for new treatment strategies has become an important pillar in clinical research and can guide physicians, patients
and policy makers in the decision processes to choose the optimal
effective and cost-effective treatment strategies. Within Switzerland
SAKK holds a pioneering position in this field by performing such
analyses prospectively alongside SAKK trials. First results on treatment
costs have been published for several studies. For further studies data
collection and analysis is ongoing.
The first health services research project we performed was about the
delivery of care to Swiss cancer patients during the last 30 days prior
to death (End-of-Life care). By means of health insurance data and the
identification of cancer patients with the help of cancer registries from
four cantons, several aspects of delivered care at the end of life have
been studied. This large study showed that within Switzerland the delivery and utilization of care shows significant differences between
the four cantons that were analyzed. We were able to uncover the fact
20
that the intensity with which cancer patients are treated near the end
of life is influenced by where the patient lives and in what hospital he
or she is treated. Moreover, such data may initiate a reflection process
on treatment practices among the Swiss oncology community.
The research performed by the Network for Outcomes Research concerns a young discipline and it has been performed within SAKK for
less than ten years. Results obtained during this short period of time
have been presented in several publications and meeting contributions. In the near future many may follow.
Section Pathology
Prof. Dr. Achim Weber
The Section Pathology is active on several levels within SAKK. Some
SAKK studies are initiated and led by pathologists such as the SAKK
28/12 trial, a standardization project for Ki-67 assessment in G2 breast
cancer which is expected to provide a still lacking solid data basis for
Ki-67 assessment in breast cancer and as such to have an impact on
daily practice decision making for breast cancer treatment. The majority of SAKK trials have a translational part in which tumor tissues are
analyzed by pathologists for defined histological, immunohistochemical or molecular markers with respect to their prognostic or predictive
value. Most tumor tissues analyzed in translational studies are stored
in biobanks or archives physically located in pathology institutes. In
the past, the translational part of SAKK trials has provided clinically
relevant information in many cases. For example, in the SAKK 50/07
trials, a multicentre phase II trial on first-line temozolomide combined
with bevacizumab in metastatic melanoma, it has been found that
response and overall survival were significantly higher in patients with
BRAF wild-type tumors. Finally, pathologists provide input to SAKK
concept papers and guidelines carefully advising and guiding clinical
disciplines with respect to pathology-relevant topics.
Section Radio-Oncology
PD Dr. Ludwig Plasswilm, Prof. Dr. Stephan Bodis, Dr. Peter Thum
Every second cancer patients needs radiotherapy during the course of
their disease. Over the past 15 years, enormous technological – and
conceptual – advances have been made in radiation oncology. The
precision, quality and quality assurance of radiotherapy and its acceptance within the oncological core disciplines and by patients and
patient organizations have brought lasting changes to the field of radiation oncology and consolidated its role in treatment.
Since it was founded, the Section Radiation Oncology has been a sustaining partner in the performance of multimodal, multicenter therapeutic trials run by SAKK. A significant contribution to the multidisciplinary approach of the SAKK from the point of view of radiation
oncology was the decision in 2000 to have a permanent radiation
oncology representative on the SAKK Board.
Over the past 15 years, representatives of the field of radiation oncology have been increasingly successful in their involvement in multidisciplinary studies. An important fundamental aspect of this was and is
our commitment to quality assurance measures throughout the entire
process of clinical testing. Radiation oncology has set new national
and international standards, also for other disciplines.
For the past 25 years, we have also been involved with great interest
in treatment protocols developed by the German Hodgkin’s Disease
Study Group.
Section Surgery
Prof. Dr. Walter Marti
Surgeons have been contributing actively to SAKK for many years: For
instance, Prof. Urs Metzger, former Head of Department of Surgery
in the Stadtspital Triemli Zürich, served as President in the early 90s;
later, Prof. Markus Zuber, Department of Surgery, Kantonsspital Olten,
served as an intermediate President in early 2000s and as Vice President of SAKK from 2001 – 2007.
Within the Section of Surgery the main focus of research was the improvement of colorectal cancer surgery. Two examples are listed below:
From 1987 - 1993 patients were randomized in a prospective controlled
trial on adjuvant chemotherapy for R0-resected colorectal cancers (SAKK
40/87). The combined data of this and the previous study revealed that
the donation of blood transfusions in patients with colorectal cancer
has continuously been handled more and more restrictively. Interestingly, in the registration study (SAKK 40/88) of resected colorectal cancer patients a high surgeon’s caseload was not significantly beneficial
in outcome, as it was in the two previous randomized controlled trials.
The trial SAKK 40/04, the most recent trial of the Section of Surgery,
was closed for accrual in 2014 after having included 336 patients.
With this randomized controlled prospective phase III study clinical
function after total mesorectal excision was assessed. Three different
types of rectal reconstructions (side-to-end anastomosis, 5cm colon-Jpouch and straight coloanal anastomosis) were compared. The primary
endpoint is defecation quality (evacuation problems / fragmentation
of stools) measured by a composite evacuation score. Surgery-related
mortality and morbidity, short- and midterm quality of life and clinical
outcomes are the secondary endpoints.
So far all published trials evaluating the question of the best reconstruction technique after total mesorectal excision of this trial have
included a smaller number of patients, resulting in insufficient statistical power to draw a clear conclusion. Moreover, functional outcome
was usually measured by the involved surgeon himself. In this study
data is ascertained by phone interview and collected centrally by independent study nurses unaware of the reconstruction method. This
results in an unbiased and standardized evaluation of anorectal function after rectal replacement.
In total 15 centers randomized patients into this trial. We are looking
forward to the data analysis starting by the end of 2015 investigating
the primary endpoint of this study. A future challenge will be to attract
the new generation of surgeons to actively take part in oncosurgical
research within the structure of the Section of Surgery.
MEMBER CENTERS - THE
NATIONAL NETWORK OF
SAKK
Baden
Dr. Clemens Caspar
The Kantonsspital Baden (KSB) is proud to be a member of SAKK. We
are convinced that the participation in clinical trials is an important
criterion of quality and that it contributes to the continuous improvement in patient care – not only by increasing our knowledge from
trial results but also through participation in the process of the trials.
We think that a particular strength of SAKK is the ability to conduct a
clinical trial in a real world setting.
The KSB offers medical services mainly for patients of the eastern
Canton Aargau with around 350’000 inhabitants. These services are
provided in a well-structured interdisciplinary and inter-professional
network, also in collaboration with external health care providers and
institutions. To ensure the continuous development of quality, a breast
cancer center and a colorectal cancer center were founded and certified (German Cancer Society and Swiss Cancer League). The establishment and certification of a cancer center at the KSB is in progress.
We see it as an important task to provide access to new methods of
diagnostics and treatment to our patients. Hence, the participation in
a SAKK clinical trial often presents the best opportunity. In addition,
the discussions in the project groups lead to a very valuable exchange
of ideas and strengthen the networking between clinicians and clinics,
enriching our daily work far beyond the participation in a trial alone.
Biel
Prof. Dr. Markus Borner
Participating in clinical research is at the essence of being a medical
oncologist. Due to well performed randomized trials, chemotherapy is
now accepted as standard treatment in most cancers despite potential toxicity. Progress was also seen in supportive measures and biologicals and predictive markers enter standard oncological practice.
Sound clinical research has made this progress visible, measurable,
and believable.
We observe every day that patients are more than happy to participate
in clinical trials. Contributing to find improved treatments for future
patients gives their suffering at least some kind of purpose. Thus, as
oncologists, we owe it to our patients to make such trial participation possible. SAKK has contributed in many ways and deserves great
gratitude for its continuous efforts. For one, it allows us to perform independent research with both patient interests and scientific progress
in mind. It has brought clinical research not only to the large teaching
hospitals but also to more peripheral and to private institutions, thus
reflecting the reality of Swiss cancer care. In addition to the usual
21
treatment efficacy trials, SAKK trials are increasingly concentrating
on patient reported outcomes and economical questions. Potentially,
many of the research questions will improve cancer care in Switzerland and outcome research will hopefully be the future focus of SAKK.
However, many regulations of the authorities are not as practical
as the care of patients in need should be. This is another important
task of an independent national research organization such as SAKK,
namely to lobby for study procedures which are pragmatic and do not
deter highly motivated patients and doctors.
Graubünden
Dr. Richard Cathomas, PD Dr. Roger von Moos
It is a privilege to be a member of SAKK – Happy Birthday and may you
prosper and flourish. And do not forget – we are SAKK.
Fribourg
Prof. Dr. Daniel Betticher, Prof. Dr. Abdelkarim Allal
Along with SAKK’s anniversary, Fribourg is celebrating important anniversaries, namely 10th birthday of the day unit of medical oncology
and 20th anniversary of the introduction of modern radio-oncology.
SAKK contributed essentially to the development of our center.
Being convinced that clinical research is necessary to improve the
quality of treatments in daily practice and to administer novel therapies to patients; we applied to become a SAKK member and were
officially accepted in 2007. In addition, we had the opportunity to
participate in the project of development of small centers allowing
us to employ a study nurse (60 %) and a data manager (60 %). This
led to the implementation of several weekly tumor boards with the
participation of all the specialists involved in the diagnostic and treatment of cancer (in order to select patients for protocol inclusion). With
this staff and the help of SAKK, we activated several protocols and
included 305 patients within seven years. Regular SAKK monitoring
meetings helped us to improve our daily work by following the protocols and standardizing our procedures. Through SAKK we became also
a member of IBCSG and ETOP.
Without doubt, the support given by SAKK helped us to develop a
small trial unit in our hospital. This increases the quality of our daily
work and gave the opportunity to our patients to receive some innovative treatments. We are looking forward to pursuing this fruitful
collaboration with SAKK. We wish SAKK a happy anniversary and all
the best for the next 50 years!
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Team Oncology Research KSG
50 years ago the Swiss Group for Clinical Cancer Research SAKK was
founded. It took another thirty years until this Swiss initiative made
its way to the south-eastern borders of Switzerland. Three of the four
national languages are spoken in Graubünden and for geographical reasons it has eleven hospitals with the central hospital in Chur
(Kantonsspital Graubünden). The specialized treatment of patients
suffering from malignant diseases was not a major priority for the
health care system in Graubünden for a long time. Until 1994, only
one specialized oncologist-hematologist practiced in Chur trying to do
his best to care for as many cancer patients as possible. One can still
find some of his fax orders sent to the small peripheral hospitals in old
notes of cancer survivors. It was not until 1995 when Dr. Fritz Egli, the
newly appointed oncological consultant at the Kantonsspital in Chur,
founded the SAKK Graubünden association. Initially, a small number
of patients were recruited mainly in breast cancer trials as well as in
lung cancer trials. With the arrival of PD Dr. Roger von Moos in 2004
the situation changed considerably: Within four years the SAKK center
Graubünden reached the top five of all Swiss recruiting centers. This
effort was rewarded with the SAKK Pfizer Prize in 2008. Clinical cancer
research is a main focus of the oncological team at the Kantonsspital Graubünden and a team of study coordinators has been built up.
SAKK Graubünden is an important part of this progress assuring that
trials are performed according to optimal GCP standards. The SAKK
coordinating center helped finance a «flying» data management with
a special grant. This was an important start-up support since the oncological team at the Kantonsspital Graubünden visits six regional hospitals on a weekly basis. With the joint forces of SAKK, most people in
the Canton can nowadays benefit from the possibility of participating
in one of the SAKK trials. The coordinating center at SAKK together
with enthusiastic physicians and research nurses made it possible
for clinical research to be brought to the most remote parts of Switzerland giving the patients in Poschiavo and Santa Maria the same
treatment opportunities to benefit from the well-known advantages
of participating in clinical trials as patients living in the city centers of
Zurich or Geneva. Bringing clinical cancer research to the people has
been proven to be more successful than sending patients far away to
academic centers and could serve as an example for other Swiss rural
regions. Certainly, in Graubünden no other clinical research in other
disease areas has been as successful and is so much appreciated by
the patients as SAKK is.
Lucerne
Dr. Ralph Winterhalder, Stéphanie Largiadèr, Evelyn Rickenbacher
Clinical research has been conducted for decades at large oncology
centers in Switzerland. Until 2004 the oncology department at Lucerne Cantonal Hospital (LUKS) had only sporadically been involved
in research projects and we recognized the importance of establishing
our own study organization. There were plenty of patients available,
but we lacked experience, financial resources and, of course, offers to
get into new research projects. However, motivation was high and the
department was aware of the significance of clinical research to the
quality of the center. In 2006 SAKK launched the project «middle sized
centers», which was funded by the Swiss Cancer League, with the aim
of promoting clinical research at interested locations. LUKS became an
official member of SAKK in 2006 during the course of this project and
the Central Swiss Cancer Research Association (Verein Krebsforschung
Zentralschweiz) was founded in 2007 by Prof. Walter Wuillemin and
Dr. Ralph Winterhalder in order to conduct clinical research in hematology and oncology at LUKS.
Founding of the association made it possible to integrate different disciplines and develop our own central study unit. Over time the number
of trials conducted at the Medical Oncology Department has grown
from 6 (2007) to a current 24 trials. Interdepartmental studies are
increasingly being performed, such as SAKK trial 63/12 in which the
study unit provides logistic support to urology colleagues. The challenge involved in the day-to-day work of a study coordinator is to
work independently, be able to work in a team, to think ahead, have
good organizational skills and be able to work in an interdisciplinary way with the nursing, secretarial and medical staff as well as the
sponsors. The declared aim is to deliver good data quality for good
analysis of study data. An important step was achieved with the DKG
(Deutsche Krebsgesellschaft) certification of the tumor center, the existing breast, pancreatic cancer and bowel cancer center as well as the
gynecology center in 2014.
Oncology Institute of
Southern Switzerland IOSI
Prof. Dr. Michele Ghielmini
The history of our Institute goes back to 1977 when Prof. Franco Cavalli created the first medical oncology unit at the hospital of Bellinzona. He had a nurse, a secretary and shortly after, he received his
first assistant, Aron Goldhirsch, whose further career is well known. In
the course of a year, this oncology department expanded to all of the
four main hospitals in Ticino and gradually acquired the facilities for
radiotherapy and later for nuclear medicine, haematology laboratory
(and later clinical department), palliative care unit, clinical research
and laboratory research.
The evolution of recent years was in the direction of higher specialization: we now have for each of the ten main diseases, one or several
specialized doctors (usually two oncologists and a radiotherapist or
haematologist) who work in a team with the other medical disciplines
Team Oncology Research IOSI
(surgeons, pneumologists, gastroenterologists, and so on). The challenge
of conducting specialized tumor boards in four hospitals is in the majority of the cases met by organizing tumor boards in teleconferences.
SAKK has played a very important role in the growth of the IOSI since
the beginning: Prof. Cavalli was SAKK president for several years, Prof.
Goldhirsch later on as well and many of our seniors have been, and
some still are, chairs of important SAKK working groups and have
also been instrumental in some of the most important SAKK trials and
publications. Today, we recruit approximately 60 patients yearly into
SAKK trials.
St.Gallen
Prof. Dr. Thomas Cerny
The «Clinic for Oncology and Hematology» at St.Gallen Cantonal
Hospital is the interdisciplinary and inter-professional platform for patient-centered, advanced, integrated oncology care of the population
of the whole of Eastern Switzerland and for many patients from the
Principality of Liechtenstein and beyond. Since integration of the two
hospitals of Rorschach and Flawil, we have an oncology presence at
all three sites and direct responsibility with outpatient and inpatient
services at all three locations.
Given the large number of clinics in the major surgical and internal
medicine disciplines, there are now over 12 established and at least
weekly interdisciplinary tumor boards. In close cooperation, work is
done according to jointly developed standards based on internationally valid diagnostic and treatment guidelines as well as best evidence.
The quality of treatment as well as innovation and teamwork are promoted through a number of joint clinical trials.
Research cooperation is well established and successful at the national level with SAKK and with various university centers and the
ETH (translational). Similarly, from the outset we work internationally with various groups of researchers and with many pharmaceutical partners in the context of joint study projects where we offer
our patients a broad range of attractive studies. Within the national
clinical research of SAKK, our center has for years been at the fore-
23
front of trial involvement and many of the studies are and have been
led and initiated by senior physicians from St.Gallen. The incumbent
SAKK President, Prof. B. Thürlimann, comes from our center. SAKK
plays a prominent role in cancer medicine in Switzerland and, with
its founding 50 years ago, actually attended the birth of oncology
in St.Gallen: at the time it was decided at the federal parliament
level that, as well as the five universities with a medical faculty,
one oncology department should be created in Eastern Switzerland
and one in Ticino. Hence, St.Gallen Canton, which was then in the
process of founding a medical academy that is still awaited to this
day, incorporated this clinic into the cantonal hospital as Clinic C of
Internal Medicine.
Thun
Dr. Daniel Rauch
pecially the involved translational research. Thun applied for a SAKK
membership being given the possibility to vote and therefore, to be
involved in future research projects. Throughout these 15 – 20 years
that Thun has participated in clinical trials we could always rely on
the professional, timely and friendly assistance from the SAKK’s staff
in a multitude of trial related questions. In 2008, we benefited from
the Flying Data Manager Service for several months and we were
very pleased with the non-bureaucratic help and the professional way
and friendly manner in which the workload was handled. With the
implementation of the Human Research Act (HRA) on January 1, 2014,
SAKK further supports the centers by submitting the documents for
new trials or amendments as well as any other official documents
to the ethics committees. The achievement of SAKK is scientifically
and politically important and with its success and strength its renown
will further increase in Switzerland and abroad. With this in mind we
look forward to another 50 years of interesting and important trials in
cancer research. Our sincere thanks go to SAKK and the whole staff
for their tireless work, support and assistance our center has benefited
from so far.
Thurgau
Dr. Christian Taverna
In the Spital Thurgau AG (STGAG), oncology treatment is performed
in both cantonal hospitals, Thurgau Canton has its own ethics committee and for several years the various weekly tumor boards of both
cantonal hospitals have been conducted jointly by video-conference.
Numerous doctors who are now represented on the tumor boards
have already been actively involved in various SAKK project groups in
the past. Participation in clinical trials has always been extremely important to them. Our activity in clinical research has increased continuously in recent years. In order to enhance our involvement in clinical
trial activity, in 2013 we applied for SAKK membership as «Zentrum
Thurgau» and were very fortunate to be accepted as a member.
Team Oncology Research STS AG
First of all, we congratulate SAKK on their 50th anniversary and their
important and successful role it plays in the fight against cancer. 50
years is a long time, especially in the field of the fast advancing and
developing clinical research. The center Thun started to occasionally
participate in SAKK and other trials in 1993 as an affiliate of the Inselspital Bern. The regular participation in clinical trials started in 2000,
two years later, Thun became an independent center and in 2010 a
full member of SAKK. During these years, we have participated in 70
SAKK trials, 20 IBCSG trials and 40 pharmaceutical trials with a total
of 750 patients. Our center has grown over recent years from 1 principal investigator, 2 Sub-Investigators and 1 study coordinator to 1
principal investigator, 5 Sub-Investigators and 3 study coordinators/
study nurses.
Thun is an intermediate center which participates in phase II, III and
IV trials and offers clinical trials for almost every tumor disease and
hematological malignancies, except head and neck tumors and acute
leukemias. The major difference from these early trials to trials in the
present time is their complexity in administration and conduct, es-
24
With the admission of Spital Thurgau AG as an SAKK member, we are
able to have a say in the research foci of SAKK and expand the exchange and cooperation with other members. It is important to us
that the smaller centers are also able to represent their concerns.
The constructive discussions with the SAKK study coordinators and
monitors as well as the exchange with the people in charge of trials
at the regular SAKK meetings have given rise to additional proposals on how to optimize structures and procedures during clinical trial
activity. With the focus on efficiency and quality of treatment, we are
able to increase our commitment to clinical cancer research, provide
our patients with the optimum treatment and maintain a high level of
motivation among the study teams.
We feel sure that, as an active SAKK member, we are best able to
ensure that cancer patients in Thurgau Canton have access to highquality clinical trials. Spital Thurgau AG intends to continue making its
contribution to clinical research and further expanding that contribution. We thank all internal and external partners for what has always
been their excellent cooperation and we wish continued, broad support for this commitment from all the offices involved.
CAREER THANKS TO SAKK
PD Dr. Dieter Köberle
I first made contact with SAKK in 1995
during my time as a clinical research assistant in the former Clinic C of St.Gallen
Cantonal Hospital (KSSG). Under the
leadership of Professor Senn, I had an
opportunity in cooperation with the consultants and the head of department to
look after patients on SAKK trials as well
as other clinical trials in the field of oncohematology. For just under two years I
gained my first experience in handling
SAKK trials and experienced the «SAKK
spirit» at the semi-annual meetings. The
Dieter Köberle
«SAKK family» appeared to me at the
time as a reasonably sized group of colleagues interested in research from the university and larger cantonal
hospitals, which in the «golden era of clinical cancer research» conducted trials in the most important tumor entities.
«SAKK enabled me to form a professional and
private network of contacts with numerous
esteemed colleagues»
After my training in Internal Medicine and Medical Oncology I became
consultant with Prof. Cerny at KSSG in 2001. One area of responsibility, which Thomas Ruhstaller and I then shared for a few years, encompassed gastrointestinal tumors. Together we regularly attended
meetings of the SAKK Group for gastrointestinal tumors. Within the
first year we had drawn up proposals for SAKK trials, which were accepted in 2002. I well remember being invited to the meeting of the
SAKK member representatives in Berne to present the proposal for a
trial on bile duct tumors (SAKK 44/02). The subsequent discussion, led
by Professor Goldhirsch, focused on the issues of whether patients
with these tumors should receive chemotherapy at all and how patients with these rare tumor diagnosis could successfully be included
in trials. As far as I was concerned, this trial became an object lesson
in writing protocols, negotiating with the sponsor, publicity at study
conferences, and not least the analysis of results and publication.
Encouraged by this experience, over subsequent years I initiated further trials in breast carcinoma (SAKK 23/03), colon carcinoma (SAKK
41/06), and hepatocellular carcinoma HCC (SAKK 77 /06 and 77/08)
and was able to supervise other additional studies as a co-principal
investigator. Trial SAKK 41/06 (bevacizumab maintenance therapy in
colorectal carcinoma) was a special trial in many respects because it
was the first time I was able to run a phase III trial that – a novelty –
was conducted in partnership with the umbrella organization of the
Swiss health insurers Santésuisse.
Alongside the growing research activity both within and outside
SAKK, my portfolio of responsibilities grew rapidly as well. The next
step was my promotion to Head of Department in 2008. The publications stacked up more and more (including 11 original publications
based on SAAK trials between 2004 and 2010). In 2011, I managed to
qualify as a professor at Bern University. My active participation in national tumor research was a key success factor in this academic step.
Involvement with SAKK also enabled me to form a professional and
private network of contacts with numerous esteemed colleagues. They
helped me to develop the perseverance and the necessary patience. It
is impossible to make any progress in clinical research without these
characteristics.
In 2012, I succeeded Professor C. Ludwig at the Claraspital in Basel.
This position involves the management of medical oncology and the
tumor center (together with Prof. Harms, Radio-oncology) but also
management of the medical clinic. The various responsibilities associated with this position enable me to create a bridge between General
Internal Medicine and specialization. The job also involves running an
«A-Klinik» with 19 training assistants and participation in executive
management. In the meantime the conditions for our own clinical
research structure at the Claraspital have been created. As our next
objective we intend to be heavily involved in SAKK trials and in the
medium term to become an SAKK member center.
At this point, I would like to express warmest thanks to SAKK as an
organization and the many colleagues who work for or with SAKK for
their excellent cooperation. We have achieved a lot together. But more
and more factors are making research difficult. So my wish is that we
all manage to revive the «SAKK spirit» of past years so that in future,
full of joy and enthusiasm, we can make our contribution towards the
shared endeavor of clinical cancer research.
PD Dr. Thomas Ruhstaller
In 1998, as a young research assistant in
St.Gallen Cantonal Hospital, I attended
my first semi-annual meeting of SAKK
which at the time was held in the Hotel
National in Lucerne. I was deeply impressed by the nature of the national collaboration and already thought I would
like to get involved in this organization.
«with SAKK I expanded and
continued developing an
esophagus research network»
Thomas Ruhstaller
In 1999, I was first taken along to a meeting of the gastrointestinal
cancer group (GI) and I have been a member of this group ever since.
After the former head of the group had left St.Gallen Cantonal Hospital, I took over his position in this research group. In 2000, I belonged
to an interdisciplinary working group, which was tasked by the then
President Arnaud Roth with producing a trial proposal for esophageal carcinomas. After several interdisciplinary sessions, we presented
two projects which were submitted to the research council (Forschungsrat – now the Board) of SAKK. At the time Aron Goldhirsch was the
SAKK President and he had nothing good to say about our proposals,
but we just managed to overcome this hurdle thanks to the support
from the centers. This resulted in the two trials SAKK 75/02 and SAKK
76/02. Another three subprojects were attached to the SAKK 75/02
trial, including PET-CT imaging, the main symptom of dysphagia and
endoscopic ultrasound in the investigations. Patients were recruited
from 2003 to 2006 and all major Swiss centers took part. This was
not exactly a matter of course – in each center the surgeon, radio-
25
therapist and oncologist had to give the project their backing – and
thus the Esophagus Network was born. Well into 2009 these projects
together yielded a total of five publications and another with a longterm follow-up is now in preparation. Many of the fellow campaigners
from the initial working group were no longer active by then, mainly
because of changing jobs to other institutions. Hence, it was left to
me to lead this esophagus trial and continue developing the network.
While the first trials served more to harmonize diagnostics and treatment in Switzerland, to become interdisciplinary and form a network,
the next project was an attempt to improve treatment with the addition of an antibody. This small phase l-ll trial (SAKK 75/06) with only
28 patients then produced a certain response internationally and was
published in the Journal of Clinical Oncology. This paved the way for
the next step, namely the planning of an international phase lll trial. In
the meantime, I have been able to make some international contacts
via poster presentations at ASCO, lectures and even critical letters to
the editor on other trials. The most important was undoubtedly my
contact with Michael Stahl, the head of a German study group. We
were then able to gain the Western Austrian Research Group AMGT
and together created the SAKK 75/08, a randomized phase lll trial
investigating the addition of the antibody tested by us versus standard therapy. The pharmaceutical company that provided the antibody
additionally supported the trial financially but as sponsor, SAKK had
the lead and provided the remaining funds for the project. A total of
300 patients were recruited from 2010 to 2014 and, during the course
of the trial, the French FFCD group was added to the trial. Over 50
centers in all were involved in this trial, 22 from Switzerland, 11 from
Germany, 7 from Austria and ultimately 12 from France. It is particularly worth mentioning that the last patient was recruited in the exact scheduled month. This compliance with the time schedule is truly
exceptional for a trimodal esophagus study. The first results from the
trial are expected in 2015.
At present we are trying to maintain our international network with
the lead of SAKK and tackle forthcoming projects. The main problem
is that an academic international trial will only be possible under the
umbrella of Horizon 2020. Hence, the obstacles are extremely high
and the future in this respect is still uncertain.
Professionally, I have always remained faithful to St.Gallen Cantonal
Hospital, apart for a two-year detour to northern England as a Consultant Medical Oncologist and a part-time appointment for three years
in Münsterlingen (TG). As well as the SAKK organization, this is certainly one of the main reasons why I have been able to expand and
continue developing this esophagus research network for nearly 15
years now. Professional stability with a certain freedom in research
and staying power are prerequisites for carrying out successful clinical
research in the longer term.
In 2006 I made an internal move in St.Gallen to the interdisciplinary
breast center, an independent operational unit. Therefore, I also joined
the Breast Cancer Project Group of SAKK. In this group I was able to
implement a project of my own, investigating a supportive measure
for the prevention of hand-foot syndrome by means of chemotherapy.
In 2012, I became President of the Breast Cancer Project Group. Owing
to the diversification of tumor entities, large adjuvant studies were
increasingly dropped for this type of tumor as well. In a brainstorming
meeting at the start of my time as president, we discussed new strategies, especially the increased focus of research on breast surgery and
radiotherapy. As a result of the discussion of our own new activities, it
was possible to re-enthuse local therapists about SAKK activities and
thereby increase the accrual of the group once more.
26
I have now been actively involved in and with the institution SAKK
for about 15 years, as project leader on a wide variety of trials, as
president of a project group and also in terms of political activities
within SAKK.
The organization SAKK enables an interested specialist to do his own
clinical trial activity, which – as long as the employer provides intellectual support and allows the necessary time – is largely dependent
on individual initiative. Newcomers can also initiate their own projects
with support from the SAKK Coordinating Center, which in turn leads
to first publications. This contrasts with abroad where you often have
to «work your way to the top» in the much larger study groups before
you can get anything moving yourself. The institution SAKK made it
possible for me to operate independently in clinical research for many
years, which meant I was able to qualify as a professor at Basel University, and it was one reason for my staying at the Zentrumspital and
specializing further in oncology.
My first contact with SAKK was as a specialist registrar in Internal Medicine. Patients with acute myeloid leukemia were
treated on the HOVON/SAKK trials and
it was clear that, as far as possible, all
patients should be treated within these
trials. I had my first direct contacts with
the SAKK Leukemia Project Group (LPG)
in 2007 and since then I have regularly
attended meetings of this group.
In these meetings I got to know the trial
landscape of leukemias in Switzerland
and was able to gain an initial insight
Georg Stüssi
into the complexity of clinical trials. In
addition, participation in SAKK was a
possible way of fostering an exchange of ideas with colleagues and
building up a network of relationships in Switzerland.
«SAKK offers the chance to develop and
implement new ideas for research»
In an initial project, we attempted to set up a trial for relapsed AML
patients. However, I learnt from this project that these trials – even if
finely conceived – do not always come to fruition. The trial proposal
was rejected by the SAKK Board because we had no guarantee that
the drug would be available throughout the whole trial. Despite this
rather frustrating experience, I would not be discouraged and continued to work in the project group. I later had an opportunity to be
involved as Swiss Trial Chair in a HOVON/SAKK study. The HOVON 103
trial is an innovative pick-the-winner concept with several parallel
phase II trials. The advantage of this design is that new substances
can be tested fairly quickly and hence, preselection of interesting
substances can be done with relatively small patient numbers. The
first experimental arm was introduced without major problems and
Switzerland relatively quickly had very good patient recruitment. Introduction of the next arm (tosedostat) proved much more difficult.
It emerged that modern concepts can be met with a lack of understanding within bureaucratic structures. The question of whether the
introduction of a new drug within the HOVON 103 trial was a matter
of a new study arm or a separate trial occupied Swissmedic and the
ethics committees for several months. Wide-ranging personal talks
and discussions with the relevant officials were needed to convince
the authorities of the trial design.
The SAKK Coordinating Center was a great help in this process. Just
when we had gained authorization from the ethics committees and
Swissmedic, the trial was temporarily suspended by the US Food and
Drug Administration (FDA) because of evidence of increased toxicity.
The drug is now available again and, after more than 3 years’ preparation, we are finally able to recruit patients to the trial once more. It is
my hope that we have been able to smooth the path for other trials
with this design as a result of this process.
In the meantime, I was elected president of the project group leukemia. We are currently endeavoring to further diversity the portfolio
of the LPG. In particular, it is the first time a trial has been realized in
the area of myeloproliferative neoplasms and this should be opened
in the spring of this year. For MDS patients we are in the process of
creating a Swiss-wide database which should act as the basis for future trials. At the same time we are trying to establish further clinical
trials for patients with MDS and AML in collaboration with HOVON in
Switzerland.
Overall, SAKK offers a very good opportunity for interested doctors
to get actively involved in clinical research. It also helps in creating
a network of collaborations at the national and international level.
However, SAKK merely provides the opportunity; the initiative and the
ideas have to come from the individual members. Once these exist,
SAKK offers the chance to develop and implement them.
PD Dr. Roger von Moos
During my training as a specialist in internal medicine, I came into close contact with clinical oncology in Limmattal
Spital and later at the University Hospital
in Zurich. I was fascinated by the professional as well as psychological challenges
with these patients, so that I decided to
complete the specialist training in oncology. While doing my further training
at St.Gallen Cantonal Hospital I was in
intensive contact with clinical research.
The development of new substances is
particularly crucial in diseases for which
Roger von Moos
standard therapies are often totally inadequate. It is not only preclinical research
and the discovery of new mechanisms of action that play a role, but ultimately the efficacy and the side effects profile in humans. Fascinated
by these aspects, I also managed to produce my first local protocol
(thalidomide and DTIC in malignant melanoma). This research project
was very soon followed by a second.
«I want to actively participate in shaping the
future of the SAKK network»
Within the SAKK framework, I was able to conduct a phase II trial that
further pursued the anti-angiogenic approach to melanoma and investigated the combination of bevacizumab with temozolomide. This trial
recruited in record time; a late-breaking abstract with oral presentation at ESMO and three publications resulted from it. After completing my specialist’s exam and gaining experience as a consultant at
St.Gallen Cantonal Hospital, I eventually took over as head of clinical research. In the technical and human sphere, I benefited hugely
from the influence of my superiors Beat Thürlimann and Thomas Cerny.
Through their support I managed to establish myself further in the
SAKK network.
After my move to Graubünden Cantonal Hospital (KSGR) as head of
department, I built up a clinical research department there. In 2008 I
was awarded the SAKK-Pfizer for successful completion of this work.
In 2014, KSGR Oncology/Hematology managed to recruit the second
most patients in Switzerland into SAKK clinical trials.
Since 2007 in the SAKK Board and since 2012 as Vice-President, I have
been able to actively participate in shaping the future of the SAKK
network. The network of SAKK has formed the cornerstone for my
academic and professional career. This bottom-up association is still
able to help interested oncologists at university hospitals but also
other oncology centers to embark on and successfully complete an
academic career. I can rightly claim that, without SAKK, I would not
be standing where I am today. This is why I want to contribute to the
further shaping of this unique, Swiss network of clinical research.
27
MY SAKK SUCCESS STORY
Prof. Dr. Miklos Pless
Perhaps the most relevant outcome of SAKK 16/96 was the formation
of a functional multidisciplinary network, including medical oncologists, radiation oncologists and thoracic surgeons, leading to a series
of successful further trials in stage III NSCLC.
In 1996, I came back from a research
fellowship in hematology in Boston and
started my training in medical oncology.
My former chief in Basel, Professor Herrmann, suggested the participation in
the SAKK semi-annual meetings, specifically, I should attend the lung cancer
sessions. I did and was impressed; at
each meeting the progress of current trials, exciting new proposals and translational research projects were presented
and discussed.
SAKK 16/96 also played a critical role in my personal career. In 1999
we discussed the possible follow-up trial, and decided to compare
neoadjuvant chemoradiotherapy to neoadjuvant chemotherapy in a
phase III trial. In the in-between meeting, the group’s president, Daniel Betticher, asked: «So who is going to write the protocol?» I gave
myself a push and volunteered (not much of a contest, since I was the
only volunteer). This was the start of a new experience: we formed a
writing committee, including Roger Stupp for the medical oncology
part, Hans-Beat Ris for surgery and Sabine Balmer Majno, Roger Kann
and René-Olivier Mirimanoff for radiation-oncology. In two meetings
we decided on the basic design of the 16/00 study, and also proposed
a separate trial for operable stage IIIB NSCLC, SAKK 16/01. The actual
writing of the protocol was time consuming and hard work, but the
Coordinating Center gave invaluable help, and essential assistance for
the statistical design. In 2001, the first patient was randomized to
what would become perhaps the longest trial in SAKK history. The
Coordinating Center gave invaluable help and assistance.
Miklos Pless
«one got to meet the Swiss leaders
in lung cancer»
I would have liked to take part, but these meetings were mostly informative, everything seemed to have been decided already. Daniel Betticher, a friend and successful oncologist at the Inselspital Bern helped
me out: «You have to come to the in-between meetings: this is where
the discussions are held and the decisions are made!»
These were completely different meetings. Fundamental, one got to
meet the Swiss leaders in lung cancer. I was welcomed and immediately included, even though I was unknown to most of them. The other
relevant aspect was that there were a lot of discussions, some of them
quite heated. These two elements automatically led to networking and
cooperation.
At one of the first meetings, we discussed the proposition for a new
study in stage IIIA/N2 non-small cell lung cancer. It was a large
phase II trial testing neoadjuvant chemotherapy with cisplatin and
docetaxel. I openly voiced my scepticism, believing that this study,
not being a phase III trial, would not teach us anything new or interesting. As it turned out, I was utterly mistaken. This trial, SAKK
16/96, would become one of the most prominent trials at the world
lung cancer meeting in Vancouver 2003. It had an important influence on the treatment of this disease and was published in a highranking journal.
28
From 2005 to 2011, I had the privilege to be the president of the lung
cancer group after Daniel Betticher had done such an excellent job as
my predecessor. Our group tried to promote young investigators and
we were tremendously fortunate as several young oncologists had
an interest in lung cancer, for example Solange Peters (now a leading
member of ETOP), Oliver Gautschi (current president of the group) and
also Martin Früh who leads the field of small cell lung cancer. In 2011,
I was elected into the SAKK board, the most important and also the
most demanding position I have held in SAKK up to now.
After almost twenty years at SAKK I can only be thankful for all the
opportunities that SAKK has offered me. My career is not particular
at all, many scientists and researchers in Switzerland had similar experiences, Daniel Betticher, Silke Gillessen, Thomas Ruhstaller, Viviane
Hess, Michele Ghielmini, Arnaud Roth, Roger von Moos and also our
president, Beat Thürlimann, just to name a few, built their career on
leading a SAKK trial.
In the meantime, Roger Stupp completed SAKK 16/01 and published it
very well, SAKK 16/08 has almost reached its accrual-goal and 16/14
is being written by another young and striving oncologist: Sacha Rothschild.
The 16/00 trial? Against all odds, it was finished after 12 years of recruitment and we will finally publish it this year in The Lancet! Happy
anniversary and all the best to SAKK!
MY SAKK SUCCESS STORY
Prof. Dr. Stefan Aebi
Stefan Aebi studied human medicine
at Bern University. Since 2011, he has
headed the Medical Oncology Department at Lucerne Cantonal Hospital and since 2014 also the certified
tumor center in Lucerne.
Stefan Aebi, you are heavily involved
in cancer research. What are your motivations?
Malignant tumors cause suffering to a
very great number of people and huge
losses to our society resulting from lost
Stefan Aebi
human lives and – less so – from the
costly treatments involved. Improved
treatment options do not appear out of blue, but they have to be
sought, researched and validated. Working on clinical or laboratory
research projects is satisfying and it trains your critical thinking (and
teaches you to put up with frustration). The time invested is not lost,
unless the research is merely for the purpose of career planning. Cancer research saves lives!
What do you hope for from cancer research?
Knowledge that prevents cancers from occurring and the practical application of that knowledge. Unfortunately, this practical application
is not a matter of course: for instance, we know that smoking causes
cancer, yet lots of people still smoke. Secondly, we need more effective
treatments that cause fewer side effects.
«Working on clinical or laboratory research
projects is satisfying and it trains your critical
thinking»
What are your wishes for cancer research?
Patients, SAKK and its partners need better conditions for research.
SAKK does clinical research, while the authorities are constantly setting up new, probably well intentioned obstacles that make it difficult
to carry out clinical research. This is why I would like to see political
support and trust for SAKK and its members, simplification of the regulations and a concentration on what matters instead of added conditions and creative interpretations of the existing legal framework.
Have there been any defining events or successes in your medical career?
As a doctor I had some outstanding teachers who shaped my thinking.
But my work is an ongoing experience, with all its successes and failures. Stand-out events are special encounters with patients, who have
probably helped me more than I have helped them, and a few successful experiments, studies and publications. These kinds of events encourage and motivate me to continue working in the field of oncology.
Did you have any role models who shaped your path as a doctor?
Yes, I had lots of role models, but it’s impossible for me to name them
all here. For example, there were the clinical role models of Professors
Truniger (Lucerne) and Preisig (Berne) whose quantitative understanding of biological processes was as important as the qualitative; Profes-
sors Lauterburg (Bern) and Howell (San Diego), from whom I learnt
about scientific working and skills, but also various others whose
thinking influenced me, such as Professors Goldhirsch (Lugano and
Milan) and Gelber (Boston) in the International Breast Cancer Study
Group and, of course, Professors Fey and Castiglione at Inselspital and
many others. You need to have a bit of luck and come into contact with
the right people.
You are active in the Breast Cancer Project Group and on the
SAKK Board. In what way did cooperation with SAKK help you?
Primarily to become part of a network of contacts with good colleagues with whom you can confidently collaborate. Obviously I also
learnt a lot about clinical research and the organizational, legal and
political framework in which clinical research can take place. SAKK
with its members at the time often helped me and this is why I am
motivated to help SAKK for my part, so that others can benefit from
their work. This is why I am active on the board. I also see that the
large hospitals make a substantial contribution to medical research
and ought to be suitably engaged with institutions such as SAKK.
What do you appreciate about the work of SAKK?
SAKK can answer questions that are very important to patients, but
are not examined by commercially interested partners in healthcare
such as the pharmaceutical companies. In clinical trials, for instance,
SAKK can investigate whether or not shorter or lower-dose treatments
deliver equally good results to standard therapies. Unlike companies,
SAKK can also investigate scientific questions whose results are not
directly reflected in financial gain for SAKK but in a growth of knowledge and which hence represent a gain for society.
What has been your experience of cooperation with SAKK?
Cooperation is usually straightforward. One challenge is communicating the decisions and deliberations of the committees of the Coordinating Center and the Board to the members. SAKK currently has a
tendency towards internal competition, towards setting up obstacles
to participation in trials and towards centralization. I view this trend
with scepticism and believe we should be even more pragmatic and
creative and that we do too little to facilitate the participation of patients and doctors in SAKK trials.
You worked in the USA for a long time. What was you experience of your time abroad?
My work in California was a long time ago. I found it extremely stimulating. I was part of a dynamic and determined team that focused
wholly on molecular aspects of the pharmacology of cytostatics. The
culture of discussion was very different from in Switzerland; anyone
could put forward well-founded opinions and thoughts in the laboratory and clinical discussions; we are much closer to this culture in
Switzerland now than we were 20 years ago. The number of people
collaborating and sharing thoughts in our small laboratory at UCSD on
certain projects was impressive. I have the impression that there are
only a few successful groups and institutes in Switzerland that bring
together such a mass of critical researchers and can be correspondingly successful.
You certainly have a very packed schedule. What do you do to
relieve the day-to-day stress?
My priority is my family and friends. Unfortunately, they can sometimes
miss out and I don’t always manage to divide my time in a way that
satisfies everyone. Music also provides a good balance and my favorite
kind is «early music». Sport is important to me too. I run regularly, I am
often out hiking and sadly only rarely get to go on skiing trips.
29
PATIENTS’ VOICE
Yvonne
Gemperle
Yvonne Gemperle is a mother of two
children and lives in Thurgau. She enjoys getting outdoors with her dog
and loves her happy family life. She
was diagnosed with breast cancer in
2002 and, after a course of chemotherapy; she took part in various trials.
pensive such cancer drugs are and feelings of guilt towards the health
insurer can actually creep in.
How were you made aware of clinical trials?
By the oncologists at St.Gallen Cantonal Hospital.
Yvonne Gemperle
How did participating in a clinical trial help you? What was
your experience of the treatment?
Thanks to taking part in clinical trials, I was given some very good
drugs which I probably would not have received otherwise and these
helped me enjoy a good, pain-free life.
You get very well informed about the new medication. I do find all
the investigations needed at the start of the trial to be rather timeconsuming. The treatments are always closely monitored and I feel I
am in safe hands.
«The treatments in a clinical trial are always
closely monitored and I feel I am in safe hands»
What do you think are the advantages of taking part?
By taking part in a clinical trial I receive new drugs free of charge that
are not covered by health insurance. I am very well monitored and the
new findings made in the clinical trials can later help other patients.
What is your motivation for taking part in a clinical trial?
Taking part in a clinical trial gives me an opportunity of getting a new
drug and the hope that this drug will be particularly effective and its
effect will last. Another motivation is to help other patients as they
are able to receive a well-researched medication. I would also like to
relieve the burden on health insurance funds because I know how ex-
What provides a counterbalance to your treatment? Where do
you find support?
I find a normal family life gives me balance. I also work part-time as a
scanner operator which I thoroughly enjoy. What’s more, I love nature
and going for long walks with my dog. In addition, I find support in
my faith.
30
AMBASSADORS
Ambassadors
SAKK is receiving energetic support in its anniversary year from 50 ambassadors, who are carrying the vision and the goals of SAKK to be public:
«We want to bring progress to cancer care!» Seven of these ambassadors are presented in brief interviews.
BAUM, Singer
Luca Hänni, Singer
Bernhard Pestalozzi, Senior Physician Medical Oncology, Zurich
University Hospital
Marc Müller, President General Practitioners of Switzerland
Bernhard Russi, Skiing legend
Catherine Berset, Trial Coordinator SAKK
Christian Stucki, Swiss Wrestler
Christine Biaggi Rudolf, Head of Clinical Project Management SAKK CC
Christoph Bieri, Swiss Wrestler
Christoph Mamot, Head of Oncology Cantonal Hospital Aarau
Christoph Renner, Hirslanden Oncocentre & Zurich, President Swiss
Tumor Institute (STI)
Christoph Rochlitz, Head of Oncology Department, Basel University
Hospital
Markus Borner, Head of Oncology & Haematology Biel
Hospital Centre
Martina Kuoni, Germanistin German philologist and literary
publicist
Mathias Schmid, Head of Oncology and Hematology Triemli
Hospital Zurich
Mathias Seger, Ice Hockey Player ZSC Lions, Captain of national
Ice Hockey Team
Nino Schurter, Mountain bike world champion
Norbert Hochreutener, President of Swiss Foundation for Clinical
Cancer Research
Philipp Baumann, Head of IT SAKK CC
Corsin Camichel, Former Ice Hockey Player
Ruedi Lustenberger, Chairman of the National Council 2014
Daniel Betticher, Head of Department of Internal Medicine and
Oncology, HFR, Hospital of Fribourg
Sandra Calmonte, Clinical Data Manager, SAKK CC
Franco Cavalli, Cancer Specialist and Scientific Director of the
Institute for Oncology in Italian-speaking Switzerland
Gabriela Manetsch, Head of Research Team, Graubünden
Cantonal Hospital
Sandro Anchisi, Head of the Department of Internal Medicine and
Geriatrics, CHVR, Valais Hospital (RSV)
Sanna Lüdi, Freestyle skier
Silvia Glaus, Patient and Study Participant
GUSTAV, Singer
Silvia Hanselmann, Clinical Research Associate (CRA) SAKK CC
Heidi Baumgartner, Clinical Research Associate SAKK CC
Stefan Kobel, Former Beach Volleyball Player, Father of 3 Children
Irma Bossart, Patient and Study Participant
Stefanie Pederiva, Senior Consultant Oncology Cantonal
Hospital Baden
Ivo Adam, Top Chef and Managing Director
Jaël Malli, Singer
Jakob Passweg, Head of Haematology Clinic University
Hospital Basel
Tanja Gutmann, TV and Event Moderator
Ted Scapa, Cartoonist
Thomas Cerny, President of Swiss Cancer Research (KFS/RSC)
Jörg Brechbühl, Clinical Research Associate SAKK CC
Tyla Durden, Pop singer
Kevin Schläpfer Ice hockey coach EHC Biel
Ursula Abgottspon, Partner of This Jenny († 15.11.2014)
Klazien W.Matter-Walstra, Network Outcomes Research, SAKK CC
Wendy Holdener, Downhill Skier
Laszlo I. KIsh, Actor, director and communication trainer
Winning team sport activity 20.05.15
Leierchischte, Roland Schwab & Ueli von Allmen, Musicians
Yvonne Gemperle, Patient and Study Participant
31
AMBASSADORS
Jaël Malli
Jaël Malli is a Swiss musician and
former lead singer of the band Lunik.
Today, the singer is performing as a
solo artist and works as a song writer
and actress.
Why are you committed to cancer research and the work of
SAKK?
As a public figure I constantly get asked to be an ambassador for a
huge variety of institutions. All these people have set themselves superb goals and are worth supporting. I would love to represent them
all. Sadly that’s not possible because then I wouldn’t get round to
making music and acting any more... So I try to choose those things
that are close to my heart and affect me personally. Cancer is a terrible
disease and has already affected various people close to me. My first
meaningful encounter with cancer happened a few years back when
my grandfather died from lung cancer after a longer stay in hospital.
As well as the obvious dream of being able to beat cancer one day, I
hope the suffering of people who are already ill can be made as bearable as possible through to the end of their life. I remember how sad I
was when my grandfather died, but also how relieved that he didn’t
have to suffer any more. There are certainly easier and more pain-free
ways of leaving this life.
I also think clarity and information would not harm anyone. Meanwhile we read every day of this or that thing causing cancer. For instance, I read in one study that certain foods were cancer-causing and
the answer was a vegan diet. When I followed a vegan diet for two
years I took B12 vitamins to avoid getting symptoms of deficiency.
Shortly after I read in another study that dietary supplements cause
cancer and a better and healthier approach is to take what the body
needs from natural foodstuffs... Nowadays it seems virtually impossible to live a «non-cancer-causing» life, however hard you try.
What do you wish for SAKK for the future?
Progress in what it does and renewed courage not to give up if no
significant progress is made in the short term. I admire people who
tenaciously pursue a goal that sometimes seems unattainable.
On May 20, SAKK celebrates its anniversary with the Active
Against Cancer Event on Bundesplatz. How will you be spending that day?
I will be there late afternoon and will be coaching one of the teams for
the «Fitness Contest». That will definitely be lots of fun for young and old.
Ursula
Abgottspon
Ursula Abgottspon is the partner of
This Jenny, former member of the
Council of States, who died from cancer. From Valais, she has three sons
and lives in Zermatt.
SAKK?
I have had personal and very close experience that cancer can strike
any of us. Even the strongest among us. It can snatch us out of the
midst of active life. When cancer is diagnosed, nothing is ever the
same again – from one second to the next. This is why supporting SAKK is close to my heart, in the hope that
we explore more and more ways of safeguarding society against this
disease. What do you hope for from cancer research?
That cancer will become less and less our enemy thanks to SAKK. What do you wish for SAKK for the future?
May they be successful in their research and retain broad, valuable
support from everywhere it is needed and practical.
Naturally I will be travelling to Bern that day and attending the event.
What is your greatest challenge?
My greatest challenge is to face up to the great loss of my partner.
Coping with the grief and supporting my sons along the way. People
need to appreciate how valuable health is and view every day as
worth living. I have to re-adjust to living without my partner. What
this loss means to me is starting out from scratch, tackling a steep
mountain climb and striking out on the best possible route.
What things about your partner This Jenny will stay with you?
I learnt an incredible amount from my partner This Jenny – like many
other fellow human beings. It was probably the most exciting and
the happiest time of my life so far. It was full of new experiences and
I never got bored for a minute! I have lots of wonderful and unique
memories that will stay with me. His zest for life, his humor, his sociability, his directness and his determination – in all situations in life
– made a huge impact on me.
Fulfilling my own high expectations every day, to be a sincere, tolerant, creative, sympathetic and helpful person. Personally I do not
engage in politics, I am not trying to cure an incurable disease, nor am
I interested in religion or shouting loud slogans at the head of demonstrations, yet it shocks me constantly what is happening now on our
planet. So I try in my own rather quiet way to make a contribution.
I firmly believe that everyone can make a big difference on a small scale.
I try to do this partly through my music. Music is my «voice» which gets
to certain people and connects them to others. That is wonderful and,
for me, it’s a good reason to keep getting up in the morning.
32
AMBASSADORS
Mathias Seger
Mathias Seger is an ice-hockey player
with the ZSC Lions and captain of the
Swiss national team. He is a father of
two children and lives with his family
in Zurich.
SAKK?
Sadly my family is also affected by cases of cancer. Cancer is one of the
major issues facing our society and, through my commitment, I would
like to draw attention to the work of SAKK.
That the treatments are improved and the disease is easier for cancer
sufferers to bear. I hope cancer will eventually cease to be so present
in our everyday life.
Continued success and progress and that they can go on researching
with such great drive as they already have.
I do not have any concrete plans yet for that day. It depends on how
the world championship goes. Either I will be back in training or I will
be indulging in a few days’ holiday with my family.
What do you see as your greatest challenge?
The education of our children and responding to their needs every day.
It is both my greatest and my most wonderful challenge.
Prof. Bernhard
Pestalozzi
Prof. Bernhard Pestalozzi, is an internationally renowned physician,
specialized in breast cancer and
gastrointestinal tumors. He is SAKK
board member since 2013 and Senior
Physician at the University Hospital in
Zurich.
SAKK?
There is a lot of room for improvement in Oncology – people suffer and people die. Cancer is one of the leading causes of death in
Switzerland, with tendency to rise. And why SAKK? SAKK is our joint
academic organization of clinical cancer research in Switzerland.
An improved life expectancy and quality of life of cancer patients.
Interdisciplinary, productive work. Reducing today’s high level of bureaucracy in our research environment. A close and effective coordination of the SAKK centers. And with it, the assurance of the excellent
further training of our young specialists.
Of course I will spend that day on Bundesplatz.
Managing my high workload in the hospital including the leadership
of my team, the research and the teaching. Remaining at the same
time a competent and humane physician, a smart and convincing superior, a perceptive clinical scientist as well as a motivating teacher in
training and further education. This is a balancing act. Research needs
dynamic people with a feverish interest. The many legal obstacles demotivate the clinical researcher. More fun and appreciation as well as
mutual motivation are needed for this task.
Ted Scapa
Ted Scapa became a well-known
personality in the 1960s and 1970s
through the children’s program «Das
Spielhaus» on Swiss television. As a
cartoonist he has drawn for the international press and published several
children’s books and collections of
cartoons. Today he works as an artist
and lives and works by Lake Morat.
SAKK?
Because I have lost several lovely people to cancer. So I think cancer
research is extremely important.
I hope they find an antidote.
Lots of success and solutions in cancer research.
Hopefully in good health I will be running a painting workshop with
children at the SAKK publicity event on Bundesplatz Bern.
Working positively and creatively with people.
33
AMBASSADORS
Kevin
Schläpfer
Kevin Schläpfer is a former ice-hockey
player and won the Swiss championship with HC Lugano. Today the fatherof-three is coach at EHC Biel.
Why are you committed to cancer research and the work of SAKK?
Cancer is a huge issue in our society and I think everyone has someone they know who is affected by cancer. New therapies and drugs are
constantly being developed and every step is very important. It bothers me that, after so many years of research and the advances made,
not every cancer is curable yet.
That cancer will finally be beaten. And until we get there, I hope that
the life expectancy and the quality of life of cancer sufferers can be
improved.
Great success in their research!
I cannot say yet what I will be doing on that day. My schedule depends
on how long my season goes on for.
What do you see as your greatest challenge?
I am father to three children. I want to help them have a good life, give
them the right values and make three good people out of them. Life is
very stressful and rushed nowadays. Everything has to move fast and
it’s all just about money. Unfortunately, interpersonal relations suffer
a lot as a result. My personal philosophy is different and I would like
to pass this on to my children. I think it would be an improvement for
our society if everyone concentrated more on humanity again.
Wendy
Holdener
Wendy Holdener is a Swiss ski racer
and since 2013 has been part of the
national team Swiss-Ski. She is particularly successful in the slalom discipline.
Why are you committed to cancer research and the work of SAKK?
Because our family and especially my brother Kevin have been affected by cancer and even now he still has frequent check-ups. You
never know what will happen or whether you will get it yourself. That
is why I would like to support cancer research.
When your brother developed cancer, how did you deal with it?
To start with I couldn’t believe what was happening. It took a moment
before I realized what was really going on. When he was doing well, I
was fine too. But to see him suffering and not be able to do anything
was bad. I tried to be with him a lot, but I still had to keep doing the
ski racing and go into training. That season I was never really on the
ball. When I think back, I didn’t fully enjoy my time spent ski racing
any more. I wanted to be at home and with Kevin instead. I think it
was all more difficult for him. That’s why I admire how he coped with
the whole thing.
Cancer researchers know exactly what they are doing, and I’m very
happy if my support can help them make advances.
Only the best! I hope they make progress step by step and are able to
make things happen in cancer research.
I will be in Majorca at a fitness camp and covering several kilometers
by bike. But I think what SAKK is doing is very important and I hope
the event is a great success.
I am always trying to do better in ski racing. I love this sport and
will constantly be facing challenges. I try to perform my sport with as
much ambition and determination as cancer researchers and cancer
patients fighting cancer. Hats off to them!
What’s more I intend to enjoy life at all times and see the positive in
everything because you never know what’s going to happen. 34
INDUSTRY POOL COOPERATION
Industry pool cooperation
Dennis Ammann / Marketing Manager SAKK
SAKK is characterized by its readiness to cooperate and, thanks to its
network structure, is creating a unique pool of specialist knowledge
and expertise in the area of clinical cancer research. In doing so, SAKK
not only works regularly with foreign centers or study groups, but also
cooperates with partners from industry in order to research new cancer therapies and constantly improve existing treatments. Both SAKK
and industry have a shared interest in making therapeutic advances.
Particularly in the case of cancer drugs, synergies can arise between
academic research groups and industry because only slightly altered
treatments can lead to results improving further or side effects being reduced. SAKK holds a central position in cooperation between
academic research groups and the pharmaceutical industry because,
due to its many years’ experience and the existing network, it is able
to conduct interdisciplinary multicenter studies investigating independent academic questions.
The cooperation between SAKK and industry is an opportunity to
achieve future progress in oncology and ultimately should always benefit the patients. SAKK maintains the industry pool in order to foster
relations with pharmaceutical companies. The purpose of the SAKK
industry pool is to create a platform for regular interchange between
SAKK and pharmaceutical firms. The members of the industry pool are
given an opportunity to enhance their visibility and recognition in the
SAKK network and to exchange ideas regularly with SAKK represen-
tatives. To do this, the members of the pool usually meet with SAKK
once a year at the SAKK Coordinating Center in Bern for a mutual
exchange of information. In addition, members have an opportunity
to foster exchanges at the SAKK half-yearly meetings with discussion
corners and satellite symposia. Furthermore, members of the industry
pool also support training and continuing professional development
and thereby ensure with SAKK that the high quality of clinical cancer
research in Switzerland is upheld.
With respect to cooperation with pharmaceutical companies, SAKK
has set clear guidelines in order to guarantee academic independence:
SAKK always focuses its work on the needs and interests of patients
and is not actively involved in the product promotion done by companies. Cooperation with pharmaceutical companies requires a written
agreement, clearly defining the rights and obligations of the contracting parties, and has objectives independent of commercial interests.
Furthermore, the people working for SAKK base their actions on the
principles of the SAMW (Swiss Agency of Medical Sciences) guideline
governing cooperation between doctors and industry. Transparency
and patient focus are central to the research activity of SAKK; against
this background SAKK welcomes efforts by the pharmaceutical industry to disclose financial contributions between the pharmaceutical industry and operators in the healthcare system in future.
Around 30 pharmaceutical companies currently belong to the SAKK
industry pool. With this anniversary, we would like to thank all our
partners for their contribution to the successful ongoing development
of SAKK as the leading institution for clinical cancer research in Switzerland. Together we are managing to strengthen Switzerland as a
research base and create understanding among the general public of
the benefits of clinical cancer research.
35
WARMEST THANKS
Warmest thanks
Peter Brauchli / SAKK CEO
Severin Strasky / Head of Fundraising & Communications SAKK
Fifty years ago SAKK was born as an innovative amalgamation of a
few centers. Today, SAKK is a Switzerland-wide network that works
with national and international centers and study groups as a cooperative group and, taking into consideration all modalities, continues
to develop tumor therapies – for the benefit of patients, for the benefit
of society.
Advances in evidence-based medicine can only be achieved by networking knowledge and experience, by promoting innovation and by
utilizing synergy effects. Therefore a basic cooperative way of thinking
and a collaborative research culture have been self-evident for SAKK
since it was founded 50 years ago – and hence the awareness that
progress in fighting cancer is only possible thanks to the interaction of
a large number of participants.
Special thanks go to the doctors, nurses and the colleagues in SAKK
centers and the SAKK Coordinating Center. In order to conduct a SAKK
trial, an investigator at the hospital must be able to rely on a strong
team of qualified professionals who have clinical trial experience and
are trained in GCP. The team often consists of other doctors and Clinical Research Coordinators (CRC) and Clinical Trial Nurses (CTN). The
CRCs and CTNs make a huge, significant and often overlooked contribution and ensure that all the operational activities specifically required for the trial can in fact be managed. The tasks of a CRC or CTN
are very diverse and require good expertise, ability to work under pressure and flexibility. Without these hard-working assistants, conducting
clinical trials as they are nowadays would become unimaginable.
We wish to express our warmest thanks to all those involved who,
through their commitment, have played their part in the advances in
the fight against cancer over recent decades.
SAKK ASSOCIATION
Mitgliederversammlung
SAKK Vorstand
Advisory Board
Mitarbeitende der SAKK
Project Groups
Breast Cancer
Lung Cancer
Leukemia
Lymphoma
Gastrointestinal Cancer
New Anticancer Drugs
Urogenital Tumors
Working Groups
CNS Tumors
Head and Neck Cancer
Imaging in Diagnostic and Therapy Monitoring
Melanoma
Sarcoma
Symptom Control and Palliative Cancer Care
Gynecological Cancer
Sections
Pathology
Surgery
Network for Cancer Predisposition Testing and Counseling
Network for Outcomes Research
Trial Chairs / Coordinating Investigator
International Advisor Project Groups
SWISS HOSPITALS WHICH CONDUCTED TRIALS IN THE YEARS 2012 TO 2015
Aarau
Aarau Kantonsspital
Olten Kantonsspital
Baden
Baden Kantonsspital
Basel
Basel Universitätsspital Bruderholz
Claraspital
Liestal Kantonsspital
BernInselspital
Engeriedspital
Oncocare Sonnenhof-Klinik
Biel
Spitalzentrum AG
Fribourg
Hôpital Fribourgeois
GenèveHUG
Graubünden
Chur Kantonsspital
Hirslanden
Aarau Hirslandenklinik
Brustzentrum Zürich Seefeld
Cham Andreasklinik
Zürich Hirslandenklinik
Zürich Im Park
36
St.Gallen
St. Gallen Kantonsspital
Tumor- und Brustzentrum ZeTuP
Thun
Simmental-Thun-Saanenland AG
Radio-Onkologie Berner Oberland
Thurgau
Münsterlingen Kantonsspital
Brustzentrum Thurgau
Frauenfeld Kantonspital
TicinoIstituto Oncologico della Svizzera Italiana
Fondazione Oncologia
Varini&Calderoni Oncology
Valais
Sion Centre Hospitalier du Centre du Valais
Brig Spitalzentrum Obervallis
Vaud
Lausanne CHUV
Winterthur
Winterthur Kantonsspital
Uster Spital
Zentralschweiz
Luzern Kantonspital
Zürich Triemli
Zürich Triemli
Zürich USZ
Zürich Universitätsspital
Spital Männedorf
WARMEST THANKS
PARTNERS
Huge thanks of course go to our partners, sponsors, foundations, donors and the industry pool for their support of the research activity
of SAKK by their participation in trial protocols or through funding:
Oncosuisse
SPOG: Schweizerische pädiatrische Onkologiegruppe
KFS: Krebsforschung Schweiz
KLS: Krebsliga Schweiz
NICER: National Institute for Cancer Epidemiology and Registration
Main Partners Collaborative Groups
ETOP: European Thoracic Oncology Platform
IBCSG: International Breast Cancer Study Group
EORTC: European Organisation for Research and Treatment of Cancer
IELSG: International Extranodal Lymphoma Study Group
HOVON: Dutch Haemato-Oncology Association
Collaboration Partners
ECPM: European Center of Pharmaceutical Medicine
SIB: Swiss Institute for Bioinformatics
IMSV: Institut für mathematische Statistik und Versicherungslehre
CTU SG: Clinical Trials Unit St.Gallen
CTU BE: Clinical Trials Unit Bern
SKAK Schweizerische Studiengruppe für Komplementäre und Alternative Methoden bei Krebs
SNHTA Swiss Network for Health Technology Assessment
SASL Swiss Association for the Study of the Liver
Foreign Cooperative Groups/Coordinating Sites
ABCSG Austrian Breast and Colorectal Cancer Study Group
AGMT Arbeitsgemeinschaft medikamentöse Tumortherapie
BIG Breast International Group
Boog Dutch Breast Cancer Research Group
CECOG Central European Cooperative Oncology Group
CESAR Central European Society for Anticancer Drug Research
Deutsche CML-Studiengruppe
EBMT European Group for Blood and Marrow Transplantation
EMN The European Myeloma Network
ENGOT European Network of Gynaecological Oncological Trial Groups
EuroEwing European Ewing tumour Working Initiative of National Groups
European APL Group (acute promyelocytic leukaemia)
European Mantle Cell Lymphoma Network
European Palliative Care Network
FFCD Fédération Francophone de la Cancérologie Digestive
GCLLSG German chronic lymphatic leukemia (CLL) Study Group
GELA Groupe d’Etude des Lymphomes de l’Adulte
GRAALL Group for Research in Adult Acute Lymphoblastic Leukemia
(Intergroup LALA/GOELAMS/SAKK)
GTCSG German Testicular Cancer Study Group
HD Deutsche Hodgkin Lymphom Studiengruppe
IBIS International Breast Cancer Intervention Study
MaNGO Mario Negri Gynecologic Oncology
MRC-CTU: Medical Research Council - Clinical Trials Unit
Alliance for Clinical Trials in Oncology
Nordic Lymphoma Group
PETACC Pan-European Trials in Alimentary Tract Cancer
SLCG Spanish Lung Cancer Group
UCL University College London
Unicancer
UoS University of Southampton
RESEARCH SUPPORT
SBFI: Staatssekretariat für Bildung, Forschung und Innovation
Stiftung Krebsforschung Schweiz
Krebsliga Schweiz
Schweizerischer Nationalfonds
Schweizer Krankenversicherer
Eugen und Elisabeth Schellenberg-Stiftung
Gateway for Cancer Research
Rising Tide Foundation for Clinical Cancer Research
Schweizerische Stiftung für Klinische Krebsforschung SSKK
Stiftung Domarena
Stiftung Empiris
Stiftung zur Krebsbekämpfung
Werner und Hedy Berger-Janser-Stiftung zur Erforschung der Krebskrankheiten
Werner Geissberger Stiftung
Weitere Stiftungen, die nicht genannt werden möchten
Individualspender
Testamentspender
Dr. Margaretha Hubacher
SAKK INDUSTRYPOOL (AS OF FEBRUARY 2015)
Amgen Switzerland AG
ARIAD Pharmaceuticals Inc.
Astellas Pharma AG
AstraZeneca AG
Bayer (Schweiz) AG
Boehringer Ingelheim (Schweiz) GmbH
Bristol-Myers Squibb SA
Celgene GmbH
Eli Lilly (Suisse) SA
GlaxoSmithKline AG
Ikopharm AG
Janssen-Cilag AG
Lipomed AG
Merck (Schweiz) AG
MSD Merck-Sharp & Dhome AG
Mundipharma Medical Company
Novartis Pharma (Schweiz) AG
Pfizer AG
PharmaMar S.A.
Pierre Fabre Pharma AG
Roche Pharma (Schweiz) AG
Sandoz Pharmaceuticals AG
Sanofi-Aventis (Schweiz) AG
Spectrum Pharmaceuticals
Takeda Pharma AG
Teva Pharma AG
Vifor AG
37
38
SPECIAL THANKS TO THE ANNIVERSARY SPONSORS
LEADING SPONSORS
PREMIUM SPONSORS
CLASSIC SPONSORS
Contact:
Swiss Group for Clinical Cancer Research SAKK
SAKK Coordinating Center
Effingerstrasse 40
CH-3008 Bern
Tel. +41 31 389 91 91
Fax +41 31 389 92 00
www.sakk.ch
[email protected]
Account for donations:
PC 60-2954422-0

50 Years SAKK Active Against Cancer!

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