ImPaCCT Foundation, Tata Memorial Centre highlights the significance of awareness around Paediatric Cancer Care

 

Mumbai: “ImPaCCT Foundation”, Tata Memorial Centre, hosted a press conference at the hospital, addressing crucial aspects of Paediatric Cancer Care in India.

Speaking at the event were, Ms. Shalini Jatia (Officer-in-Charge, ImPaCCT Foundation, Tata Memorial Centre), Dr. Shripad Banavali (Director, Academics, Tata Memorial Centre), and Dr. Girish Chinnaswamy (Head of Department, Paediatric Medical Oncology, Tata Memorial Hospital).

The esteemed speakers explored pivotal talk points such as Pediatric Care, unveiling enlightening statistics on patients, facilities, treatments, cure rates, and recent breakthroughs. Addressing the prevalent challenges in Pediatric Cancer Care in India, they articulated a Survivorship Program tailored to facilitate the seamless reintegration of young survivors into their everyday lives.

The press conference highlighted collaborative efforts and support initiatives aimed at fostering a cultivating environment for effective treatment and care. The experts shed light on advancements in multimodality therapy, with a particular emphasis on the pivotal role of Immunotherapy in improving treatment outcomes. A noteworthy highlight of the event was the official announcement of the forthcoming annual cultural event - HOPE 2023, the biggest annual cultural event hosted by ‘The ImPaCCT Foundation’, Tata Memorial Hospital for Pediatric Cancer Patients.

‘HOPE 2023’, curated by ‘ImPaCCT Foundation’, ‘Tata Memorial Centre’, is committed to supporting pediatric cancer care. Embracing the lively essence of Bollywood, this year's theme ensures spreading laughter resembling The Kapil Sharma Show. The spotlight will be on children as they showcase their unique interpretation of the comedian, injecting the event with laughter and entertainment.

Below are the statistics and highlights from the Press Conference:

Dr. Shripad Banavali (Director, Academics, Tata Memorial Centre):

• Delivery and advancement in multi-modality therapy including Immunotherapy.
• Initiation of newer therapies for high-risk pediatric cancers.
• Immunotherapy for Leukemia, neuroblastoma.
• Blinatumomab therapy is provided on an access program supported by St. Jude Children’s Hospital USA. About 30 children benefited from this program. This is a therapy to treat difficult leukemia.
• CAR T cell therapy undergoing clinical trials in children.
• Newer targeted therapy for brain tumors, neuroblastoma.
• To improve outcomes and decrease toxicity.
• The liver transplant service started with collaboration.

Dr. Girish Chinnaswamy (Head of Department, Paediatric Medical Oncology, Tata Memorial Hospital):

• Childhood cancer research initiatives.
• Numerous multicenter trials started in the country.
• National Cancer Grid support.
• TMC actively leads and participates in trials (Hodgkin Lymphoma, Leukemia trials, etc.).
• Malnutrition and cancer.

Collaborations to improve childhood cancer outcomes:

• WHO GICC
• St. Jude Global Alliance
• Working on a global initiative for improving childhood cancer survival to 60%.

Ms. Shalini Jatia (Officer-in-Charge, ImPaCCT Foundation, Tata Memorial Centre):

• Few facts and figures on childhood cancer.
• India accounts for 20% of the new childhood cancer cases diagnosed worldwide each year. As India has approx. 70000 cases (less than 18 years) and worldwide approx 400,000.
• In TMC centers alone nearly 3500 cases are being seen every year annually.
• Childhood cancer cure rates are 70 to 95% in high-income countries. In India, the average survival rates are approx. 40%. global cure rates of childhood cancers are 35%.

Childhood cancer services over a decade and our survival outcomes:

• ImPaCCT - set up in 2010 – registrations in 12 years.
• Components of the holistic support model.
• Additional support staff to improve the quality of care.
• Development of a database.
• Analysis of the data – long-term survival outcomes.
• 80% of the children coming to TMC are treated in the general category.
• Set up ImPaCCT in 2010 – abandonment rates were extremely high – 25%.
• This necessitated the development of a robust database for monitoring the implementation of the program and the impact assessment.
• Captured data over 12 years – demographics, socio-economic factors, treatment abandonment, survival outcomes, survivorship.
• Data is entered via a Google sheet by all members of the multi-disciplinary team.
• Also used for tracking the patients during and after post-therapy.
• We have recently analyzed the database of the past 12 years.

Survivorship program - reintegration into society:

• No. of survivors registered in ACT – ACT clinic started on the 5th of February, 1991. To date, we have 4634 patients registered.
• Survivorship support program - components of support – financial, psychosocial, educational, vocational, - all crucial to our population of survivors.
• Details of the education program – initiated in 2016, until date, supported 662 patients with funding to the tune of Rs. 1.5 crores (1,50,48,055).
• Full circle of life - treatment, survivorship, reintegration, giving back to the hospital – Anamika Soni, Arun Nadar. Other survivors who are doing very well professionally are in sports, computer application, engineering.

Comprehensive database for delivery and monitoring of holistic pediatric cancer care - Experience of ImPaCCT Foundation over a decade:
 
Author and co-author details:
Shalini Jatia, Maya Prasad, Gaurav Narula, Chetan Dhamne, Nirmalya Roy Moulik, Badira CP, Akanksha Chichra, Shyam Srinivasan, Janhavi Sawant, Shreyas Chunekar, Sameer Jogale, Komal More, Girish Chinnaswamy, Shripad Banavali.

Tata Memorial Centre, Paediatric Oncology, Mumbai, India

Background and Aims (300 words):
Providing comprehensive support through the ImPaCCT (Improving Paediatric Cancer Care and Treatment) Foundation, established in 2010, necessitated the development of a robust database for monitoring the implementation of the program and impact assessment. This database, which was set up with the help of an NGO in 2010, has captured data over a decade including demographics, socio-economic factors, treatment abandonment, and survival outcomes amongst others. The model is being replicated strategically across all TMC centers. We analyzed the data captured on this database over the last 12 years.

Methods:
The ImPaCCT database captures real-time patient data entered via Google Sheets by all members of the multidisciplinary team. This is also used for tracking patients during and post therapy. We performed a descriptive analysis of the data captured over the last 12 years, with specific emphasis on the changing trends in patient profiles, socioeconomic factors, disease outcomes, abandonment rates, and survivorship.

Results:
Over the last 12 years since the database was created, data from a total number of 21181 children with cancer who were referred to 'Tata Memorial Centre' (TMC) has been captured. Amongst them, 75% of children (16038) undertook treatment at TMC and 10.4 % were referred to local centers. 85% (17997) of the children were treated in the general category supported by ImPaCCT. The total financial support provided during this time is Rs. 3,188,462,294. The male-to-female ratio across the whole group is 1.8:1 and no change in the sex ratio was observed over a decade. The education status of the parents remained unaltered as well with the proportion of fathers having undergone high school education varying between 53-61% and mothers 45-49% over the years. The proportion of mothers having completed university education increased from 16% to 21%. The abandonment rate was 20% before 2010 which decreased to below 5% in 2015 and is 2% in 2021.

The survival across the whole study period of children treated in TMC (between 2010-2018 n=10799) is 48%. It increased from 41% in 2010 and for children treated in 2018 it is 58% (5-year follow-up). Over 4500 children are registered in the ACT clinic.

Conclusions:
The ImPaCCT model for keeping the patient data is low cost and serves a manifold purpose. This has been replicated in all TMC centers. This has the potential to be adapted and implemented in other centers treating children with cancer across India and similar settings.