Committee. Mot du Président du Congrès

Transcription

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2 Mot du Président du Congrès Mesdames, Messieurs, Cher(e)s Collègues Depuis Octobre 2000, date de la création de l Institut National de Pathologie, beaucoup de nouveautés ont vu le jour en anatomie pathologique. L INP a réussi durant ces années à relever le défi: Des techniques de routine, aux techniques d immuno histochimie et de biologie moléculaire, automatisées aux plus hauts degrés, aucun moyen n a été épargné, de telle façon que l INP entame l année 2013 avec une plateforme d automates et des techniques de pointe rivalisant avec les plus grands centres régionaux et mondiaux. D autre part, une collaboration étroite avec la «Faculté des Sciences Médicales de l Université Libanaise», qui a connu un essor très important, avec le développement de nouvelles disciplines et l acquisition de moyens modernes d éducation, fut très fructueuse donnant naissance a de nombreux programmes éducatifs aboutissant a la formation de résidents de haut niveau, appréciés de leurs pairs et des services qu ils ont fréquentés. L INP se trouve ainsi doté, en plus, d un label académique. L évolution rapide des technologies, en association avec le développement de la «thérapeutique ciblée» ne pouvait que susciter des explications, des demandes d éclaircissements et une coordination maximale avec les différentes disciplines médicales, pour une prise en charge adéquate des patients. Ce congrès a été imaginé dans deux buts: Le premier, essayer de répondre d une façon collégiale aux questions soulevées par nos collègues et arriver autant que possible a un consensus pour la prise en charge du patient. Le second, faire connaitre a nos collègues, le rayonnement de l Université Libanaise et l infrastructure de «l Institut National de Pathologie INP», son personnel médical, ses capacités techniques nouvelles ainsi que leurs champs d application. J espère que ce congres multidisciplinaire va rentrer dans le cadre des «us et coutumes» de l INP et de l Université, et qu on sera souvent, et a un rythme soutenu, au rendez-vous avec nos spécialistes. Je remercie tous ceux qui ont collaboré pour rendre cet événement possible. Bienvenue à vous tous. Dr Saad KHAIRALLAH Directeur de l Institut National de Pathologie - INP Chef de département de pathologie a FSM- UL Committee Dr. Saad Khairallah Dr. Georges Aftimos Dr. Selim Nasser Dr. Hikmat Husseini Dr. Salem El Khoury Dr. Georges Chahine Dr. Fayçal El Kak

3 Friday May 17th 2013 Vendredi 17 Mai :00-13:30 Registration Inscription 13:30-13:45 Welcome Note Note de Bienvenue INP Team : Dr. Saad Khairallah - Dr. Georges Aftimos 13:45-14:00 Preface of the FSM UL / Preface de la FSM - UL Prof B. Yared - Doyen FSM-UL SESSION I Miscellaneous Tumoral Conditions of the GI Tract (1) Conditions Tumorales Particulieres du TD (1) Moderators : Dr. Sahar Rassi - Dr. Samir Kai - Dr. Hikmat El Hussieni 14:00-14:30 Molecular pathology and tumors of the GI tract Latest updates Apport de la Biologie Moleculaire dans les Tumeurs Digestives - Nouveautés Prof. Jean François Flejou 14:30-14:50 Medical Management of Malignant Bowel Obstruction Prise en Charge Medicale des Obstructions Neoplasiques Digestives Dr. Antoine Abi Rached 14:50-15:10 Peritoneal Surface malignancy: Treatment 2013 Tumeurs de surface du Péritoine - Traitement 2013 Dr. Walid Salamoun 15:10-15:20 Questions & Answers 15:20-15:40 Coffee Break SESSION II Miscellaneous Tumoral Conditions of GI (2) Conditions Tumorales Diverses du TD (2) Moderators : Dr. Raja Wakim - Dr. Elham Hobeika - Dr. Patricia Saliba 15:40-16:10 Neuro-Endocrine Tumors of GI Tract / Physiopathology: Diagnostics Tools and Therapeutic Implications Tumeurs Neuro-Endocrines du TD / Physiopathologie: Moyens Diagnostiques et Implications Thérapeutiques Prof. Jean François Flejou

4 16:10-16:30 GIST - Combining Local and Systemic Treatment : Localized and Metastatic Disease Conduite à Tenir Devant n GIST : Diagnostic et Traitement : Non Métastatique et Métastatique Dr. Christina Khater 16:30-16:50 Surgical Approach of Liver Metastasis in Colon Cancer Approche Chirurgicale des Métastases Hépatiques du Colon Dr. Eddy Abdallah 16:50-17:00 Questions & Answers 17:00-17:15 Coffee Break SESSION III Dysplasic Lesions of the GI Tract Lesions Dysplasiques du TD Moderators : Dr. Antoine Geagea - Dr. Elias Makhoul - Dr. Fadi Daniel 17h15-17:45 Dysplastic Lesions of GI Tract - Diagnostics Challenges Lésions Dysplasiques du Tube Digestif - Défis Diagnostiques Prof. Jean François Flejou 17:45-18:05 Endoscopic Management of Dysplastic Lesions What to Do? When? And How? Traitement Endoscopique des Lesions Dysplasiques Que Faire? Quand? et Comment? Dr. Joe Abou Jaoude 18:05-18:15 Questions & Answers Special Session for Pathologists Session Spéciale pour Pathologistes 17:45-18:45 Thinprep Technique Technique Thinprep Dr. Vignesh Pattinam 18:45-19:45 Anal Pathology Pathologie Anale Prof. Jean Francois Flejou

5 Saturday May 18th 2013 Samedi 18 Mai :00-8:30 Registration Inscription SESSION IV Breast Session Tumeurs Mammaires Moderators : Dr. Henri Bitar - Dr. Roger Khater - Dr. Fouad Boulos 8:30-8:50 Sentinel Node Technique Data from INP - Are We Performing Well? Ganglions Sentinelles Expérience de l INP Sommes-nous Performants? Dr. Saad Khairallah 8:50-9:10 Molecular Classification of Breast Carcinomas : Luminal I,II, Basal type Nouvelle Classification : Luminal I, II, Basal Cell Dr. Georges Aftimos 9:10-9:30 IHC, FISH, SISH, BDISH - Discrepancies and Realities - Where Are We? IHC, FISH,SISH,BDISH - Discordances et Realites - Ou Nous en Sommes? Dr. Saad Khairallah 9:30-9:50 New Predictive Factors in Breast Cancer : Oncotype DX, Mamma Print Facteurs Predictifs des Cancers du Sein : Oncotype DX, Mamma Print Dr. Marwan Ghosn 9:50-10:00 Questions & Answers 10:00-10:30 Coffee Break SESSION V Ovarian Neoplasia Tumeurs Ovariennes Moderators : Dr. Fayez Bitar - Dr. Paul Barakat - Dr. Michel Saade 10:30-11:00 Classification of Ovarian Neoplasia - New Approach Classification des Cancers de l Ovaire - Nouvelle Approche Prof. Xavier Sastre 11:00-11:25 Role of Aggressive Surgical Debulking in Primary and Recurrent Ovarian Cancer: Does it Really Make a Difference? Rôle de la Chirurgie Agressive «Debulking» dans les Cancers Primaries et Récidivants. Muhieddine Seoud, MD, FACOG, FACS 11:25-11:45 Ovarian Cancer Management - Role of Angiogenesis Cancer de l Ovaire : Conduite a Tenir et Angiogeneses Dr. Dany Abi Gerges 11:45-11:55 Questions & Answers

6 SESSION VI Cervical Neoplasia 1 Neoplasies Cervicales 1 Moderators : Dr. Selim Nasser - Dr. Edgard Haddad - Dr. Tony Helou 11:55-12:25 HPV and Cancer of the Cervix Physiopathology and Molecular Pathology HPV et Cancer du Col Physiopathologie et Biologie Moleculaire Prof. Xavier Sastre 12:25-12:55 Thin Prep New approach for Cervical Screening Thin Prep Nouvelle Approche pour le Depistage Cervical Dr. Vignesh Pattinam 12:55-13:05 Questions & Answers 13:05-14:05 Lunch SESSION VII Cervical Neoplasia 2 Neoplasies Cervicales 2 Moderators : Dr. Imad Abou Jaoude - Dr. Ziad Massaad - Dr. Ramzi Finan 14:05-14:25 Updates on Cervical Screening Guidelines Mise à Jour sur les Directives de Dépistage des Néoplasies Cervicales Dr. David Atallah 14:25-14:50 Screening for Cervical Cancer: Will HPV Screening and HPV Typing Replace or Complement Cytological Screening? Dépistage du Cancer Cervical : Le dépistage et le Typage de l HPV Pourraient-ils Remplacer ou être Complémentaires du Dépistage Cytologique? Muhieddine Seoud, MD, FACOG, FACS 14:50-15:10 Vaccination and Cervical Neoplasia Vaccination et Cancer du Col Dr. Fayçal el Kak 15:10-15:20 Application of the new recommendations in Lebanon Application des nouvelles recommendations au Liban Dr. Imad Abou Jaoude 15:20-15:30 Questions & Answers

7 Merck Serono Oncology Combination is key TM ERBITUX (cetuximab) abbreviated prescribing information. NOTE: Before prescribing ERBITUX, please consult the full prescribing information. Presentation: *ERBITUX 2mg/ml solution for infusion. Each glass vial contains 50 ml. Excipients: Sodium dihydrogen phosphate, disodium phosphate, sodium chloride, water for injections. *ERBITUX 5mg/ml solution for infusion. Each glass vial contains 10 ml, 20 ml, 50 ml or 100 ml. Not all vial sizes may be marketed. Excipients: sodium chloride, glycine, polysorbate 80, citric acid monohydrate, sodium hydroxide, water for injections. Indications: Treatment of patients with epidermal growth factor receptor (EGFR)-expressing, KRAS wild-type metastatic colorectal cancer (mcrc): in combination with chemotherapy, or as a single agent in patients who have failed oxaliplatin- and irinotecan-based therapy and who are intolerant to irinotecan. Treatment of patients with squamous cell cancer of the head and neck (SCCHN): in combination with radiation therapy for locally advanced disease or in combination with platinum-based chemotherapy for recurrent and/or metastatic disease. Dosage and administration: Administer ERBITUX once a week. Very first dose 400 mg/m 2 infused over 120 mins; subsequent doses 250 mg/m 2 infused over 60 mins. Maximum infusion rate must not exceed 10 mg/min. Administration must be supervised by a physician experienced in antineoplastic therapy. Closely monitor the patient throughout the infusion and for at least 1 hour afterwards. Resuscitation equipment must be ensured. Prior to first infusion patients must receive premedication with an antihistamine and a corticosteroid; premedication recommended for all subsequent infusions. *ERBITUX 2mg/ml: Administer intravenously via in-line filtration with an infusion pump, gravity drip or a syringe pump. *ERBITUX 5 mg/ml: Administer intravenously with an infusion pump, gravity drip or a syringe pump. Administer ERBITUX first and do not administer chemotherapeutic agents earlier than 1 hour after the end of the ERBITUX infusion mcrc: ERBITUX should be continued until progression of the underlying disease. SCCHN locally advanced disease: Start ERBITUX therapy one week before radiation therapy and continue until the end of the radiation period. SCCHN recurrent and/or metastatic disease: Administer ERBITUX in combination with platinum-based chemotherapy followed by ERBITUX as maintenance therapy until disease progression. Special Populations: No dose adjustment required in the elderly (experience limited in patients older than 75 years). Safety and efficacy in children not established. Only patients with adequate renal, hepatic and hematological parameters have been investigated. Contraindications: Known severe hypersensitivity (grade 3 or 4) reactions to ERBITUX. Contraindications for concomitantly used chemotherapeutic agents or radiation therapy must be considered. Special warnings and precautions: Infusion-related reactions: Severe infusion-related reactions to ERBITUX have been reported. They occur usually during the first infusion and up to 1 hour after the end of infusion, but may occur after several hours or with subsequent infusions. Occurrence of a severe infusion-related reaction requires immediate and permanent discontinuation of ERBITUX and may necessitate emergency treatment. Decrease infusion rate if mild or moderate infusion-related reaction occurs and use lower rate in all subsequent infusions. Closely monitor patients with reduced performance status and pre-existing cardio-pulmonary disease. Skin reactions: Interrupt treatment if patient experiences a severe skin reaction ( grade 3 NCI-CTC). Only resume if reaction resolves to grade 2. With second or third occurrence of severe skin reactions, resume at lower dose (200 mg/m 2 after second occurrence, 150 mg/m 2 after third occurence) only if reaction resolves to grade 2. A fourth occurrence of severe skin reaction, or failure to resolve to grade 2 during interruption, requires permanent discontinuation of ERBITUX. Respiratory disorders: Individual cases of interstitial lung disorders of unknown causal relationship to ERBITUX have been reported. If interstitial lung disease is diagnosed, ERBITUX must be discontinued and patient be treated appropriately. Electrolyte disturbances: Severe hypomagnesaemia has been observed. Hypomagnesaemia is reversible following discontinuation of ERBITUX. Hypokalaemia as a consequence of diarrhea may develop. Hypocalcaemia may also occur; in particular in combination with platinum-based chemotherapy the frequency of severe hypocalcaemia may be increased. Determination of serum electrolyte levels is recommended prior to and periodically during ERBITUX treatment. Electrolyte repletion is recommended, as appropriate. Neutropenia and related infectious complications: Patients who receive ERBITUX in combination with platinum-based chemotherapy are at an increased risk for the occurrence of severe neutropenia, which may lead to subsequent infectious complications such as febrile neutropenia, pneumonia or sepsis. Careful monitoring is recommended in such patients, in particular in those who experience skin lesions, mucositis or diarrhoea that may facilitate the occurrence of infections. Pregnancy and lactation: Only use during pregnancy or as woman not employing adequate contraception if the potential benefit justifies potential risk to fetus. Breast-feeding during treatment with ERBITUX and for 2 months after the last dose is not recommended. Undesirable effects: Very common ( 1/10): skin reactions (mainly as acne-like rash and/or pruritus, dry skin, desquamation, hypertrichosis, or nail disorders, single cases of skin necrosis), hypomagnesaemia, mild or moderate infusionrelated reactions (such as fever, chills, dizziness, or dyspnoea), mild to moderate mucositis, which may lead to epistaxis, increase in liver enzyme levels. Common ( 1/100, <1/10): headache, conjunctivitis, diarrhea, nausea, vomiting, fatigue, dehydration, hypocalcaemia, anorexia, weight decrease, severe infusion-related reactions, in rare cases with fatal outcome, some may be anaphylactoid/anaphylactic in nature (including bronchospasm, urticaria, hypotension, loss of consciousness, or shock); in rare cases, angina pectoris, myocardial infarction, or cardiac arrest. Uncommon ( 1/1000, <1/100): blepharitis, keratitis, deep vein thrombosis, pulmonary embolism. Frequency not known: superinfection of skin lesions with subsequent complications (e.g. cellulitis, erysipelas, staphylococcal scalded skin syndrome, or sepsis). In combination with local radiation therapy of the head and neck area, additional undesirable effects were those typical of radiation therapy (such as mucositis, radiation dermatitis, dysphagia or leucopenia, mainly as lymphocytopenia). Reporting rates of severe acute radiation dermatitis, mucositis, late radiation-therapy related events were slightly higher in combination with cetuximab. Interactions: In combination with infusional 5-fluorouracil, frequency of cardiac ischaemia including myocardial infarction and congestive heart failure as well as the frequency of hand-foot syndrome were increased. In combination with platinum-based chemotherapy, the frequency of severe leukopenia or severe neutropenia may be increased, and thus may lead to a higher rate of infectious complications such as febrile neutropenia, pneumonia and sepsis compared to platinum-based chemotherapy alone. Marketing Authorization Holder: Merck KGaA, Darmstadt, Germany. Licence number: EU/1/04/281/ General classification for supply: Medicinal product subject to medical prescription. Date of Revision: November Merck KGaA, Darmstadt, Germany, Tel: +49 (0) , ERBITUX is a trademark of ImClone LLC, a wholly-owned subsidiary of Eli Lilly and Company, used under license by Merck KGaA, Darmstadt, Germany. *Please contact your local Merck Serono affiliate regarding the availability of the specific formulation in your country.

8 Precise HER2 testing increases the chance of survival with Herceptin. 1-2 ABBREVIATED PRESCRIBING INFORMATION Herceptin (trastuzumab) Please refer to Herceptin SPC for full prescribing information Therapeutic indications: 1) Treatment of patients with metastatic breast cancer whose tumours overexpress HER2: a) As monotherapy after at least two chemotherapy regimens for their metastatic disease. b) In combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable. c) In combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease. d) In combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive metastatic breast cancer, not previously treated with trastuzumab. 2) Treatment of patients with HER2 positive early breast cancer following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable). Posology and method of administration: MBC Weekly schedule:initial loading dose of 4 mg/kg body weight, subsequent doses of 2 mg/kg body weight. MBC 3-weekly schedule: Initial loading dose of 8 mg/kg body weight, followed by 6 mg/kg body weight 3 weeks later and then 6 mg/kg repeated at 3-weekly intervals. EBC weekly schedule: In the adjuvant setting, Herceptin has also been investigated as a weekly regimen (an initial loading dose of 4 mg/kg followed by 2 mg/kg every week for one year) concomitantly with paclitaxel (administered weekly (80 mg/m 2 ) or every 3 weeks (175 mg/m 2 ) for a total of 12 weeks) following 4 cycles of AC (doxorubicin 60 mg/m 2 IV push concurrently with cyclophosphamide 600 mg/m 2 over minutes). EBC 3-weekly schedule: Initial loading dose of 8 mg/kg body weight,subsequent doses of 6 mg/kg body weight. Administration: as infusions over approximately 90 minutes. Contraindications: Patients with known hypersensitivity to trastuzumab, murine proteins, or to any of the excipients. Patients with severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy. Special warnings and precautions for use: The use of Herceptin is associated with cardiotoxicity. All candidates for treatment should undergo careful cardiac monitoring. Serious adverse reactions including infusion reactions, hypersensitivity, allergic-like reactions and pulmonary events have been observed. Herceptin should be avoided during pregnancy and lactation. Undesirable effects: Related to first infusion: chills and/or fever. Other signs and/or symptoms: nausea, vomiting, pain, rigors, dizziness, rash, asthenia, diarrhoea, hepatic toxicity. In patients treated with Herceptin combinations: cardiac toxicity, haematological toxicity, infections. Packaging: Herceptin 150 mg Powder for concentrate for solution for infusion. References: 1. Bang Y, et al. J Clin Oncol 2009; 27:Abstract Van Cutsem E, et al. J Clin Oncol 2009; 27:Abstract Full prescribing information is available upon request. In case of any adverse event occurring with Herceptin, please forward details to fax number: ext: 170 or by to: the beirut.safety_reporting.bs1@roche.com LB.HER Roche Lebanon SARL Atrium Building, 5 th Floor 33 Weygand Street Beirut Central District PO Box: Beirut, Lebanon