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Strategic plan 2020-2022

 A PDF version of the Strategic plan 2020-2022 is available HERE
 The document was drawn up in Spring 2019

This document defines the European School of Oncology (hereinafter ESO) strategy in the triennium 2020-22. Its draft was presented and discussed during the ESO Strategic Meeting, which was held in Inveruno (Milan) on 15 February 2019, and has been adapted taking into consideration the suggestions and comments coming from the ESO Scientific Committee and the Department/Programme Coordinators.

The ESO Strategic Plan has been approved by all the members of the Executive Committee, by the Scientific Committee and Department/Programme Coordinators, and by the School’s Board of Directors and the two supporting Foundations, the ESO Foundation (ESOF) and the Fondazione per la Formazione Oncologica (FFO).

This document will become the reference text for the preparation of the next annual activity plans until 2022, with the recommendation of avoiding major deviations from its main lines.

1. Introduction

ESO is a not-for-profit scientific organization, which has no membership and that does not hold elections for its governance. According to the wish of its founders, ESO is a self-controlled and self-developing organisation, taking its direction from the decisions of its Board of Directors at the time of its establishment in 1982.

In 2016, ESO mourned the loss of Prof. Umberto Veronesi, who had the original idea of founding a European School of Oncology and served as chairman of the Scientific Committee for 30 years. Also Princess Laudomia Del Drago, first donor and founder, passed away in 2018. We will all miss the visionary intelligence and acute wisdom of Prof Veronesi and the grace of Princess Del Drago, but ESO will continue on the track they have traced.

Many things are changing in the global fight against cancer: the increase of cancer burden, but also of its awareness, worldwide; the improvement of scientific knowledge on cancer and the increasing access to research and development; the interaction with stakeholders who aim at promoting health and research policies. One of the most important challenge for ESO, which is at the same time a vast opportunity, is related to the role of technology. Due to recent developments in the field, it will be increasingly possible to make oncological education available at-a-click, to improve cancer care through better knowledge, particularly in countries with limited resources, and to focus on individual development plans. In this sense, ESO is very much committed to invest in keeping the pace with the development of technology, by increasing its e-learning offer. Moreover, with respect to carrying out projects in the developing countries, ESO is evaluating the huge opportunities that open with the possibility to transmit data. Particular focus will be given to the expansion of ESO activities in the Eastern Europe Balkan Region.

Another important goal of ESO over the next three years is related to expansion of its career development programmes (Masterclasses, Clinical Training Centres, and Certificates of Competence). This will lead to greater commitment in supporting young and promising health professionals in the development of their career in cancer care.

In order to achieve its goals, ESO aims at progressively reducing all externally sponsored activities and focus primarily on its core programme, which is supported financially by its Foundations and by private donations. In this sense, a legally independent entity, Sharing Progress in Cancer Care (SPCC) has been established in Lugano, Switzerland, under the guidance of Dr. Matti Aapro and the control of the two ESO Foundations. The aim of SPCC is to keep the relationship with industry in the educational field and to facilitate the dialogue between the ESO community and the research departments of the medical industry.

2. Organizational and structural changes at ESO

Executive Committee

The Executive Committee was established in 2014 to coordinate the activities of ESO in general and of its two offices (Milan and Bellinzona).

The Executive Committee is composed by:

- Franco Cavalli, Chair of the Scientific Committee of the Executive Committee and of the World Oncology Forum
- Alberto Costa, CEO and Department coordinator of Cancer World
- Matti Aapro, Coordinator of the sponsors’ programme (Sharing Progress in Cancer Care – SPCC), and of the Latin-American Programme
- Fedro Peccatori, Scientific Director and Programme Coordinator of Eurasia
- Alexandru Eniu, Deputy Scientific Director and Programme coordinator of the Eastern Europe, Balkan and Mediterranean Regions

These officers are responsible for transferring the decisions of the Board to the Departments/Programmes coordinators and to the ESO staff.

Scientific Committee

The members of the Scientific Committee for the period 2017-2019 have been:

Adriana Albini, Milan - Felipe A. Calvo, Pamplona - Alexander M.M. Eggermont, Paris - Stan Kaye, Sutton - Peter Naredi, Göteborg - Larry Norton, New York - Christian Rolfo, Baltimore - Lena Sharp, Stockholm (EONS) - Stephan Stilgenbauer, Ulm - Eric P. Winer, Boston - Paul Workman, London

The composition of the Scientific Committee for the strategic period 2020-2022 will include:

- Adriana Albini, Milan
- Felipe A. Calvo, Pamplona
- Stan Kaye, Sutton
- Peter Naredi, Göteborg
- Christian Rolfo, Baltimore
- EONS representative (Lena Sharp)
- Stephan Stilgenbauer, Ulm
- Fatima Cardoso, Lisbon (tbc)
- Silke Gillessen, Bellinzona (tbc)
- Eric Van Cutsem, Leuven (tbc)
- Tanja Cufer, Ljubljana (tbc)
- Joseph Gligorov, Paris (tbc)
- Holger Moch, Zürich (tbc)
- Enriqueta Felip, Barcelona (tbc)
- Leslie Fallowfield, Brighton (tbc)
- Andres Cervantes, Valencia (tbc)

An invitation letter to renew or become a member of the Scientific Committee will be sent to the above list of members.

Departments and Programmes
The operational bodies of the School are the Departments (which reflect long term or permanent sectors of activities) and the Programmes (which are usually activated on a three-year basis, renewable in case of success). Department and Programmes coordinators are listed below

Department Coordinators
Cancer World, Alberto Costa, Milan
Career development, Nicholas Pavlidis, Ioannina
e-ESO, Marco Siano, Rennaz
World Oncology Forum , Franco Cavalli, Bellinzona

Programme Coordinators
Breast Cancer, Olivia Pagani, Bellinzona
Eastern Europe, Balkan and Mediterranean Regions, Alexandru Eniu, Cluj-Napoca
Eurasia, Fedro A. Peccatori, Milan
Gynecological Cancers, Cristiana Sessa, Bellinzona
Latin-America, Matti Aapro, Genolier
Lung Cancer, Enriqueta Felip, Barcelona
Lymphoma, Emanuele Zucca, Bellinzona
Rare Tumours, Paolo Casali, Milan

3. A different way to collaborate with Pharmaceutical Industry: the new Sharing Progress in Cancer Care (SPCC)

In July 2004 ESO established the Sharing Progress in Cancer Care (SPCC) programme in order to facilitate its interactions with industry partners. Up to today, SPCC partners were required to make an annual unrestricted donation to the School. Donations from SPCC partners were pooled and used to support a number of ESO initiatives including the Masterclass in Clinical Oncology, Cancer World magazine and free or low-fee educational events. Many of these events were held in low- to middle-income countries, which are not well served by other providers of cancer education.

In order to increase its transparency, ESO has now decided to become progressively independent from any direct industry support and to shape its educational offer around the amount of private donations available each year. In this respect, SPCC will become a new non-profit organisation under the guidance of Dr. Matti Aapro. As a legally independent entity, SPCC has been established in Lugano, Switzerland, under the control of the two ESO Foundations.

Its aim is to keep the relationship with industry in the educational field, focusing on areas where collaboration between various stakeholders is pronounced and key for success, and to facilitate the dialogue between the ESO community and the research and development departments of the medical industry. Also, it will focus on the personal career development of mostly young health professional involved in oncology.

4. The School’s main educational activities

ESO’s mission has always been defined as the provision of independent, evidence based, patient oriented medical education to health professionals active in Europe and in oncology.

ESO’s Europe is a cultural rather than geographical entity and it includes:

- The European Union
- The non-EU European Countries (Norway, Switzerland, non-EU Balkans)
- The Eurasia region (essentially the former USSR)
- The other side of the Mediterranean Sea (Middle East and North Africa)
- The Spanish and Portuguese speaking Central and South America (Latin America)

ESO’s non-strictly European initiatives include:

- The World Oncology Forum, The Advanced Breast Cancer International Consensus Conference (ABC, Lisbon), The scientific magazine Cancer World

ESO’s oncological content is particularly focused on the so-called neglected areas, which are not supported, or poorly supported, and in need of cultural feeding. These are represented by:

- Advanced breast cancer
- Breast cancer in young women
- Psycho-oncology, survivorship and patient advocacy
- Screening
- Rare tumours
- Paediatric tumours
- Critical evaluation of new drugs

ESO can currently offer the following list of educational activities:

Certificates of competence
They represent the most valuable educational activity from the academic point of view because they comply with the regulations of the Bologna Higher Education System and they are endorsed by a European University. They include front teaching and self-paced distant learning for a total of 300-400 hours of study.

This term defines a full immersion, residential educational activity, with a limited number of participants and with admission by competitive application. ESO Masterclasses are organised by discipline, in collaboration with the major European scientific societies, or for specific geographical areas and their relevant educational needs.

Inside track conferences
This category currently includes conferences, targeting senior doctors and nurses in cancer medicine, organised on a biannual basis and dedicated to topics in which ESO has invested a particular cultural effort: e.g. Advanced Breast Cancer and Breast Cancer in Young Women within the Breast Cancer Programme.

e-learning (e-ESO)
A dedicated website (www.e-eso.net) provides distant learning education within the network of former participants in ESO events and further oncologists worldwide. The main feature of this department is the weekly e-session which is held every Thursday at 6.15 pm CET - live, free of charge, without commercial support, on new specific topics selected by the e-ESO Committee. Recorded material is also available from ESO events and of all the weekly e-sessions.

Clinical Training Centres (CTC) Fellowships
Planned as a logical evolution of the theoretical learning process provided by ESO educational events, this programme offers financial support to award winning doctors willing to spend from 3 to 6 months in a restricted group of European cancer centres. These centres have accepted a special agreement with ESO to ensure high standard clinical practice and scientific tutorship to its fellows.

Visiting Professorship programmes
This educational model combines academic teaching with discussion of clinical cases at the bedside of local cancer centres. The interaction between the ESO visiting professor and the team of doctors and nurses of a given centre can be very positive, with mutual scientific and cultural benefit. A standard visiting professorship activity usually lasts 2-3 days.

Refresher Courses
Educational courses of different duration (2-4 days) on specific topics, usually held in countries where there is a specific educational need (e.g. Balkan Region)

Collaboration with scientific journals
ESO has always paid particular attention to the potential of scientific journals as a key tool to reinforce the investment made by participants who have attended its educational activities. The official journal of ESO is Critical Reviews in Oncology/Hematology (CROH), which was chosen for its strong educational content. Financial support is given in exchange of free online subscriptions to ESO alumni and free advertising of ESO events. The collaboration with CROH also feeds the School’s media department and in particular it provides content for the scientific magazine Cancer World.

5. Cancer World and the training of journalists

At its meeting of 13 December 2018, the ESO Board of Directors decided to continue the current asset of Cancer World until issue 100. This will give time to rethink the whole project and to take some key decisions: reducing or closing the print version, transforming it in a periodical monograph by moving the core magazine to the online version, defining the target as only medical and health professionals (in line with the career development concept), linking the online magazine to e-ESO.

Key decision will also be to keep the magazine within the ESO core activities (hence without pharma sponsors) to involve more journalists (some of them refuse to collaborate at the moment due to the commercial funding), or to move it to the SPCC new organisation.

Training for journalists, with small ateliers in Villa Veronesi conducted by the assistant editors will also be taken in consideration.

6. The ESO Career Development Programme

One of the focuses of ESO over the next three years concerns the investment in the career development programme. The aim is to support young and promising health professionals in the development of their career in cancer care. In particular, ESO plans to expand its activities in the Eastern Europe Balkan Region.

Medical Students Educational Course in Oncology
The Medical Students Educational Course in Oncology was established in 2004. Up to 2018 16 events were organized (11 in Ioannina, 4 in Valencia and 1 in Naples). Since 2010 the courses, transferred to Valencia in 2015, have been organized in collaboration with ESMO. In 2018 Naples was added as second course site, due to the high demand. Thus, the upper limit of participants has been escalated to 90 students. The Ioannina courses were devoted to general Oncology, while Valencia/Naples courses are mainly dedicated to Medical Oncology. All courses are highly evaluated by the students, and will be continued in the next three years.

Masterclasses (MCO) in Clinical Oncology
Established in 2002, 42 events have taken place in all over the world up to 2018. MCOs are geographically classified as:

a) ESO-ESMO MCO in Clinical Oncology (17 events)
b) ESO-ESMO Eastern Europe and Balkan Region MCO (9 events)
c) ESO Arab and Southern European Countries MCO (7 events)
d) ESO Baltic and Eurasia MCO (5 events)
e) ESO-ESMO Latin America MCO (4 events)

Number of participants ranges from 40 to 60 students. All MCOs are highly evaluated by the participants and they are characterized as the “Key Educational Event” of the School.

The Clinical Training Centres (CTC)
The CTR is a Fellowship Programme dedicated to trainees who have specialized within the last five years or will complete their specialization by the start of the Fellowship. Students can be enrolled with a visiting observer status or a visiting practitioner status for 3-6 months with a grant of 2.500 euro / month. Candidates should come from either Europe, Latin America and Mediterranean African region.
At the end of 2019, 15 Centers in major European cities have agreed in hosting fellows to complete their training in different areas of oncology.

The Certificates of Competence
In cooperation with reputable European universities and with the contribution of recognized specialist physicians and scientists on breast cancer, lung cancer and lymphoma, ESO offers a diploma of competence for oncologists on the above tumours.

a) Certificate of Competence on Lymphoma, ESO and University of Ulm, German
b) Certificate of Competence on Breast Cancer, ESO and University of Ulm, Germany
c) Certificate of Competence on Lung Cancer, ESO and University of Zurich, Switzerland

7. The e-ESO Programme

The e-ESO programme was initiated in 2008 and has had a sustained development over the last years.

With the intention to provide free, easily available and high-quality learning to students and young oncologists, e-ESO was able to initially establish monthly and in the following weekly session formats, with a growing audience. Interactivity during the sessions with the possibility to ask questions live was a huge step forward and the advent of the e-ESO mobile app for later viewing the sessions enhanced its status among the oncology community.

The sessions can be watched live or at any time thereafter by streaming or downloading for better convenience in times in which more flexibility in learning is needed. More than 250 sessions are available online and slide-sets of over 400 presentations are ready for viewing and for free downloading.

Over the next years, ESO intends to strengthen and increase the e-ESO sessions, which will be held in collaboration with ESO activities. The co-operation with other European societies, patient advocacy groups will also be intensified and common sessions planned and pursued.

The mobile app and the activity on social media platform will be enhanced and expanded. Social media are an important source of information and e-ESO should enhance its activity to reach out the respective audience, which regularly uses and interacts over these platforms.

Providing high-quality learning for the oncology community worldwide remains the primary goal of e-ESO. By adapting to new technologies and communication tools, we are convinced to reach our goal and enhance knowledge within our community.

8. World Oncology Forum (WOF)

The success of the World Oncology Forum (WOF), originally conceived and designed to celebrate the 30th anniversary of ESO Foundation, went well beyond the expectations and was unanimously recognized as very special effort to give cancer the visibility it deserves on the global health policy agenda.

The WOF held in Lugano in October 2012 was cautiously announced as a one-stand event but it quickly became very clear that the 10 points of its final statement (written and published in partnership with The Lancet) would have required further discussion. Two smaller editions were therefore held in 2014 and 2015, focusing on “Treat the Treatable” and on “Prevent the Preventable”.

In 2017 ESO organized a new edition devoted to “From Science to Policy”, which came to the conclusion that a “Global Fund for Cancer” is absolutely necessary to start tackling the challenge of the worldwide looming disaster with the steadily increase of the number of cancer deaths, which is projected to be in the order of 18-19 million by 2030, whereas in 2004 the number of cancer deaths worldwide was 7.5 million.

After these four editions of WOF, the Executive Committee thought that it was time to change the format and decided to create a WOF taskforce encompassing 14 experts, which met for the first time in Inveruno, Milan, on 1-3 November 2018. The meeting was an organizational success, but from the point of view of the content only partially satisfactory. In fact, most of the data were already known and not enough new aspects emerged. The Executive Committee feels that probably the format of a taskforce is not the ideal one and decided not to carry out a WOF in 2019. While the endeavours with WOF and the related problems should continue, possibly we have to find a new format, based on successful experiences in developing cancer care in a few countries with limited resources (e.g. the ESO experience in Kyrgyzstan, which could serve as a basis for a general discussion about models and means to tackle the challenge of the global fight against cancer).

In the previous strategic plan, it was suggested to create a World Oncology Foundation, which could serve as a basis for developing activities related to WOF. However, since ESO was unable to find other organisations, which would agree to start such an endeavour, this project was abandoned. In view of the new orientation of the activities of ECCO, this idea could however now be reassessed, whereby a cooperative alliance would probably be more realistic than a creation of a new Foundation.

9. Evolution of the ESO support to the field of Advanced Breast Cancer

ESO has strongly supported the promotion of this important topic under the guidance of Dr. Fatima Cardoso. In November 2019 the 5th edition of the ABC conference will be held in Lisbon, in collaboration with ESMO. The conference has always been international (with a very relevant contribution from US experts) and has a unique programme including also health professionals other than medics and patient advocates.

ESO wishes to reaffirm its commitment to the topic of advanced breast cancer and support a further phase of its development by helping with the establishment of an independent organisation originating from the already existing ESO initiative (The Global Alliance on ABC). The new Global Alliance will most probably be based in Lisbon as a Portuguese non-profit organisation: ESO is happy to be involved with an ex officio membership in the board, a dedicated senior member of its staff and full assistance in all relevant financial issues and procedures.

ESO and Global Alliance will also continue to collaborate in the organisation of the ABC conference, which it is expected to be operationally coordinated by ESMO from 2021 but always with an ESO input at all levels.

10. The Eastern Europe and Balkan Region programme

ESO is committed to further expand the implementation of a specific programme in Eastern Europe and Balkan Region programme (EEBR) with the aim of further reducing the gap between Western and Eastern Europe. This will be achieved by improving the impact of current activities (EEBR Masterclass, refresher courses and Visiting Professorships) and introducing new-targeted activities. Clear data exists on important patient outcome differences in terms of survival, with several countries in the EEBR reporting significant worse results than Western Europe. While several issues regarding access to care still exists, at the EEBR retreat meeting (January 2019) experts from EEBR clearly highlighted several educational needs that ESO can tackle through its activities, achieving ESO’s aim of “reduction of deaths from cancer due to late diagnosis and/or inadequate treatment”.

Access to journals and textbooks remains an issue in some countries; therefore, over the next three years ESO will look into solutions to increase access to information. Fellowships that allow observership and “hands on” teaching at the bedside, in the context of working in multidisciplinary teams was highlighted as a priority for completing the training of residents in EEBR at the recent retreat, and possibly be mandatory for obtaining the ESO fellow status (see 17. ESO College). Several centres in Central/Eastern Europe are ready to participate in the Clinical Training Centres (CTC) programme by hosting fellows for a certain period: for this reason, the CTC programme will be developed to include EEBR. Moreover, pathology is crucial for the optimal care: in this respect, ESO will promote a course on pathology for clinicians.

11. The Eurasia Programme

The Eurasia Programme represents a challenging initiative that aims to create a specific programme for Eurasian countries. In these areas, particular attention is given to the selection of priorities that correspond to the specific need of each of the countries and of the societies involved. The main aim is to focus and to organise teaching educational courses on cancer types that are considered a priority issue for the population of each country, and to convene participants from all these countries and address of a variety of medical communities including specialised doctors, nurses, as well as hospital managers and administrators.

Over the next three years the Eurasia Programme aims in particular to increase its collaboration and its multidisciplinarity in teaching with RUSSCO and Saint Petersburg teams; to dedicate part of the programme and budget to Visiting Professorships in areas/cities different from Moscow and Saint Petersburg; to organise Refresher Courses in key Russian area/cities; and to continue the organization of the Masterclass in Caucasus or Baltic Region. Moreover, the Eurasia Programme intends to be a centre of diffusion for the expertise and latest knowledge in the field of cancer prevention and cure throughout the Eurasian countries, developing a web of scientific relationships and collaborations between cancer specialists in Europe and Asian countries.

12. The Gynaecologic Oncology Programme

A gynaeco-oncology programme was launched in 2019 because of the relevance of the related pathologies and following the increasing activities that ESO is undertaking in this field. The main objectives of the programme are:

1) increase multidisciplinary in the respect of the relevance of the specific therapeutic approach in each tumour type;
2) introduce new topics of general interest regardless of each tumour type (either in the masterclass, as well as in the e -learning platform and case discussions;
3) reach consistency among the different educational products (presentations at events, e -platform material) for specific tumour type and topics of general interest.

The first objective will be pursued through the collaboration with other European scientific societies active in the field of gynaecological cancer. The collaboration with the European Society of Gynaecologic Oncology (ESGO), includes joint organization of events, involvement of ESGO speakers, in particular in the Balkan and Russian masterclasses, exchange of videos and e-learning presentations and the organization of the “observatory in ovarian cancer” during the biannual ESGO congress.

The second objective will be implemented introducing new issues which are related to gynaecological cancers, including palliative care and symptoms control, relevance of molecular pharmacology, role of screening and vaccination in cervical cancer control.

The third objective will be pursued through a coordinated revision and selection of the available material and the acquisition of specific needed components. Adherence to European clinical practice guidelines for diagnosis and treatment should be one of the criteria followed in the preparation of the educational material.

13. The Latin-American Programme

In 2015 ESO reintroduced activities in Latin America with the organisation of the first ESO-ESMO Latin-American Masterclass. Since 2015, every year a Masterclass has been organised (Sao Paolo, Bogotá, San José, Mexico City, Lima).

Because of the success of the previous editions, ESO has decided to continue with the Latin-America Programme also over the next three years. The sixth edition will be held in Buenos Aires in April 2020.

14. The Lung Cancer Programme

The Lung Cancer Programme was launched in 2013 as a consequence of the considerable scientific progress in the field, of the increasing availability of early detection measures which could effectively downstage the disease with benefits in survival and of the growing demand for advocacy initiatives in favour of these patients. In cooperation with the University of Zurich, ESO organized in 2018-2019 a structured Certificate of Advanced Studies in Lung Cancer programme, which was developed with the contribution of internationally recognised physicians and scientists in oncology and in the specific field of lung cancer and other thoracic malignancies. The objectives of the CAS were:

- improve theoretical knowledge;
- enhance the competence and performance of state-of-the-art care for patients with lung cancer and other thoracic malignancies;
- provide additional skills and deep knowledge of how to design and perform clinical research in the field.

A new edition of the Lung Cancer CAS will take place in 2020-2021, with registrations opening in summer 2019.

15. The Lymphoma Programme

ESO has a long tradition of education in the diagnosis and treatment of lymphoma. The educational offer for the next three years includes the Certificate of Competence in Lymphoma. In collaboration with the University of Ulm, the Certificate provides professional development in the competence of treating lymphoma patients. The fourth edition will start in February 2019 and will conclude in April 2020.

Furthermore, the lymphoma educational programme focuses on constant updates in the fast-growing field with close interaction with the International Conference in Malignant Lymphoma (ICML), which includes the traditional pre-conference course on leukaemia and lymphoma in Ascona, Switzerland.

16. The Rare Tumours Programme

ESO is aware that medical education should tackle rarity appropriately and, for this reason, joins the worldwide movement about rare cancers. ESO is already covering paediatric cancers (all of which are rare) and haematological cancers (many of which are rare) and has now decided to set up a specific programme on rare solid cancers of the adult. There is a huge educational gap on these tumours, which ESO will try to help fill.

According to the RARECARE project, rare solid cancers of the adult make up 15% of all new cancer cases, being the following: sarcomas; rare thoracic tumours (mesothelioma, thymic neoplasms); neuroendocrine tumours; endocrine gland tumours; head & neck cancers; central nervous system neoplasms; digestive rare cancers; rare urological and male genital tumours; rare female genital cancers; rare skin cancers & non-cutaneous melanoma.

In partnership with ESMO, Rare Cancers Europe and the Istituto Nazionale Tumori of Milan, an annual Clinical Update on Rare Adult Solid Cancers course is presented as a regular appointment for updating clinical oncologists. Furthermore, in cooperation with the University of Milan and the Istituto Nazionale Tumori, a more structured programme organised will be launched. This programme will be divided into modules, whereby each module will discuss in depth the several tumour types of the field.

17. ESO College

A core value for ESO represents the career development of cancer professionals. As a strategic goal for the next period, ESO decided to create a structured educational path, which will be developed for individuals participating in ESO events. This project seems a natural response to the immense growth the ESO’s community: only in 2018, just over 2'700 participants from 85 countries attended the 25 ESO events.

With the aims of creating such an ESO network, in February 2019 the ESO College was launched. Scopes of the ESO College will be to assign titles of quality in oncology training (namely, on business cards the oncology community will be proud to write the title ESO College).

This new project falls within the larger scope of ESO’s career development program.

18. The ECCO membership and Oncopolicy

ESO feels that to promote multidisciplinarity it is vital to keep a dialogue among all specialty scientific societies and mostly the oldest and most solid: ESSO, ESTRO, EONS, ESP, SIOPE, ESGO, plus the other two major European Organisations, EORTC and OECI. ESO believes that ECCO is still the right tool to develop this coordinating action and to expand the area of the so-called oncopolicy, by continuing its programme on essential requirements for quality cancer care, the programme on workforce in oncology and others.

A member of the ESO executive committee has been elected ECCO President for 2020-21 and the School will fully support his action in all possible directions and fields.

In a broader sense, ESO would like to evaluate, among others, possible collaboration in the following fields:

- Masterclass for nurses (in collaboration with EONS)
- Critical evaluation of phase I-II studies and assessment of new drugs (in collaboration with EORTC )
- Gynaecologic oncology for Russian speaking countries (in collaboration with ESGO)
- Radiation oncology in LMIC (in collaboration with ESTRO)
- Breast cancer surgery (in collaboration with ESSO and EUSOMA)
- Communication and burnout for medics and nurses (in collaboration with IPOS)
- Immunotherapy in older adults (in collaboration with SIOG)
- Supportive and Palliative care for oncological patients: a cultural approach (in collaboration with EAPC and MASCC)
- Artificial Intelligence, Big Data and prediction of cancer (in collaboration with ECCO and AACR)
- Breast cancer in older women (in collaboration with EUSOMA and SIOG)

19. ESO: Challenges and opportunities for 2020-2022

During the ESO Strategic meeting, there were intensive and wide-ranging discussions on the future challenges and opportunities of the School. Over the next three years, ESO is therefore committed to carry out and develop its programmes and activities by keeping into consideration and tackling the following emerging topics:

Create a structured educational path
A central value for ESO represents the career development of cancer professionals. As a strategic goal for the next period, ESO has decided to develop a structured educational path, which will be developed for individuals participating in ESO events (see 17.).

Importance of internet and social media
To improve its visibility and to promote the events, ESO will improve its presence on social media and/or information channels/groups that residents currently use, maybe through the identification of a national ESO focal point of contact (ESO Ambassador). Another important use of the internet for educational purposes may be the introduction of ESO Webinars.

Developing leadership among oncologists
A lack of leadership was recognised to be a major limitation in improving cancer care (especially in in EEBR). For this reason, ESO will consider the development of a Leadership course.

The role of technology
The role of technology should be also evaluated over the next years. This is directly linked to the transmission of data (for example in projects with developing countries, e.g. Kyrgyzstan), artificial intelligence, Big Data and to the methods of early diagnosis. The ESO programmes should keep these technological factors into consideration when developing its activities.

ESO courses tend to be and should remain multidisciplinary. In this sense, courses should avoid listing 4-5 disciplines as main disciplines (also because oncologists of lower-middle income countries often cover a lot of disciplines).

Screening and prevention
ESO activities offer too few courses that deal with screening. This differs drastically from the trend for example in the UK, where instead screening is a high priority. While ESO has carried out events which include screening (e.g. event during ECCO meeting), it remains difficult to speak about prevention to oncologists. In any case, screening and prevention are evaluated by all the participants as being an important topic, which should be further developed in ESO courses. Such activities should be directed also to nurses.

Education of educators
ESO should offer more activities aimed at the education for educators. Professionalism and educations among educators may be carried out also via the universities: this is an important way to maintain education independent.

Evaluation at the end of an ESO activity
Some form of evaluation should be carried out at the end of each course in order to assess its outcome. This both on a participant level as well as on the level of the organisation. An evaluation might even help in following the students on a medium and long term.

ESO courses are given in English. This is sometimes a problem in Latin American countries and also with many professionals in Europe. ESO should evaluate the possibility to carry out courses in other languages in order to have a more elevated impact in a local context (for example, Spanish and Portuguese in Latin America).

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