11 clinical teams are located in these different sites:
Distribution by specialty of clinical activity in our partner hospitals
Moreover, the Centre d’Essai Précoce en CAncérologie (CEPEC), « Early Cancer Trials Centre (CEPEC) » is fully integrated into CARPEM and is part of the Oncology department of HEGP.
CEPEC is dedicated to early phase clinical trials (Phases I, I/II) as well as complex phase III trials (“complex” refers to trials with a high probability of serious adverse events and multiple or repeated blood tests).
It includes 2 day-hospital beds which opened in 2014, allowing to treat 147 patients : 7 phase 1, 9 phase 2 and 17 complex phase 3 clinical trials for a total of 1.361 daily stay.
Every 14 days, all the oncology departments (thoracic oncology, digestive oncology and medical oncology) have CEPEC meetings.
In January 2015, CEPEC received the authorization by the French Health Agency to run first-in human (FIH) clinical trials. The first FIH trial opened the same year. The number of ongoing FIH trials was 26 in December 2016.
The Early Cancer Trials Centre (CEPEC) has been supported by CARPEM to facilitate the recruitment of patients.
Director : Pr Stéphane Oudard / Operational Officer : Dr Yann-Alexandre Vano / Doctor for phasis 1 and 2 trials : Dr Jacques Medioni / Project leader : Mme Mara Brizard (Association Artic) / Clinical research nurse: Mme Valérie Feuillet / Follow up of toxicities : Mr Reza Elaidi (Association Artic) / « Cadre de Santé » : Mr Per-Yann Balanant
HEGP : Hôpital Européen Georges Pompidou
20, rue Leblanc, 75015 Paris
- 24 operating rooms including
- 4 ambulatory surgery wards,
- 1 surgical robot,
- 8 wards for digestive and bronchial endoscopy,
- 2 PET scans,
- 3 gamma cameras,
- 3 CT scans,
- 2 MRIs.
Necker : Hôpital Necker (département d'Hématologie)
149, Rue de Sèvres, 75015 Paris
The Necker-Enfants Malades Hospital, situated mid-way between the HEGP and Cochin Hospitals in the western Paris arrondissements which form the mainstay of Paris Descartes Medical School and the Assistance Publique-Hôpitaux de Paris (AP-HP), is both an acute and tertiary medical center for children, but also for adults with hematological, renal and infectious diseases. Opened in 1778 (Necker) and 1802 (Enfants Malades), the two structures fused in 1926 and have henceforth used this juxtapositioning to encourage synergistic interaction between adult and pediatric specialties. It has 435 pediatric and 145 adult beds. Its global oncological activity includes pediatric surgical oncology for lymphoma and solid tumors, with the largest European recruitment in neurosurgery, in collaboration with the Curie and Gustave Roussy Cancer Centers and adult hemato-oncology. Only the latter will be detailed here. The adult sector is specialized in disorders associated with immune dysfunction, be it in the context of renal or hematopoietic transplantation (over 300 transplants/year, including 96 bone marrow/stem cell auto/allotransplants) or in the context of infectious disease and hematological malignancies. These specialties work in close interaction with pediatric immuno-hematology-rheumatology, and form one of the 7 divisions (Pôles) of medical activity. Clinical activity in adult hematological oncology at Necker includes management of leukemia, lymphoma and myeloma, as well as benign hematological disorders, exemplified by the mastocytosis and immune deficiency. The Rare Disease Network covers the spectrum of benign to malignant disorders. This corresponds to over 10000 consultations/year, in-patient care in 12 high-intensity, 12 standard in-patient and 12 day-care beds.
There is a close interaction between hematology on the Cochin and Necker sites, with a clear orientation towards myeloid disorders at Cochin and lymphoid malignancies at Necker. The joint adult-pediatric hematology/immunology division reflects the unparalleled strength of the Necker Campus in integrated research in hematology and immunology. Cancer research in hematology-oncology at Necker is mainly done in the INEM https://www.institut-necker-enfants-malades.fr/ center of research (Macintyre/Asnafi team), but also at the Paris Descartes Faculty of Pharmacy (Molina team) and at IMAGINE (Hermine team). High-throughput sequencing has generated the bases of unprecedented synergy between classical genetics and hemato-oncology, as exemplified by the Descartes informatics platform (Prof. J.P. Jais and P. Nitchke), which is increasingly integrated with other bio-informatic structures at Descartes.
Clinical research in adult Hemato-oncology at the Necker hospital includes over 200 clinical trials (25% industry, 75% academic driven) but also the diagnostic laboratories covering the fields of hemato-oncology and hematopathology. The Necker hospital houses the national reference center for adult T-Acute Lymphoblastic Leukemia (GRAALL study group) and Lymphoblastic and Mantle Cell Lymphomas (LYSA study group). Prof. T. Molina is coordinator of the LYSA national adult Lymphoma Pathology Platform.
Cochin : Hôpital Cochin
27, Rue du Faubourg Saint-Jacques, 75014 Paris
The Cochin/Hôtel-Dieu Hospital Group results from the merger in January 2011 of Cochin opened in 1780 and Hôtel-Dieu, the most ancient hospital of Paris created in 651. It is a 1500 bed facility, with more than 7000 employees, including 1000 physicians. The organization of cancer and development of cancer research is the leading project of the Cochin/Hôtel-Dieu hospital. An oncology department leaded by Prof. F. Goldwasser was created in June 2011. This department deals with urology, digestive, liver and endocrine surgeries, dermatology, hepatology, gastroenterology, haematology, medical oncology and palliative care. In 2016, 6659 cancer patients were admitted in 2016 (>24h stays), among whom 4416 were new patients.
The Cochin/Hôtel-Dieu hospital ranks No. 3 in France for lung cancer surgery (1st among AP-HP hospitals in 2015), No. 1 among AP-HP hospital and among all hospitals in France for bone and soft tissue surgery (2015) and No. 4 in France (2nd in AP-HP in 2015) for urological surgery (prostate, bladder, kidney). The Cochin/Hôtel-Dieu hospital also stands out for the treatment of rare gynaecological tumors, endocrine tumors, melanoma, adult hematology, and sarcomas. An experimental pluridisciplinary outpatient unit is dedicated to the evaluation of patient requirements and treatment risks: the ARIANE center develops integrative medicine including
- professionals dedicated to patient requirements (social workers, psychologists, dieticians, pain and palliative medical doctors),
- nurses dedicated to the coordination of the overall trajectory of the patient outside the hospital,
- medical specialists (cardiologist, anesthesiologist, geriatrist, diabetologist, and medical oncologist) required for the careful evaluation of treatment risks in vulnerable patients with comorbidities.
A specific pluridisciplinary staff provides the medical synthesis and recommendations on a weekly basis. Major programs include:
- treatment education and follow-up,
- decision-making in non-curable cancer diseases,
- follow-up of patients under treatment with anti-angiogenic therapies.
The clinical activities are supported by the department of Pathology (Prof. B. Terris, Prof. D. Damotte) and by the hematology laboratory, which is a reference center for myeloid malignancies. Prof. Damotte is the coordinator of the National study of bone marrow biopsies (GEBOM). A translational research platform with all required research facilities has been created in the recently renovated Jean Dausset building. This includes the next generation sequencing platform connected to the Paris Descartes bioinformatics platform, a multicolor flow cytometry platform and a pluridisciplinary platform dedicated to anticancer drug monitoring in preclinical studies. In particular, this team was amongst the first to routinely:
- measure the concentrations of sunitinib, sorafenib, erlotinib in biological fluids,
- set up therapeutic drug monitoring,
- determine the pharmacokinetics of a range of antineoplastics.
This platform offers a large range of assays for other anticancer drugs such as methotrexate, mitotane and its metabolites, tyrosine kinase inhibitors sorafenib, sunitinib, erlotinib, gefitinib, vemurafenib, pazopanib and mTOR inhibitors (sirolimus, everolimus). The laboratory helps the clinician in its management of patient care and develops models of population pharmacokinetics.
Physicians are currently leading more than 75 clinical trials for adult cancers. Special attention is paid to early clinical trials (currently about 15 open phase 1 and 2 trials).
Furthermore, the Cochin/Hôtel-Dieu hospital group benefits from an outstanding environment for basic and translational programs through the “Cochin Institute” (https://www.institutcochin.fr) which is dedicated to basic research, led by Pierre-Olivier Couraud, affiliated to INSERM, CNRS and Paris Descartes University. Created in 2002, the Cochin Institute currently hosts 38 teams (organized in 3 research departments: (1) Development, Reproduction, Cancer, (2) Endocrinology, Metabolism, Diabetes and (3) Infection, Immunity, Inflammation. Six teams involved in
- endocrine tumors and signalization,
- oxidative stress, cell proliferation and inflammation,
- normal and pathological hematopoiesis,
- oncogenesis of digestive epithelium,
- lymphocyte activation and immunological synapse participate to the present SIRIC project.
The Cochin Institute has set-up 8 core facilities including genomics, proteomics, cell sorting and immunobiology, electron or 2-photon microscopies, small animal intravital imaging, laser microdissection and homologous recombination dedicated to basic and biomedical research.