2018 Activity Report

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CHANGCANCER IS

AND SO ARE WE

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Throughout 2018, the Centre Léon Bérard (CLB) celebrated the 60th anniversary of its establishment in the Laennec area of the 8th arrondissement of Lyon. Founded within the Hôtel Dieu in 1923 and then transferred in the 1930s to one of the wings of the future Édouard Herriot hospital, our hospital grew and changed, going from 52 beds to 320, creating a medical plan based on humanity, innovation and excellence, and beginning at an early stage to develop research programs to improve patient care.

The CLB maintains the same values to this day. This is evidenced by the various activities of our medical and scientifi c plan 2016-2021.

We invite you to look through this activity report to discover which specifi c actions were carried out in 2018.

In response to the wishes of our patients and their families, we inaugurated the fi rst sports hall within a Center for the Fight Against Cancer, transformed our website so as to be better able to meet the expectations of our various target groups and their families, and organized the fi rst salon of the ‘K Fighteuses’, a support group for women with cancer.

We acquired new state-of-the-art equipment: 2 MRIs, 2 scanners, 1 digital PET scan.

We also hosted the fi rst multidisciplinary workshop on mesothelioma by the International Association for the Study of Lung Cancer (IASLC), demonstrating the high quality and expertise of our teams, which have gained international renown.

All these activities are initiated and run by our staff and we want to put them in the spotlight for our 60th anniversary. More than 1,700 employees dedicate their efforts every day to offering our patients the personal care that is most appropriate to their disease and their situation.

Very soon, in 2023, we will be celebrating 100 years of the Centre Léon Bérard – a century of service to our patients.

Our institute is part of the history of the city and of the region, and it is now known far beyond its base.

SOPHIE BEAUPÈRE

Deputy Executive Director

PROFESSOR JEAN-YVES BLAY Executive Director

−THE MANY FACES

OF THE CLB

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service to our patients.

Our institute is part of the history of the city and of the region, and it is now known far beyond its base.

PROFESSOR JEAN-YVES BLAY Executive Director

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Our institute is part of the history of the city and of the region, and it is now known far beyond its base.

SOPHIE BEAUPÈRE BEAUPÈRE

Deputy Executive Director

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SUMMARY

−PREVENTING AND SCREENINGPAGE 16

01−HOSPITALISATIONPAGE 2604− DOING RESEARCHPAGE 3407

−SHARINGPAGE 4009

− DIAGNOSTICSPAGE 1802− SUPPORTING AND LISTENINGPAGE 28

05

− SOLIDARITYPAGE 4210

−TREATING PAGE 2203−CLINICAL RESEARCHPAGE 32

06− TRANSFERRINGPAGE 3808

− SUPPLY AND USE

ACCOUNTSPAGE 48

−MANAGEMENT

STRUCTURE AND ORGANIZATION

PAGE 6

−WELCOME, HUMANITY AND

INNOVATION: 60 YEARS OF DEDICATED WORK

PAGE 4

−HIGHLIGHTS

OF 2018PAGE 12

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−WELCOME, HUMANITY AND INNOVATION:

60 YEARS OF DEDICATED WORK

A welcoming entrance hallThe proportions of the building’s entrance hall were designed to create a feeling of calm and comfort. It led to the treatment areas - the waiting rooms for consultations, furnished with comfortable, fl ower-patterned armchairs and side tables.

A varied gastronomic rangeEven in the early days, the catering service aimed to offer patients a varied range of meals. The general service offered ‘three menus for the patients to choose from’, which allowed patients to combine elements from these three menus to create the meal that most appealed to them.

Cutting-edge equipmentSince it opened, the Centre Léon Bérard has boasted a surgical service and operating unit that are modern and state-of-the-art. An important screening center, it was one of most modern of its kind in Europe from the outset.

A RETURN TO THE PASTThe Centre Léon Bérard opened its doors in the Laennec district on May 19, 1958. Founded in 1923 by Prof. Léon Bérard at the Hotel Dieu, the center had already moved once, in the 1930s, to the B wing of Édouard Herriot hospital. From that time, it had 300 beds, compared to 52 previously. Since then, 60 years have passed, but the values of the original institute and its teams remain the same: innovation, patient comfort, a high-quality reception, and excellence!

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35 PROFESSIONS IN THE SPOTLIGHTTo celebrate the 60th anniversary of its establishment at the current site, the new face of the CLB was lit up: its architectural face, covering more than 43,000 square meters divided between eight buildings dedicated to the care of our patients and to cancer research, but also the faces of the

1,700 women and men who make the Centre Léon Bérard what it is on a daily basis.

A poster campaign put the spotlight on the expertise of the nurses, physicians, researchers, logistics officers, technical staff, accountants, quality assurance and

risk management staff, etc. This campaign enabled the CLB to present the 35 different professions that are essential for our institute to function properly and for us to care for our patients and their families.

ÉRICAnesthesia nurse

“ In the operat ing uni t , I pract ice hypnosis to reduce each pat ient ’s

anxiety.”

SONIAPain specialist nurse“ In pain management , I a l so of fer innovat ive protocols .”

CÉCILEClinical research assistant“19% of our pat ients are included in a cl in ica l t r ia l and I g ive them suppor t .”

QINGResearcher

“ The proximity to the hospi t a l enables me to make more

rapid therapeut ic and diagnost ic advances .”

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BOARD MEMBERS (AS AT MAY 31, 2019)

MEMBERS WITH AN ADVISORY CAPACITY> Regional Health Agency

Auvergne-Rhône-Alpes (ARS-ARA)Dr. Jean-Yves GRALLDirector of ARS – Auvergne-Rhône-Alpes

> Executive Director of the CLBProf. Jean-Yves BLAY

> Employees of the CLBMrs. Sophie BEAUPÈRE Deputy Executive Director

Mr. Damien SÉBILEAU Director of Human Resources

Mrs. Cécile MARINI Administrative and Financial Director

Prof. Alain PUISIEUX Director of Basic Research

> AuditorsMrs. Valérie MALNOY Audit fi rm ORFIS BAKER TILLY

MEMBERS WITH VOTING RIGHTS > The President

Mr. Pascal MAILHOS Prefect of the Auvergne-Rhône-Alpes region, Prefect of the Rhône department (October 25, 2018)

> Representative of the Medical School University Lyon 1 Claude BernardProf. Pierre COCHATPresident of the Medical Studies Coordinating Committee in Lyon

> Representative of the Hospices Civils de LyonMrs. Catherine GEINDREExecutive Director of the Hospices Civils de Lyon

> Representative of the National Cancer Institute (INCa)Prof. Alain VIARI (reappointed by INCa in June 2018)

> Representative of the Regional Economic and Social Council (CESER) Mrs. Sandrine STOJANOVIC

> Expert Outside Consultants Mr. Yannick NEUDERDeputy Vice-President for Higher Education, Research, Innovation and European Funds – Auvergne-Rhône-Alpes Region

Mr. David KIMELFELDPresident of Metropolitan Lyon

Mrs. Anne BRUGNERA Member for the 4th district of the Rhône, municipal and metropolitan councilor of Lyon

Mrs. Bernadette DEVICTOR President of the Auvergne-Rhône-Alpes regional health conference and administrator of the Auvergne Rhône-Alpes inter-associative collective on health (CISSRA)

> User Group RepresentativesMrs. Janine CHAMBATLigue Nationale Contre le Cancer, Rhône Committee

Mr. Jacques RAPHINLigue Nationale Contre le Cancer, Rhône Committee

> Representatives of the Medical Association Committee of the Centre Léon Bérard (CLB)Dr. Pierre MÉEUS Dr. Pierre HEUDEL

> Representatives of the Social and Economic CommitteeMr. Christophe PEZET (november 2018)

Mrs. Carole REYNAUD (november 2018)

−MANAGEMENT STRUCTURE AND ORGANIZATION

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Partnerships/cooperative agreementsPr Jean-Yves BLAYSophie BEAUPÈRE

Anne MIERMONT

Fundraising/International DevelopmentÉlise TABET

DEPUTY EXECUTIVE DIRECTOR

SophieBEAUPÈRE

QualitySophie BEAUPÈRE

(interim)

Big DataThierry DURAND

FinanceCécile MARINI

Human Resources and OperationsDamien SÉBILEAU

Admissions and patient satisfaction

Abdel ACHACHE

LegalBérénice CAMHI

CommunicationNathalie BLANC

Facilities Management Eric PANZER

CRCL

MANAGEMENT STRUCTURE OF CLB (AS AT MAY 31, 2019)

- THE CORPORATE BODIES > Scientific Board > Social and Economic Committee> Patients’ Committee

DIRECTOR OF BASIC

RESEARCH

Prof. Alain PUISIEUX

DIRECTOR OF CLINICAL RESEARCH

Dr. DavidPÉROL

DIRECTOR OF TRANSLATIONAL

RESEARCH

Prof. Patrick MEHLEN

DEPUTY EXECUTIVE

DIRECTOR FOR MEDICAL AFFAIRS

Dr. Philippe ZROUNBA

MEDICAL DATADr. Frédéric

GOMEZ

Translational Teams

Research Grants Administration

Partnership and Institutional

Relations (SIRIC, INCa, etc.)

Head of NursingChristelle GALVEZ

Head of TeachingProf. Michel RIVOIRE

Clinical Risk CoordinatorHead of operating Unit

Dr. Philippe ZROUNBA

Healthcare Network RelationsDr. Philippe ZROUNBA

Medical Departments

EXECUTIVE DIRECTORProf. Jean-Yves BLAY

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Executive board

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−MEDICAL DEPARTEMENTS

Dr. Thomas MOGNETTIDepartment of Nuclear Medicine – the LUMEN Center

Prof. Michel RIVOIREDepartment of Surgery

Dr. Catherine CHASSAGNE CLÉMENTDr. Véronique HADDAD (deputy)

Department of Pathobiology

Prof. Vincent GRÉGOIRE

Department of Radiotherapy

Mr. Bertrand FAVIER (managing pharmacist)Department of Pharmacy

Dr. Jean-Luc SOUBIROUDepartment of Anesthesiology

Prof. Frank PILLEUL Department of Radiology

Dr. Perrine MAREC-BÉRARDDepartment of Pediatric Oncology – Institute of Pediatric Hematology and

Oncology (IHOPe)

Dr. Bruno RUSSIASDepartment for Coordination of External Care and Interfacing

(At Home Hospitalization/Home Care)

Dr. Béatrice FERVERSDepartment of Cancer and the Environment

Prof. Christine LASSETDepartment of Public Health

Dr. Gisèle CHVETZOFFDepartment of Oncology Supportive Care

Dr. Thomas BACHELOTDr. Olivier TRÉDAN (deputy)

Department of Medical Oncology

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AS AT MAY 31, 2019

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−STATE-OF-THE-ART TECHNOLOGY PLATFORMS

A NUCLEAR MEDICINE PLATFORM EQUIPPED

with 2 PET scans, one of which is 100% digital, and 3 gamma cameras, as part of a cooperative healthcare consortium with the

Hospices Civils de Lyon.

AN IMAGING PLATFORM

equipped with 2 MRI scanners, 2 scanners, radiography, ultrasound, mammography, stereotactic table for guided biopsies, and

a women’s center.

A PATHOBIOLOGY PLATFORM

combining anatomical and cytopathology analyses as well

as molecular biology procedures.

AN 11-ROOM STATE-OF-THE-ART OPERATING UNIT

with one room dedicated to screening and interventional endoscopy.

A BRACHYTHERAPY UNIT

A THREE-ROOM INTERVENTIONAL OPERATING UNIT

dedicated to interventional radiology, endoscopy and central venous line

insertion.

ONE OF THE LARGEST RADIOTHERAPY CENTERS

IN FRANCE with 8 accelerators comprising

1 Cyberknife©, 2 tomotherapy machines, and 5 accelerators on two sites in Lyon and Villefranche-sur-Saône, as part of a cooperative healthcare consortium with the Hospital of the North-West. Expertise in pediatric radiotherapy

is also available.

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1,781EMPLOYEES

AS AT DEC. 31, 20181,429 WOMEN

(80.2%)

352 MEN (19.8%)

−THE CENTRE LÉON BÉRARD IN 2018

+8%

PATIENTS DEALT WITH OF WHOM

10,838 NEW PATIENTS

37,050 BEDS AND

OUTPATIENT PLACES IN SURGERY AND

MEDICINE

320

+5%

CONSULTATIONS

90,090

HOME HOSPITALIZATION

PLACES

205

SCIENTIFIC PUBLICATIONS

396

PATIENTS INCLUDED IN A CLINICAL TRIAL

(18.5 % OF THE INFORMATION SYSTEM MEDICALIZATION PROGRAM (PMSI)

ACTIVE LIST)

2,095

CONVENTIONAL HOSPITALIZATIONS

+1% 12,155

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ADMINISTRATIVE STAFF127

EMPLOYEES

LOGISTICS AND TECHNICAL STAFF122

EMPLOYEES

MEDICAL TECHNOLOGY STAFF182

EMPLOYEES

MEDICAL ADMINISTRATIVE STAFF205

EMPLOYEES

MEDICAL STAFF232

EMPLOYEES

RESEARCH SECTOR303

EMPLOYEES

CARE SECTOR610

EMPLOYEES

DAY HOSPITAL STAYS

30,669 +5%

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DIFFERENT JOBS

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37,050PATIENTS OF WHOM 11,499 NEW PATIENTS

22,729 WOMEN (I.E. 61% OF PATIENTS)

14,321 MEN (I.E. 39% OF PATIENTS)

118 FOR A HEMATOLOGICAL

DISEASE BY THE TEAMS OF THE HCL

109 FOR A SOLID TUMOR

BY THE TEAMS OF THE CLB

227NEW PATIENTS TREATED

−OVERVIEW OF OUR PATIENTS

−FOCUS ON THE IHOPe

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0-14 YEARS

15,2

25

15-24 YEARS

14,0

43

25-44 YEARS

5,78

5

45-64 YEARS

1,180

> 65 YEARS

817

BREAKDOWN BY AGE GEOGRAPHICAL BREAKDOWN

The I ns t i t u t e o f Pe d i a t r i c Hematology and Oncology (IHOPe) is a structure that is unique in France. A cooperative healthcare consortium with the Hospices Civils de Lyon (HCL), IHOPe has treated children and adolescents with cancers and malignant and non-malignant hematological diseases.

141ABROAD

2,947FRANCE(EXCEPT SAÔNE-ET-LOIRE AND RHÔNE-ALPES)

16,190 RHÔNE-ALPES(WITHOUT RHÔNE WITH SAÔNE-ET-LOIRE)

17,772 RHÔNE

DEPARTMENT

603PATIENTS482

AGED UNDER 15

121 AGED 15

AND OLDER

−HIGHLIGHTS OF 2018

MONDAY JANUARY 1

THE LYRIC BECOMES LYRICANThe Lyon project LYriCAN – an integrated site for cancer research and care – was selected in the second round of accreditation by the French National Cancer Institute (INCa).

This project is led by Prof. Jean-Yves Blay, under the aegis of the Cooperative Healthcare Consortium – Lyon University Oncology, which comprises the CLB and the Hospices Civils de Lyon. LYriCAN is proposing a new project focused on cellular plasticity and therapeutic innovation. It aims to understand better how cancer cells or cells of the immune system adapt (i.e., are ‘plastic’) so as to avoid or resist treatments or the immune system. (Read further on page 35).

THURSDAY APRIL 26

A SALON THAT PACKS A PUNCH!On Thursday April 26, the fi rst salon of the ‘K Fighteuses’ was held at the Centre Léon Bérard, in partnership with the association of a female patient of the CLB: Dégom’crab.

This was a fi rst in France: a gathering to highlight and introduce great professional initiatives and associations created by women concerned with cancer. More than 300 people converged on the Centre Léon Bérard on the day. The salon was organized by the CLB in collaboration with Séverine Martin, a former patient, and her association, Dégom’crab.

SATURDAY MAY 26

PUTTING ON SHOW THE EXPERTISE OF OUR COLLABORATORSThe Prefect of the region, Prefect of the Rhône department, and President of the Executive Board of the Centre Léon Bérard, invited us into the prestigious rooms of the prefecture to celebrate the 60th anniversary of the opening of the CLB in the Laennec district.

Nearly 400 guests, representing local institutions and associations, were received by Prof. Jean-Yves Blay and Sophie Beaupère at a distinguished gathering, which enabled us to showcase the work of every individual from 20 professions carried out at the CLB.

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THURSDAY MAY 31

PHYSICAL ACTIVITY DURING CANCER: CAN SMART BRACELETS HELP PATIENTS?At the HealthIT Expo (HIT 2018), the Centre Léon Bérard launched a new clinical study to evaluate the effectiveness of a device involving a smart bracelet as part of an appropriate physical activity program offered to women with breast cancer.This project is being carried out in partnership with Orange Healthcare.

For a period of two years, more than 400 women being monitored for breast cancer in the localized state will take part in this research program that is unique in France. It is expected that the fi rst results from the DISCO study will be published in 2021.

FRIDAY JULY 6 AND SATURDAY JULY 7

MESOTHELIOMA: EXCELLENCE BROUGHT TOGETHER AT THE CENTRE LÉON BÉRARDThe CLB hosted a multidisciplinary workshop of the International Association for the Study of Lung Cancer (IASLC).

More than 60 leading physicians and biologists from all over the world gathered to report on the latest advances in the diagnosis and treatment of mesothelioma.

The goal was to improve the treatment of this primitive cancer of the pleura. Cancers of this type affect 1,100 individuals in France each year.

WEDNESDAY SEPTEMBER 5

FIRST SPORTS HALL IN A CENTER FOR THE FIGHT AGAINST CANCERAfter several months of work, the Espace Pyramide [Pyramid Space] was opened by Sophie Beaupère, Deputy Executive Director of the CLB. This sports hall welcomes patients – adolescents, young adults and older adults – who are looked after by the teams for appropriate physical activity, therapeutic education and physiotherapy of the Centre Léon Bérard and IHOPe*.

It was made possible by a large donation from the Fondation Hôpitaux de Paris-Hôpitaux de France [Hospitals of Paris-Hospitals of France Foundation], the assistance of other partners and many donors from the Centre Léon Bérard.(Read further on page 45).

*Institute of Pediatric Hematology and Oncology

WEDNESDAY SEPTEMBER 12

A NEW WEBSITE TO BETTER INFORM OUR TARGET GROUPSwww.centreleonberard.fr has been launched. The special feature of this new website is that it offers a dedicated space for each target group:our patients, their families and potential patients, donors and future donors to the Centre Léon Bérard, as well as healthcare professionals, researchers, and all CLB employees. Each person will fi nd relevant information in his or her specifi c space, and will thus enjoy a more personalized browsing experience.

This is useful for providing practical information and expert information on healthcare or on cancer research.

THURSDAY SEPTEMBER 27 AND FRIDAY SEPTEMBER 28

CRCL: DECISIONS ON FUTURE DIRECTOR AND TEAMSThe International Scientifi c Board of the Cancer Research Center of Lyon (CRCL) held a meeting, chaired by Prof. Éric Solary. This Board was to issue two opinions that would determine the future of the CRCL: one on the choice of the next director for the fi ve-year contract from 2021 to 2025, and the second on the teams that will be part of the project submitted to the High Council for Evaluation of Research and Higher Education (HCERES) in 2019. (Read further on page 36).

WEDNESDAY OCTOBER 17

MRI SCANNER: THE NEW SERVICE The Centre Léon Bérard inaugurated its new imaging service in new premises where the focus is on patient care. In operation since January 2018, the CLB’s new imaging service hastwo scanners and two state-of-the-art MRIs in completely refurbished rooms on level 1 of our institute. This renovation enabled us to rethink the organization of the patient pathway in order to improve it by making it progress more smoothly.

The move to a more spacious location and the arrival of the new equipment made it possible for us to redefi ne the patient-focused team project. Physicians, electroradiology manipulators, medical assistants, secretaries and reception staff have all given thought to this pathway, which has been adapted to each age group, with an area being arranged specially for children.

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SATURDAY NOVEMBER 24

THE FIRST ‘RACE OF LIGHTS’ MADE IN LYONMore than 2,400 people – a record number – assembled on Maréchal Lyautey Square in the 6th

arrondissement of Lyon for the fi fth Marche des Lumières (March of Lights),this time transformed into a race.

The program this year comprised a 10-km race in support of the CLB and a 4-km night-time march through the streets of Lyon. The objective was to light up the night against cancer in aid of progress in research and to send a message of hope in the face of the disease.

Thanks to everyone’s efforts, more than ¤190,000 in donations was collected this year.

THURSDAY DECEMBER 20

A CHEF AT THE HOSPITALThe Centre Léon Bérard, catering company SHCB and chef Christian Têtedoie have signed a partnership agreement. The aim is to offer cancer patients being treated by the Lyon and Rhône-Alpes region’s French Comprehensive Cancer Center meals that are ever more varied and also respect the dietary constraints linked to their condition.

“Promoting therapeutic and organizational innovation in the service of our patients is one of the priorities of the Centre Léon Bérard,” explains Sophie Beaupère, Deputy Executive Director of the Centre Léon Bérard, “but human care and attention are also essential for our teams. Mealtimes should be moments of relaxation during a hospital stay; this is what we hope to achieve with SHCB, through this partnership with chef Christian Têtedoie, who has paid close attention to our expectations.”

FRIDAY NOVEMBER 30

THE FIRST 100% DIGITAL PET SCANNER IN SOUTH-EASTERN FRANCEThe LUMEN Center, the department of nuclear medicine of the Cooperative Healthcare Consortium of the Centre Léon Bérard and the Hospices Civils de Lyon, commissioned the fi rst Vereos PET scanner (100% digital) of the south-eastern region. Installed in spring 2018, this device designed by Philips is one of the fi rst such pieces of equipment in operation in France.

Its benefi ts for patients are a better detection of lesions due to better image resolution; a shorter examination time; and a 20 to 40% reduction in the dose of radioactive tracer injected into the patient.

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01− P R E V E N-TING AND SCREENINGPREVENTION – THE FIRST WEAPON AGAINST CANCER

++

THE CENTRE LÉON BÉRARD: A MAJOR PLAYER IN PREVENTION IN AUVERGNE-RHÔNE-ALPESPrevention and screening also have a role to play in precision medicine and are one of the Centre Léon Bérard’s missions. The CLB’s teams are leading a large number of activities in this context:

> Studying and informing target groups about cancer risks and how to prevent them, particularly in cooperation with the International Agency for Research on Cancer (IARC);

> Offering screening to all, as part of the monitoring of familial (oncogenetic) cancers, but also as part of organized screening (breast and colorectal cancers) in partnership with the Auvergne-Rhône-Alpes coordination center for cancer screening;

> Promoting prevention activities at the local and national level (‘Non-smoking hospital ’ – Respadd (network for the prevention of addictions), ‘Tobacco-free month’, prevention of cervical cancers through vaccination, Blue March and Pink October, etc.);

> Offering patients secondary and tertiary preventive activities through nutritional programs adapted to their specifi c disease and state of health (treatment of undernutrition and excess weight, appropriate physical activity, etc.);

> Consultation for the detection of occupational cancers.

90,090consultations carried

out by all medical departments

1,900oncogenetic

1,733medical

gynecology

361nutrition and metabolism

130occupational

cancers

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APA: A PROGRAM AIMED SPECIFICALLY AT ADOLESCENTS AND YOUNG ADULTSEstablished in 2017, a program of appropriate physical activity (PREVAPAJA) is now offered systematical ly to adolescents and young adults of the Centre Léon Bérard and the Institute of Pediatric Hematology and Oncology (IHOPe). Every afternoon, an appropriate physical activity (APA) instructor provides group sports sessions. In addition, individual sessions are organized daily in sterile rooms for

patients in isolation. Physical activity assessments enable instructors to adapt the activities to the capabilities, the needs and above all the wishes of these patients. With the help of partner associations (OL, ASVEL, Handisport, etc.), adolescents and young adults can also benefi t from a variety of sessions and discover appropriate sports that they will be able to continue once treatment has ended.

In April 2010, the Centre Léon Bérard was the fi rst French Comprehensive Cancer Center to offer its patients the chance to do appropriate physical activity (APA) during treatment. There is currently a team of seven instructors in appropriate physical activity. A profession worth discovering!

What is the role of an instructor in appropriate physical activity at a Comprehensive Cancer Centres?

We work both for the clinic, that is to say the CLB’s hospital-based activity, and for research.

On the clinical side, we organize all the APA programs offered to patients being treated at the CLB. These programs are adapted to suit the greatest number of people and they can all be personalized. They are aimed at all patients, regardless of their treatment, the stage of their disease or the location of their tumor. We work with children, adolescents, young adults and adults, but also with patients aged over 70.

Alongside this clinical activity, we work on clinical research projects in order to demonstrate the effects of physical activity on the care of patients with cancer.

ONE FACE, ONE PROFESSION:INSTRUCTOR IN APPROPRIATE

PHYSICAL ACTIVITY

> FLAGSHIP ACTIVITY IN 2018

CONVENTIONAL HOSPITAL STAYS AND OUTPATIENTS288 adult patients

138 adolescent and young adult patients (15-25 years)

IN DAY HOSPITAL476 patients and family members

supported (in APA sessions or for advice)

IN 2018 :138 young people(86 boys et 52 girls)

of whom 28 young patientsin sterile rooms (10 more young patients than in 2017)

5 MASTER’S

IN APA

2 POST-DOCS

7 APA

INSTRUCTORS

76patients

AGED 15 TO 25 AGED 10 TO 15

62patients

− DIAGNO-S T I C SACCELERATING INNOVATION

02 BETTER TRACKING OF THE DEVELOPMENT OF A DISEASEOn one single site, the Centre Léon Bérard has the full array of equipment and technical platforms necessary for screening, diagnosis and also the monitoring of cancers:

> Pa thob i o l ogy : ana tomy and cytopathology, molecular biology;

> Imaging: radiography, ultrasound, MRI , scanner , sc in t igraphy , PET scan;

> Interventional diagnostic: stereotactic, percutaneous or surgical biopsies, and endoscopies.

> FLAGSHIP ACTIVITY IN 2018ARTIFICIAL INTELLIGENCE FOR THE BENEFIT OF DIAGNOSTICSAdvancing research against cancer, facilitating the choice of the best treatment depending on the tumor and the patient, or improving the diagnosis of the rarest cancers… In cancer research, artifi cial intelligence is opening up numerous opportunities and the Centre Léon Bérard is working to accelerate innovation for the benefi t of patients.

The CLB has initiated many innovations in the area of IT systems, such as e-health, and it is in a partnership with the French start-up Owkin for developing its projects.

An initial project focuses on the automatic analysis of the virtual anatomic-pathology slides produced by the CLB’s pathobiology department, which are associated with the treatment data, in particular the data on rare cancers, such as mesothelioma

or sarcomas. Indeed, diagnosing these multifaceted and diverse tumors remains a delicate matter, requiring medical expertise that is increasingly rare. Thanks to AI, combined with the great computing powers now available, medical data from hospitals, data from examinations and imaging, as well as data from medical records, will be analyzed automatically in order to extract information and develop machine learning algorithms.

Other similar collaborations are in progress, aimed at making good use of the signifi cant volume of imaging data (scanners, MRI) that the CLB has at its disposal. “It is an asset for our patients: artifi cial intelligence opens the way to medicine that is even more predictive and personalized.”, explains Prof. Jean-Yves Blay.++−

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Respecting the confi dentiality of data

As part of the Owkin Socrates platform, available from 2019, the Centre Léon Bérard will grant secure and anonymized access to the medical data that it holds. “The security of the data that we hold is

of paramount importance and the system offered by Owkin was satisfactory to us from the outset, because no data will leave the hospital,”notes Prof. Jean-Yves Blay.“The server that will enable the development of the machine learning algorithms will be installed within our institute.”

NUCLEAR MEDICINE11,341 procedures in total

Gamma camera3,908 diagnostic procedures

100 therapeutic procedures

PET scan7,333 procedures

ENDOSCOPY 2,629 endoscopies carried out

1,977 patients

RADIOLOGY Breast cancer5,738 mammograms

5,672 breast ultrasound scans

160 stereotactic biopsies

732 ultrasound-guided biopsies

903 percutaneous markers

Non-breast cancer3,839 ultrasound scans

13,769 standard X-rays

12,068 scanner uses

9,470 MRI scans

PATHOBIOLOGY 20,826 anatomic procedures

2,684 cytology procedures

112,286 slides produced

3,046 molecular biology procedures

2,276 procedures and 3,499 tumors frozen for the tumor tissue bank

10,779 procedures and 28,016 frozen blood samples (blood, serum, plasma, cells)

3,027 procedures and 8,004 derived products produced (DNA and RNA extracts)

INTERVENTIONAL RADIOLOGY2,824 proceduresInterventional radiology is used for the diagnostic but in also proposed for cancer treatment and supportive care.

20−

1,457DIGESTIVE SYSTEM

13%

STOMACH, COLON, RECTUM,

GALLBLADDER, PANCREAS, ETC.

1,161RESPIRATORY SYSTEM

10%

LUNGS, BRONCHI,

TRACHEA, HEART, PLEURA, ETC.

−CANCER DISTRIBUTION

2,562BREAST

23%

21NEURO-

BLASTOMA less than 1%

675FEMALE

REPRODUCTIVE TRACT 6%

GONADAL GERM CELL TUMORS,

EXTRA-GONADAL GERM CELL TUMORS,

CERVIX, UTERUS, VAGINA, ETC. 190

CENTRAL NERVOUS

SYSTEM2%

GLIOMAS, OLIGO, NERVES, MENINGES, SPINAL CORD, ETC.

11,295 patients were hospitalized or had treatment as outpatients

(chemotherapy, surgery and

radiotherapy).

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AT THE CENTRE LÉON BÉRARD

619MALE

REPRODUCTIVE SYSTEM

5%

GERM CELL TESTICULAR TUMORS,

EXTRA-GONADAL GERM CELL TISSUES, TESTICLE EXCLUDING

GERM CELL TUMORS, PROSTATE, PENIS, ETC.

21−

−CANCER DISTRIBUTION

2,562BREAST

23%

940NON-TUMORAL

8%

900UPPER

AERODIGESTIVE TRACT

8%

LIPS, TONGUE,

SALIVARY GLANDS, GUM, FLOOR OF THE

MOUTH, ETC.

1,018HEMATOLOGY

9%

MYELOMAS, PLASMOCYTOMAS,

BURKITT LYMPHOMAS, MNHL, ALL, ETC.

348URINARY

TRACT3%

WILMS TUMOR, BLADDER, DOME, KIDNEY, PELVIS,

ETC.

272SKIN

2%

MELANOMAS, NEVUS, SKIN

(OTHER HISTOLOGY)

SOFT TISSUES, FIBROSARCOMAS,

NEUROFIBROMATOSIS, EWING SARCOMAS,

OSTEOSARCOMAS, ETC.

938SOFT TISSUES,

BONE AND CARTILAGE 8%

134ENDOCRINE

GLANDS 1%

THYROID, PARATHYROID,

PINEAL, ADRENAL

56OTHER LOCA-

LISATIONS less than 1%

LYMPH NODES, UNKNOWN

OR ILL-DEFINED PRIMITIVE LOCATION

4EYE

less than 1%RETINOBLASTOMAS,

EYE, BODY, CHAMBER, GLOBE, ETC.

OAT THE CENTRE LÉON BÉRARD

− TREATINGCOMPREHENSIVE CARE ON A SINGLE SITE

03 INNOVATING FOR OUR PATIENTSCancer treatments are constantly evolving. Every year, new molecules or treatment combinations are offered to patients either as routine therapies or as part of a therapeutic trial. Whether surgery, radiotherapy or drugs are needed – the Centre Léon Bérard

carries out the full range of innovative cancer treatments on a single site.

Of 872 hospitals in France authorized to treat cancers, only 74 offer the three types of treatment (source: Directorate General of Health 2017).

> FLAGSHIP ACTIVITIES IN 2018RCP TOXIMM IS ONE YEAR OLD!

In order to give better care to immunotherapy patients, a new multidisciplinary consultation meeting (RCP) called Toximm was created in September 2017. This RCP is managed by the medical oncologists Prof. Isabelle Ray-Coquard and Dr. Souad Assaad.

Immunotherapy represents a major advance in cancer care. Its use in recent times has given rise to a new spectrum of toxicities affecting many organs: joints, skin, heart, kidneys,

liver, etc., and whose management involves many organ specialists.

This new RCP was created to provide such patients with better monitoring and care. There is a monthly consultation meeting with medical oncologists and hematologists of the Centre Léon Bérard and organ specialists from other hospitals.

In 2018, 61 fi les were studied within the framework of this RCP.

−22

23−

23−

At the French Comprehensive Cancer Centres, the therapeutic management of patients is provided by oncologists who are specialist medical practitioners of the Centers. These are surgeons, medical oncologists, hematologists, and radiotherapists.

After having a consultation with the patient and confirming the diagnosis using various examinations that are all available at the Centre Léon Bérard, the practitioner in charge of the patient will decide on the treatment protocol to offer, in conjunction with his or her other colleagues, at a multidisciplinary consultation meeting (RCP)*. These RCP are organized every week and for each tumor location. They may also be used to consider patients’ medical records sent by colleagues from other hospitals.

At the same time as they perform this hospital – or clinical – activity, most of the Center’s medical specialists also do research. For example, in 2018, 94 physicians

took part in clinical research projects, either by including patients in therapeutic trials (we then refer to them as investigative doctors) or by coordinating a trial, i.e. by initiating it (we then refer to them as coordinating doctors).

Thus, each year at the CLB around 40 clinical trials of the 300 on average that are open to inclusions are set up and coordinated by a physician from the Center, in conjunction with the institute’s Directorate of Clinical Research and Innovation.

The researching physicians present the results of their trials at the world’s largest conferences or publish them in major international scientifi c journals.

Among the major international meetings are ASCO, the conference of the American Society of Clinical Oncology, which is held in Chicago each year, and its European counterpart , the European Society

for Medical Oncology (ESMO). These conferences bring together thousands of physicians from every part of the world. Other specifi c events are organized at the national and international level for surgeons and radiotherapists.

In addition, some of our specialist physicians also work in translational or basic research laboratories.

ONE FACE, ONE PROFESSION: DOCTOR AND RESEARCHER

D I D YO U KN OW ? The Centre Léon Bérard has one of the few inst i tutes of exper iment a l surger y in France .

*The 14 RCPs of the Centre Léon Bérard: thoracic, ENT, sarcoma diagnostics (bone + soft tissue), hematology, gynecologic oncology and rare tumors, care of referrals in gynecology, urology, skin tumors, molecular diagnostics, metastatic lesions of the bone, digestive tract, sarcomas, breast and Toximm.

++

ASSESSMENT OF TREATMENTSON’COHUB™ is a new solution for oncological monitoring and therapeutic response assessment offered to the Centre Léon Bérard by the Department of Radiology. Led by Dr. Charles Mastier and devised by physicians, this solution is accessible to all the French Comprehensive Cancer Centres, which integrate it into their information systems. ON’COHUB™ makes it possible to organize exchanges between the oncologist and the

radiologist, by structuring the assessment of treatments, standardizing prescriptions and reports, and making use of treatment and assessment data. ON’COHUB™ brings benefi ts to patients as regards reliability and security in the assessment of their treatment. This data, checked in a quality assurance process, is accessible in real time for clinical research. This project was awarded the 2018 Unicancer Innovation Prize in the care pathway category.

24−

−CANCER TREATMENT

CELL THERAPY

167 sessions

(147 for the CLB and 20 for IHOPe*)

115 patients

(147 for the CLB and 20 for IHOPe)*Institute of Pediatric Hematology

and Oncology

NUCLEAR MEDICINE

Gamma camera 100

therapeutic procedures

MEDICINE & PHARMACY

59,179 consultations carried out

by the medical department

2,095 patients included in clinical trials

83,478 chemotherapy interventions

12,800 interventions carried out as part of a clinical trial

1,531 medical interventions during consultations

k€25,475 of anti-cancer spending

ANESTHESIA 7,957

consultations

5,352 patients

7,315 anesthesia applications

2,975 insertions of venous

catheters

CHIFFRES 2018

25−

+

CHIRURGIE 28,826

consultations

4,036patients operated on except endoscopy

and except insertion of venous catheters

5,365procedures except endoscopy and except

insertion of venous catheters

4,730procedures under general anesthetic

635procedures under local anesthetic

RADIOLOGY2,821

interventional radiology procedures

Interventional radiology is offered for the treatment of cancers

and supportive care (e.g. pain management, nutrition), and is also

used in diagnostics.

RADIOTHERAPY 3,692patients

3,834initiations of treatment

Lyon 3,416patients

29,365classical radiotherapy

sessions

2,612Cyberknife© sessions

6,256tomotherapy sessions

7,706Versa HD© sessions

Villefranche-sur-Saône

600patients

11,679sessions in total

6,737classical radiotherapy

sessions

4,942tomotherapy sessions

BRACHYTHERAPY660

sessions

04− HOSPITA-LISATIONIMPROVING THE CARE PATHWAY

TAKING A DIFFERENT VIEW OF HOSPITAL ORGANIZATIONModes of hospitalization and types of care pathway: the Centre Léon Bérard also innovates in healthcare organization. In the 1990s, it was the first French Comprehensive Cancer Center to organize the return and home care of its patients. Currently,

more than 3,800 individuals are monitored at home. More recently, the CLB has opened eight local apartments to facilitate the care of patients who do not live in the department or whose accommodation is not suitable.

> FLAGSHIP ACTIVITIES IN 2018HAVING ACCESS TO ONE’S HEALTHCARE DATAPatients have had access to their administrative and medical data since 2016, thanks to the patient portal myCLB. They can also communicate more easily with the care teams that are treating them. In 2018, 9,290 patients were registered!

79% OF PATIENTS SATISFIED WITH OUR CAREAt the end of 2018, the National Health Authority published the results of a patient satisfaction survey for all French hospitals*. Patient responses provide a satisfaction score out of 100 and in 2018, the Centre Léon Bérard obtained a score of 79/100. It is among the best hospitals in Auvergne-Rhône-Alpes.

Apart from an overall satisfaction score, this survey also shows the levels of satisfaction for different items, such as care by nurses and nursing assistants, meals, and the organization of the discharge from hospital.

In addition, in 2018, outpatient surgery patients were questioned for the fi rst time. The Centre Léon Bérard obtained a good score, as 86%* of patients admitted for outpatient surgery would defi nitely recommend our institute.

All the results of the Centre Léon Bérard, as well as the results of other medical establishments, can be found on www.scopesante.fr a n d o n o u r i n f o g ra p h i c o n www.centreleonberard.fr

84%* of hospitalized patients saying that they would defi nitely recommend it to friends and family.

O−26

*e-Satis

COMPARING CARE PATHWAYS AT THE EUROPEAN LEVELIn 2018, the CLB became involved in the ICHOM All.Can project. Some 10 healthcare institutes in Europe participate in this program, which aims to compare the value of care pathways in different countries. The CLB and the Institute of

Cancer Research in Western France are the only two participating institutes in France. For the CLB, the study will involve 100 patients with breast cancer who will be monitored for six months.

*D0 : entry on the same day as the surgical procedure **At Home Hospitalization

CAPACITY

HOME CARE CONTINUOUS CARE

CONVENTIONAL HOSPITALIZATION AND OUTPATIENT CARE

1,632HOME CARE

STAYS

3,570PATIENTS CARED

FOR BY AHH**

5,264 AHH** STAYS

2,179 HOME CARE

PATIENTS

205 placesFOR AHH**

9 placesOUTPATING

SURGERY STAYS AND D0*

8 bedsFOR

CONTINUING CARE

20 bedsFOR BRACHYTHERAPY

145 bedsFOR MEDICINE

61 bedsFOR SURGERY

77 placesDAY HOSPITAL STAYS

51 bedsFOR

PEDIATRICS12,155

CONVENTIONAL HOSPITALIZATION

STAYS

4,417OUTPATIENT

SURGERY STAYS

5.61DAYS

(AVERAGE LENGTH OF

STAY)

716STAYS WITH TRANSFERS 3.4 jours

AVERAGE LENGTH OF STAY

(IN DAYS)

2,447 ADMINISTRATIVE

DAYS

644DIFFERENT

PATIENTS83.8 %

OCCUPANCY RATE

30,669OUTPATIENT

MEDICINE STAYS

−27

-

05− S U P P O R -TING AND LISTENINGCOMPREHENSIVE CARE OF THE PATIENT

++--To support patients and their families, the Centre Léon Bérard offers complementary care services that are organized at the CLB in two categories:

Supportive care > Social assistance> Addictology> Physiotherapy> Nutrition> Wounds and scarring> Pain management> Psychological support.

Living better with cancer > Appropriate physical activity> Associations> Therapeutic education> Meeting and information spaces.

The quality of the reception of patients and their families is a constant concern of the Centre Léon Bérard teams. As part of a drive for continuous improvement, the institute also seeks to innovate in this area and listens to its patients and their families. Patients have been involved in the quality

drive for a number of years, through bodies such as the Executive Board or the Users’ Committee, and they are regularly asked for their opinion on the reception, organization, and the information they are given by their teams or the institution.

D I D YO U KN OW ? Sexology consul t ing are a lso sug gest to pat ients .

A BETTER QUALITY OF LIFE FOR FIGHTING CANCER

−28

> FOCUS ON PATIENTS’ MEETING AND INFORMATION SPACE

The ERI was involved in organizing 4 exceptional events: projection of the film Personn’elles (90 people in January); 1st salon of K Fighteuses in April; 1st book fair in October: writers and cartoonists invited; Blue March and Pink October 2018: nearly 600 people attended these gatherings.

1,852individuals were received in the patients’ meeting and information space

(ERI)

8 CONFERENCES

WERE ORGANIZED

424 PEOPLES

ATTENDED

CARE OF CHRONIC WOUNDS108

PATIENTS

CARE IN LYMPHOLOGY283

PATIENTS

SEEN REGULARLY BY THE MOBILE PALLIATIVE CARE TEAM

564PATIENTS

SEEN REGULARLY BY THE MOBILE ANALGESIA TEAM

805PATIENTS

SEEN REGULARLY BY THE SOCIAL SERVICE

1,934PATIENTS

SEEN REGULARLY BY THE DIETICIAN TEAM2,615

PATIENTS

SEEN REGULARLY BY THE PSYCHOLOGY TEAM1,572

PATIENTS

−THE COMPLEMENTARY'S CARE

76%were

patients

13%were family members

−29

30−

> FLAGSHIP ACTIVITIES IN 2018

DIVERSE PERSPECTIVES: THE CLB’S GROUP OF PATIENTS AND FAMILIESIn March 2018, the Centre Léon Bérard set up a group of around 10 patients, together with family members of people being treated by the CLB.

Objectives : to think about our non-medical organizations and be a source of ideas and proposals.

The work of this group, called Regards Croisés [Diverse Perspectives], focuses on our institute’s non-medical organizations and is intended to inform and enhance the thinking of management and the institute’s teams. This group meets once a quarter and in 2018, it focused on ‘supporting the patient’s

family’, ‘telling the patient about the disease and treatments’, and ‘the period after cancer’.

PASCA: HEALTHCARE PATHWAY THROUGHOUT CANCERFollowing treatment for cancer, the CLB teams offer all patients follow-up medical monitoring adapted in order to monitor how the patient’s health develops and prevent risks of a relapse. The new program PASCA ‘Parcours de Santé au cours du Cancer’ [Healthcare Pathway Throughout Cancer] goes further by offering patients more comprehensive monitoring to take better account of the physical scars of cancer treatments, but also of the psychosocial impact of the disease. This program targets adult patients aged 18 to 65, living in the Auvergne-Rhône-Alpes region.

Its twin objectives are:

> Screening for early and late complications linked to treatments and their associated risk factors, for which an intervention is possible;

> Guiding patients within a network consisting of professionals who have knowledge of the subject in the Auvergne-Rhône-Alpes region – general practitioners, specialists or other healthcare professionals – to initiate personalized care and monitoring.

In 2018, 60 pat ients wi th a hematologic mal ignanc y or tes t icular cancer benef i ted f rom the program .

+O

-APPROPRIATE PHYSICAL ACTIVITY, PHYSIOTHERAPY AND SOCIO-ESTHETICSIn 2018, 288 new adult patients benefited from appropriate physical activity (APA) as well as 138 adolescents and young adults. The majority of the adult participants were women with breast cancer (60%), although the program is also structured to suit other patients.

THERAPEUTIC EDUCATIONIn June 2018, the program Therapeutic Education for Patients and their Families (ETAPP) opened fi ve days a week thanks to the secondment of a FTE educational nurse. Since that time, four nurses have been involved in these activities on behalf of patients, with the key aim of giving them ownership of their care pathways.

In September 2018, a room specifi cally for therapeutic education was created in the ‘Pyramid Space’ [Espace Pyramide].

136 patientsTREATMENT WORKSHOP

88 patients STOMA WORKSHOP

81 patients FATIGUE

WORKSHOP

305individual

workshops

1,516 PATIENTS BENEFITED

FROM A SOCIO-ESTHETIC SESSION OR

WORKSHOP

2,183 PATIENTS SEEN

REGULARLY BY THE PHYSIOTHERAPY TEAM

415 PATIENTS IN

EDUCATIONAL EVALUATION

(COMPLETION OF CARE)

658 EDUCATIONAL

DIAGNOSES CARRIED OUT

41 sessionsNUTRITION WORKSHOP

104group

workshops

5 sessionsTREATMENT WORKSHOP

23 sessionsSOCIO-ESTHETIC

WORKSHOP

10 sessionsFATIGUE

WORKSHOP

25 sessionsAPPROPRIATE PHYSICAL

EXERCISE WORKSHOP SESSIONS

3,587 PATIENTS WERE TREATED

BY THE INTERDISCIPLINARY DEPARTMENT FOR PATIENT

SUPPORT CARE IN ONCOLOGY

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06− CLINICAL RESEARCHINCREASINGLY ACTIVE RESEARCH

FOUR CLINICAL TRIALS HIGHLIGHTEDRT-IMMUNE STUDY: IMMUNOTHERAPY IN SARCOMASThe RT-Immune study (European multicenter Phase II trial) has been open to inclusions since April 2018 (12 inclusions to date). The goal of this early phase trial is to assess the clinical and biological impact of an immunotherapy treatment (anti-PD-L1 atezolizumab) in patients with operable soft tissue sarcomas that require radiotherapy treatment. The principal investigator for this trial facilitated by the CLB is Prof. Jean-Yves Blay.

Soft tissue sarcomas are rare tumors representing 1 to 3% of tumors in adults.

TGM 2013-NS STUDY: A TRIAL IN PEDIATRICS AND YOUNG ADULTSThis trial is a multicenter study to evaluate the efficacy of four prognostically appropriate therapeutic strategies in extracranial nonseminomatous malignant germ cell tumors (NSGT) in children, adolescents and young adults.

The prognosis for these tumors in children and adolescents has been excellent since the introduction of chemotherapy based on cisplatin. However, this molecule is responsible for long-term side effects (in particular renal or auditory), depending on the total

dose administered. There is currently no alternative treatment and it is therefore necessary to fi nd therapeutic strategies (by de-escalation of doses) that improve the risk/benefi t ratio for these patients.

Open to participants since 2015, this trial, coordinated by pediatric oncologist Dr. Cécile Faure-Conter, has already included a total of 117 patients (26 in 2018). The initial objective was to include 94 patients over fi ve years.

ATEZOGIST: A TRIAL SELECTED FOR PHRC 2018Selected as part of the 2018 Hospital Program for Clinical Research (PHRC), ATEZOGIST, coordinated by Dr. Mehdi Brahmi, is a comparative, prospective and multicenter study designed to measure the effectiveness of reintroducing imatinib in combination with atezolizumab, versus imatinib alone. This trial will be offered to patients with advanced GIST (gastrointestinal stromal tumors) that are inoperable after the failure of treatment with imatinib and sunitinib (progression or toxicity). Atezolizumab is a monoclonal antibody targeting PD-L1, approved since July 2017 for the treatment of advanced urothelial carcinoma and non-small-cell lung cancer, following the failure of platinum-based treatments. Recently, preclinical data have shown that imatinib and immune

−32

33−

ONE FACE, ONE PROFESSION: DATA-MANAGER

checkpoint inhibitors have a synergistic anti-tumor effect. There is an important biological rationale for testing the anti-tumor effectiveness of atezolizumab in combination with imatinib in patients with GIST who have been previously treated.

PREFACE: IMPORTANCE OF PET-PSMA IMAGING IN PROSTATE CANCER TREATMENTThe PREFACE project, coordinated by nuclear medicine physician Dr. Anne-Laure Giraudet, was selected in the call for proposals for the Interregional Hospital Program for Clinical Research

(PHRC-I 2018). The aim of this study is to detect recurrences after initial treatment (surgery or radiotherapy) of prostate cancers as early as possible by means of an examination with PET-PSMA, positron emission tomography using the PSMA radiotracer, a prostate-specifi c membrane antigen detected by the PET scanner.

This study will involve 52 patients, in fi ve hospitals, over a period of one year.

In the near future, PET-PSMA will be a crucial tool for routine care and at all the stages of patients presenting with a prostatic adenocarcinoma.

The concept of an electronic case report form (eCRF) for clinical trials holds no secrets for data managers. Previously outsourced, this activity has long been digitized and has now been mastered by a dedicated team within the Directorate of Clinical Research and Innovation (DRCI).

Each clinical trial is accompanied by data collection. Age, weight, height, examination results, description of side effects, questionnaires on quality of life – many hundreds of variables may be necessary in order to study and validate the effectiveness of a new treatment or a new examination. These variables must be reliable and continuously updated, and it must ultimately be possible to analyze them for the purposes of the conclusions and publication of the trial.

The electronic case report form is therefore a key part of clinical research and creating it is the main activity of a new, three-person DRCI team created in 2015. Previously, the production of the eCRFs of trials designed and carried out by the Centre Léon Bérard was fully outsourced to a specialized fi rm. Now, in the interests of greater fl exibility and effi ciency, the majority of eCRFs are 100% made at the CLB.

The CLB’s data management team works only on trials facilitated by the Center. One team member deals specifi cally with the early phase trials as part of the dedicated unit. However, the three employees on the team are all able to perform a variety of tasks.

601 early phase I and II trials, of which 151 phase I trials

116 patients included in an early phase I and II trial, of whom 32 in phase I

2,095patients included in a clinical trial, or 18.5% of the

active list

315trials for

biomedical research

357studies open to patients

1,863patients included

in biomedical research

42clinical trials designed and

implemented by the CLB

07 T R A N S L A T I O N A L R E S E A R C H

− DOING RESEARCHPOOLING EXPERTISE

O�

> FLAGSHIP ACTIVITIES IN 2018

FIRST SYMPOSIUM FOR HUMAN AND SOCIAL SCIENCES IN CANCER RESEARCH AND CAREOn the initiative of the department’s coordinator, Marc Billaud, a symposium was organized for 25-26 October 2018, looking at therapeutic innovations and patient care,which were two issues that emerged from the LYriCAN (SIRIC*) and PLAsCAN (Institutes of Convergence) programs. More than 30 speakers from Lyon and all over France, as well as 10 moderators, contr ibuted to the success of this event. This multidisciplinary sympos ium brough t toge ther clinicians, researchers, sociologists, geographers, and health economists, as well as representatives of patient associations.

UA8: A NEW ACCREDITED TEAM ON THE CENTRE LÉON BÉRARD SITEThe project to create a unit, led by Nicolas Foray, was favorably received by Inserm, which announced its creation in December 2018. This new joint Inserm/Ministry of the Armed Forces unit, UA8 ‘Radiation: Defense, Health, the Environment’, aims to address all the main aspects of the

biological and clinical effects of the various types of radiation. It will enable the creation of a reference center in Lyon on the effects of radiation in France. The unit was officially created on January 1, 2019, prior to its evaluation by the High Council for Evaluation of Research and Higher Education (HCERES) in 2020.

LYON CANCER IMMUNOTHERAPY LABORATORY (LICL) ESTABLISHEDWith the support of the Auvergne-Rhône-Alpes region, the LICL was set up in 2018, bringing expertise in immunology together on one site. The aim of this laboratory is to provide the region’s medical and scientific community with the necessary skills to monitor innovative clinical trials in immunotherapy for the treatment of cancers, identify resistance mechanisms but also new targets, and fi nally to develop new drugs to use against these targets, in partnership with the pharmaceutical industry and biotech industries. The platform has been created by recruiting qualified staff and has acquired cutting-edge equipment for monitoring anti-tumor immunity. The LICL, which fully -O

−34

*Integrated Cancer Research Cluster

35−

+

*Consortium Partners: Centre Léon Bérard, Hospices Civils de Lyon – Lyon; Centre Jean Perrin, University Hospital – Clermont-Ferrand; Institut de Cancérologie de la Loire Lucien Neuwirth (ICNL) [Lucien Neuwirth Institute of Oncology of the Loire]; University Hospital – Saint-Étienne; Grenoble-Alpes University Hospital (CHUGA) – Grenoble; University Lyon 1; University Clermont Auvergne; Grenoble-Alpes University; Jean Monnet University; Mines Saint-Étienne; Synergie Lyon Cancer Foundation (SLC)

42%of the projects

funded

2patents

fi led

60cooperation contracts

10Confi dential Disclosure

Agreements

3european projects funded

16Material Transfer

Agreements

103PROJECTS

SUBMITTED IN 2018

integrates research, development and innovation (R&D&I), will be a unique center for promoting synergies between research, therapeutic innovation, patient care, and training adapted to emerging medical needs in immuno-oncology.Partnerships are in the process of being signed.

FIRST YEAR OF LYRICAN; NEW SIRIC IN LYON Approved at the end of 2017, the SIRIC (Integrated Cancer Research Cluster) of Lyon, led by Prof. Jean-Yves Blay and implemented by the Centre Léon Bérard and the Hospices Civils de Lyon, offi cially started operations on January 1, 2018. This project focused on plasticity brings together clinicians and researchers in a multidisciplinary approach. The offi cial launch was on March 29, 2018, attended by representatives of the National Cancer Institute (INCa). This first year enabled the various actors involved to create a structure and initiate the first projects of this ambitious program. Links have been strengthened with the International Agency for Research on Cancer (IARC), a partner of LYriCAN, on an epigenetic theme. In 2018, two important events enabled clinicians and researchers to mobilize their efforts on human and social sciences questions, and on immunomonitoring the clinical trials carried out in the region. The structuring effect of LYriCAN has also been given practical implementation in

the technological platforms developed for the medical and scientifi c community. A website specifically for this project presents the structure of LYriCAN, the three integrated research programs, and the support programs necessary for implementing this ambitious project (www.cancer-lyrican.com).

THE TECHNOLOGICAL PLATFORMS SUPPORTING THE PROJECTS The technological platforms, the majority of which are located on the Centre Léon Bérard site, are essential tools for meeting the needs of the community, while adapting to changes linked to the projects. The Gilles Thomas bio-informatics platform is central to numerous research projects, and it is also closely involved in the AURAGEN project, a very high-speed sequencing platform for healthcare purposes. A winning project in the France Médecine Génomique 2025 (France Genomic Medicine 2025) plan, AURAGEN has been set up with participants from hospitals and universities, and the French Comprehensive Cancer Centers in Clermont-Ferrand*. In 2018, new acquisitions and structuring on the site gave project leaders the opportunity to use new technologies such as NanoString DSP, equipment that allows gene expression analysis coupled with spatial distribution, as well as genomic analysis at the cellular level with the Single Cell approach.

36−

B A S I C R E S E A R C H

> FLAGSHIP ACTIVITIES IN 2018

CRCL: PREPARATION OF NEXT FIVE-YEAR CONTRACT 2021-2025The International Scientifi c Board of the Cancer Research Center of Lyon (CRCL) held a meeting on September 27 and 28, 2018, chaired by Prof. Éric Solary. This Board issued two opinions that determined the future of the CRCL: one on the choice of the next director for the 2021-2025 fi ve-year contract, and the second on the teams that will participate in the project submitted to the High Council for Evaluation of Research and Higher Education (HCERES) in 2019 for the 2021-2025 contract.

As regards the management of the CRCL, after two successive mandates, Alain Puisieux, one of the historical founders of the Center, did not wish to renew his mandate as director. Prof. Alain Puisieux took over as Director of the Research Center of the Institut Curie on September 1, 2019. Three researchers

put themselves forward as candidates to succeed him: Patrick Mehlen and Charles Dumontet, then deputy directors of the CRCL, and Antonio Iavarone, professor at Columbia University, New York. When Antonio Iavarone withdrew his candidacy, Patrick Mehlen and Charles Dumontet decided to stand together, as director and deputy director respectively.

Regarding the constituent teams of the CRCL in the context of the next fi ve-year contract, 17 of the 29 project leaders were interviewed and 12 were validated by the Scientifi c Board on the basis of very strict international competitiveness criteria. A total of 24 teams have therefore now been selected to take part in the next fi ve-year contract of the CRCL.

LAUNCH OF ERICAN RESEARCH PROJECTThe CRCL and the Institute for Advanced Biosciences (IAB) in Grenoble have been

selected by the MSD Avenir endowment fund to jointly carry out the ERiCAN research project ‘Epigenetic Reprogramming of CANcer cell plasticity and resilience’ over four years.

With fi nancial support of 2.12 million euros from this endowment fund, the ERiCAN project is led by the two research center directors (Alain Puisieux for the CRCL and Pierre Hainaut for the IAB), in partnership with the Lyon Auvergne-Rhône-Alpes Cancer Research Cluster (CLARA). This program originates from the expertise and the research programs carried out by the two institutions in the fi elds of epigenetics, stem cell biology, and the study of the microenvironment in cancers.

A tumor is considered to be a heterogeneous and highly adaptive ecosystem, based on complex interactions between cancer cells and their microenvironment. The originality

* Professor of hematology, scientifi c director of the Île-de-France Cancer Research Cluster, director of the Gustave Roussy Institute of Oncology

�O

of the project consists of studying the evolution over time of the plasticity of cancer cells, placed under the selective constraint of targeted therapies. For this purpose, ‘pairs’ of unique experimental cellular models will be developed, representing, for the same patient, the primary tumor on the one hand and the tumor that will have become resistant to treatments on the other. Two cancer diseases will be studied in particular: melanoma and non-small-cell lung cancer. These experimental models will enable the development of

a multidisciplinary approach combining molecular, cellular and bioinformatics biology analyses to characterize the reprogramming mechanisms underlying cancer progression and post-treatment resilience.

Ultimately, the results of this ambitious program could lead to the development of new therapeutic approaches by targeting the molecular circuits that govern cellular plasticity and by modulating interactions between cells and the tumor microenvironment.

396joint CLB and

CRCL scientifi c publications

+

-

CRCL : 5 NEW RESEARCHERS RECRUITED

281CRCL scientifi c

publications, of which 31 journals with an impact factor

> 10

publications, of which

500members of the CRCL

of whom 151 are researchers

and teacher-researchers

29different

nationalities at the CRCL

INSERM COMPETITIONLaura BroutierYenkel Grinberg-BleyerPierre Martinez

CNRS COMPETITIONNicolas AznarMaria Ouzounova

O

CRCL DIRECTOR ALAIN PUISIEUX, WINNER OF THE RESEARCH AWARD ‘GRAND PRIX RUBAN ROSE DE LA RECHERCHE 2018’The ‘Grand Prix Ruban Rose de la recherche 2018’ prize was awarded to Prof. Alain Puisieux by the association ‘Le Cancer du Sein, Parlons-en!’ [Breast Cancer: Let’s Talk About It] for his work as a whole and his research program on breast cancer. The award was presented to him during the evening event to launch the Pink October campaign in Paris on October 1, 2018.

NEW TEAM: ‘MOLECULAR REGULATION OF IMMUNITY IN CANCER’Dr. Yenkel Grinberg-Bleyer was successful in the DEVweCAN Laboratory of Excellence’s call for proposals to set up his research team at the CRCL. He joined the ‘Immunity, Virus, Infl ammation’ department.

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In 2018, the Training Institute of the Centre Léon Bérard established new training courses:

> For physicians: ‘Management of ovarian cancers’, ‘Antitumor immunotherapies: immunomonitoring and escape, clinical concepts and applications’, and ‘Management of sarcomas’;

> For nurses, a new action training course: ‘Monitoring patients treated with oral anticancer drugs, medical-nursing cooperation’.

Finally, in May 2018, the Institute also organized the 24th course for medical assistants in oncology.

08− T R A N S -FERRINGADAPTING TO SOCIAL DEVELOPMENTS

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INTERCULTURALISM: TRAINING THAT IS OPEN TO OTHERS How should one treat a patient from another culture or one who does not understand our language or cannot read; a patient who in some cases perceives the body, the disease and treatment in a very different way from our own? Difficult or even confrontational situations encountered during patient care, particularly at the time of a patient’s end of life and death (very specific cultural practices that can be a source of misunderstanding between patients, their entourage and staff members), have led the CLB teams to question their practices.

As part of its 2016-2021 establishment project and the Cancer Plan’s action to reduce inequalities of all kinds, the Centre Léon Bérard is mobilizing its efforts. As early as 2017, on the initiative of the management,

a multidisciplinary intercultural steering committee was set up to answer these questions and implement concrete actions.

Currently, working groups are meeting to create tools, such as picture books and a resource library on rites and customs related to disease. A feedback group is being set up, which lists and analyzes the difficult situations experienced by the healthcare teams.

In 2018, more than 80 employees (e.g. care staff, medical administration staff) received in-house training in cultural outreach. Provided by a specialized facilitator from outside the CLB, this training gave them tools to facilitate the care of these patients and they now pass on this policy as ‘ambassadors’ in the fi eld.

> FLAGSHIP ACTIVITY IN 2018

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16courses

accredited by the ANDPC*

* Agence nationale du développement professionnel continu (National Agency for Continuing Professional Development)

UNIVERSITY EDUCATION

The university and inter-university degrees managed in conjunction with the University Claude Bernard Lyon 1:

> DU** senology: 3 sessions of 2 days/academic year

> DIU*** oncogeriatrics: 5 sessions of 2 days/academic year

> DIU pediatric pain and palliative care: 5 sessions of 2 days/academic year

> DU oncology of the upper aerodigestive tract: 4 sessions of 2 days in January, February, March and April 2018

> DIU supportive care in oncology: 5 sessions of 2 days/academic year (but not open in 2018)

> DIU comparative pathology in oncology: 8 modules over 3 weeks + e-learning

> European DIU surgical practices in oncology: 5 sessions of 2 days/academic year

THE 2018-2019 LYON MASTER’S DEGREE IN CANCEROLOGY

Created in 2013 as part of the Cancer Research Center of Lyon (CRCL), the Master’s degree course in cancerology is the only one in France to bear the title “Cancerology”.

In 2018-2019, this Master’s degree course has 106 students at cancer research sites in Lyon, including the Centre Léon Bérard.

The M1 offers a basic foundation course, which gives students access to three specializations in M2.

36 students in M1

29 students in M2 biology of cancer

28 students in M2 therapeutic innovation in cancerology

13 students in M2 oncology 3.0 ‘-omics’ approaches to personalized medicine

IN-HOUSE TRAINING

1,108 employees of the Centre Léon Bérard trained (who have attended one or more training courses)

1,581 employees taking study leave

26 919 hours of training

62 radiotherapists,

18 anesthetists,

16 dental surgeons

6 nuclear doctors

TRAINING INSTITUTE FOR EXTERNAL HEALTH

PROFESSIONALS

11 university teachers, including

> 3 assistant heads of clinic (CCA)

> 8 university lecturers – hospital practitioners (PUPH)

75 non-university doctors and nurses participating in university courses

29 medical forums organized

3 clinicians/researchers meetings organized

498persons trained

of whom

102doctors

60sessions

+O−EDUCATION AND TRAINING

30training courses offered

46instructors

8,904hours

of training given

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**DU : university degree***DIU : inter-university degree

SHOWING SOLIDARITY...With the Institut Télémaque Under the impetus of Sophie Beaupère, deputy executive director, the Centre Léon Bérard entered into a partnership with the Institut Télémaque. We offer young people visits to the hospital and the Research Center. In 2018, we welcomed 20 young people who had the opportunity to visit the radiotherapy department and a research laboratory, and to talk to health professionals and management staff.

In 2019, we also received four young people for their 9th grade job-shadowing internship.

Founded in 2005, the Inst i tut Télémaque is an association that promotes equal opportunities in education by supporting young people from less privileged backgrounds from high school onwards.

09−SHARINGPARTNERSHIPS AND COLLABORATIONS

EUROPEAN CONFERENCE ON MEDICAL ONCOLOGY: CLB WELL REPRESENTED AT ESMOFor the first time, the Centre Léon Bérard had a stand at the major annual conference of the European Society for Medical Oncology (ESMO), which was held in Munich from October 19 to 23, 2018. Some

30 spec ia l i s t phys ic ians and researchers from our institute also traveled to the conference to present their latest scientific publications, either in talks or as posters.

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> FLAGSHIP ACTIVITIES IN 2018

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HOSPITAL PARTNERSHIPSIn 2018, we strengthened two of our hospital partnerships:

> With the Northwest Hospital (Villefranche-sur-Saône), for the creation of 20 home hospital beds coordinated by the medical and nursing team at the Centre Léon Bérard;

> With the Hôpital de l’Arbresle hospital, for the consolidation of a follow-up care and rehabilitation division, following on from our division for addiction management before surgery.

CREATION OF AN INTERNATIONAL PATIENTS’ OFFICE As part of the development of CLB’s international activity, a new team was set up at the beginning of 2018 to receive and care for foreign patients, with the creation of the International Patients’ Offi ce.

In recent years, the CLB has received an increasing number of patients from abroad (excluding European patients who hold Form S2). These patients, from

different regions of the world (Maghreb region, Middle East, Africa, Central Europe, Asia, etc.), choose the Centre Léon Bérard to benefi t from its expertise and treatments that are sometimes not available in their country. In 2018, the CLB received more than 400 requests and 250 international patients received treatment or examinations at the Center.

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With the temporary accommodation center ‘Maison de l’Hospitalité de Béthanie’In order to fi nd temporary accommodation solutions for patients over 60 years of age, whose care does not require conventional hospitalization but whose home or social situation does not allow for home care (e.g. isolated individuals, people whose home is not suitable), the CLB signed an agreement with the Maison de l’Hospitalité de Béthanie, a temporary accommodation center located in Villeurbanne.

Since then, this establishment managed by Habitat et Humanisme (Father Bernard Devert) has welcomed 10 CLB patients for short stays (on average three to six weeks). These patients benefited from a transitional stay between their time in hospital and their return home, in a pleasant and friendly environment, and one of them found a long-term housing solution there.

10−SOLIDARITYDONORS ENGAGED IN THE FIGHT AGAINST CANCER

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DONATIONS AND BEQUESTS: EVER GREATER MOBILISATION6.8 million euros – the total amount of donations and bequests received over the year to aid innovation in research on cancer and support to patients.

• 4.5 million euros were given to our institute as donations:

> 3.9 million euros to support the research carried out at the Center;

> close to 300,000 euros to support pediatric research programs;

> close to 300,000 euros to contribute towards improving the ‘comfort and quality of life’ of our patients of

all ages (children, adolescents and adults) and throughout their period of treatment in hospital.

• 2.3 mil lion euros received as bequests:

This amount corresponds to the sum of sales made during 2018 of property bequeathed to the Centre Léon Bérard (movable and immovable property) and fi nancial products (life insurance, etc.). This money will also provide support to all the research programs carried out at the CLB.

DEDICATED VOLUNTEERS The Centre Léon Bérard regularly appeals for support from volunteers to help organize its various actions to promote research. Mainly concentrated in the second half of the year, these operations aim to publicize the research done on the CLB site and collect donations to assist in developing that

research. We carry out a wide variety of actions: handing out fl yers; providing refreshments, for example during sponsored races; sales of products to raise money, etc. Depending on the event, the Center obtains the help of 20 to 170 volunteers.

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€633,000 collected thanks to hundreds

of large and small associations that organized various events (e.g. theatrical performances, concerts,

fl ower sales) to help the CLB’s research teams and patient care.

Our thanks go out to them and to their volunteers for their fantastic efforts!

€44,769 from close to 330 municipalities in the region that voted in favor of a grant to

support the Center and its missions for the general good.

39,000individuals

supported the CLB by responding to our appeals for donations,

participating in events or with spontaneous actions.

€140,000from the corporate

philanthropy of around 20 companies.

The 4.5 million euros received in 2018 came from individual donors, associations, companies and municipalities.

−SOURCES OF DONATIONS

TO THE CENTRE LÉON BÉRARD

COURSE DES LUMIÈRES For its fi fth year, the Marche des Lumières [March of Lights] became a Course des Lumières [Race of Lights]. Thanks to the outstanding efforts of more than 2,400 people – families, groups of friends or colleagues – more than 190,000 euros in donations was collected in 2018. A total of more than 950,000 euros in donations have now been collected for cancer research at the CLB since 2014, the fi rst year that this event was held.

GALA DINNERThe fourth Gala Dinner of the Centre Léon Bérard took place in the function rooms of Lyon’s City Hall on December 13, 2018. More than 200 guests invited by the 16 partner companies assembled to show their support for cancer research in the presence of the Mayor of Lyon, Gérard Collomb. At the end of this Gala Dinner, donations totaling more than 51,000 euros were made to aid the cancer research carried out at the CLB.

The fourth Gala Dinner of the Centre Léon Bérard took place in the function rooms of Lyon’s City Hall on December 13, 2018. More than 200 guests invited by the 16 partner companies assembled to show their support for cancer research in the presence of the Mayor of Lyon, Gérard Collomb. At the end of this Gala Dinner, donations totaling more than 51,000 euros were made to aid the

−A YEAR OF GREAT ENGAGEMENT

colleagues – more than 190,000 euros in donations was collected in 2018. A total of more than 950,000 euros in donations have now been collected for cancer research at the CLB since 2014, the fi rst year that this event was held.

‘PUT ON YOUR SNEAKERS’From March 19 to 23, 2018, the Centre Léon Bérard organized the fi rst intercompany challenge, ‘À vos Baskets’ [Put on Your Sneakers], with the goal of having employees cover the greatest possible number of kilometers against cancer using exercise bicycles.

This event was a defi nite success, with more than 6,000 kilometers covered and more than 600 employees involved at the fi ve participating companies: LDLC Group, SFC Group, and the fi rms Egis Rail, iD SCENT, and EDF.

At the end of this week of competition, nearly 40,000 euros were donated to the Center to help fund the Pyramid Space, designed to provide patients with appropriate physical activity.

‘PUT ON YOUR SNEAKERS’From March 19 to 23, 2018, the Centre Léon Bérard organized the fi rst intercompany challenge,

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THE PYRAMID SPACE In order to support the development of the appropriate physical activity (APA) offered to patients, the Centre Léon Bérard opened the Espace Pyramide [Pyramid Space] on September 5, 2018. This 300 m² space, which is unique in France, is designed for physical activity, but also for prevention and to provide a better quality of life for patients. The objective is to support patients in all aspects of their illness.

Conceived primarily to provide young people aged 15 to 20 with a space reserved for APA in the place where they receive treatment, the space also accommodates APA sessions for adults who are inpatients or who have

come for a consultation.

Physical activity brings many benefi ts, both before, during and after illness, as it encourages social bonding and self-esteem, as well as reducing fatigue and the risk of recurrence. The Pyramid Space therefore offers patients a structured and convivial space where they can do various activities in a completely safe environment:

- for the youngest patients: football, basketball, hockey, archery, muscle strengthening, etc.

- for adults: fitness training, Pilates, Zumba, etc.

Constructing and equipping this space was funded through donations, notably a large donation of 100,000 euros from the Fondation Hôpitaux de Paris – Hôpitaux de France [Hospitals of Paris – Hospitals of France Foundation]. The companies that took part in the ‘Put on Your Sneakers’ challenge, as well as the women’s sponsored race association ‘Courir pour Elles’, also gave this project financial support. Finally, the Center was also able to count on the generosity of more than 600 of its donors, who gave over 80,000 euros. In total, 240,000 euros in donations were collected to fund this substantial project.

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−WHAT WAS SPECIFICALLY FUNDED BY DONATIONS

IN THE COURSE OF THE YEAR?

SUPPORTING RESEARCH SUPPORT FOR PATIENTS AND THEIR FAMILIES

During 2018, 5.9 million euros from donations and bequests were used by our institute to fund a variety of actions.

CLOSE TO€94,000

were devoted to various actions, such as:

The donations enabled the CLB to spend

€100,000on the Pyramid Space

in 2018.

With the help of

€600,000 the CLB opened apartments nearby

to facilitate the care pathway of patients who do not live in the

department or whose accommodation is not suitably adapted.

• the work of the socio-estheticians, hairdresser and chiropodist on behalf of our patients;

• carrying out cultural workshops as part of the ‘Art in the Hospital’ program (music, photography, fashion, etc.);

• purchase of Christmas presents for young patients hospitalized during this period;

• purchase of small items to help with support at home or for pain relief.

NEARLY

€4 million to support basic, translational

and clinical research

€2.4 MILLION CONSTRUCTION, FITTING OUT

AND OPERATION OF THE RESEARCH BUILDINGS,

FOR A TOTAL OF

FUNDING OF 17 RESEARCH POSTS

FUNDING FOR INNOVATIVE EQUIPMENT TO THE VALUE OF

€371,000

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The total of the costs represents 16% of all funds raised (¤6.8 million). This is a relatively low fi gure in view of the fact that the Centre Léon Bérard is further developing its fundraising activities and is therefore initiating numerous actions that will bear fruit at a later date.

FUNDRAISING EXPENSESExpenditure of ¤810,000 linked to appeals for donations from the public (mail shots, telephone, e-mails, events, websites), as well as donor management software.

OPERATING EXPENSES¤305,000, of which ¤65,000 of expenses linked to the management of bequests (co-ownership charges linked to the management of bequeathed real estate assets, bills for repairs and maintenance of these assets, disposal costs, local taxes, grave maintenance, etc.). The remaining portion corresponds to the remuneration of the donor relations department staff.

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−SUPPLY AND USE ACCOUNT

EXPENDITURE (in euros)

EXPENDITURE2018

= profi t and loss account

EXPENDITURE ALLOCATION of income from the public

in 2018

1 - SOCIAL MISSIONS 194,968,425 2,765,9531.1. Carried out in France 194,968,425 2,765,953

Actions carried out directly 178,941,972 2,765,953

• Research: basic, translational and clinical 22,650,283 2,672,181

• Provision of care and patient quality of life 156,291,689 93,772

Transfers to other agencies active in France 16,026,453 -

1.2. Carried out outside France - -

2 - FUNDRAISING EXPENSES 810,076 810,0762.1. Expenses of public appeals 810,076 810,0762.2. Expenses of obtaining funding from other private sources - -

2.3. Expenses of obtaining funding from grants and open competitions - -

3 - OPERATING EXPENSES 32,385,728 305,024I - Total expenditure for the fi nancial year as in the fi nal accounts 228,164,230 -II - Provision for liabilities and charges 3,429,224 -

III - Funds already allocated to projected uses - -

IV - Surplus for the fi nancial year - -

V - GRAND TOTAL 231,593,453 -VI - Capital expenditure during the fi nancial year that was covered

by public donations - 2,039,261

VII - Reversal of amortization charges of fi xed assets fi nanced as of the fi rst application of the regulation by the resources obtained from the public

- -

VIII - Total expenditure covered by public donations - 5,920,315

The supply and use account, structured in the form of tables below, provides a breakdown of the funds raised from the public in 2018 and the expenditure that was made with money from donations and bequests. This supply and use account has been checked and certifi ed by an auditor.

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−SUPPLY AND USE ACCOUNT

INCOME (in euros)

INCOMEobtained in 2018

= profi t and loss account

SURVEY OF INCOMEfrom public sourcesexpended in 2018

1 - INCOME FROM THE PUBLIC 6,804,028 6,804,0281.1. Donations and legacies 6,759,259 6,759,259

Non-allocated donations 3,831,917 3,831,917Allocated donations 658,831 658,831Legacies and other earmarked donations 2,268,511 2,268,511

1.2. Other income items from public appeals 44,769 44,769

2 - OTHER PRIVATE FUNDING 21,250,911 -2.1. Income on CRD T1 & T3 aside from 15,194,746 -2.2. 777 account 1,515,607 -2.3. 791150 accounts 4,540,557 -

3 - INCOME FROM GRANTS AND OTHER PUBLIC COMPETITIVE SOURCES 181,463,970 -

3.1. Grants (PHRC research) 146,053 -3.2. MERRI/MIG 24,463,107 -3.3. Operating income 153,141,093 -3.4. FIR 2,897,347 -3.5. AME 816,370 -

4 - OTHER ITEMS 27,402,186 -4.1. T2 hospital income excluding 5,991,236 -4.2. T3 income excluding CRD, FIR and provisions 21,410,950 -I - Total income for the fi nancial year entered in the profi t and loss account 230,117,068 -

II - Reversal of provisions 622,591 -

V - Income shortfall in the fi nancial year* 853,795 -

VI - GRAND TOTAL 231,593,453 6,804,028VII - Total expenditure funded by income from the public - 5,920,315

VIII - Balance of income from the public, non-allocated and unused at the end of the fi nancial year** - 15,624,132

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*Refers to the budget defi cit in the CLB’s hospital sector. This defi cit has no effect on the budget for research carried out at CLB because this budget is completely separate from that for hospital care. The donations collected are applied only to cancer research and are never used to relieve the defi cit run by the hospital.

**Refers to reserves essential for sustaining research positions funded by donations and legacies as well as for investments scheduled in the CLB’s 5-year forward plan 2016-2021 (continuing refurbishment of the research buildings).

DESIGNalteriade

TRANSLATIONMichelle Wilbraham

ICONOGRAPHYCentre Léon Bérard

PHOTOGRAPHIC CREDITSAlexandra Franconnet

Armen HambardzumianCentre Léon Bérard

Gilles ReboissoniD SCENT

Marie-Laure LucaRomain Étienne – collectif Item

Sébastien Garnodier

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w w w . c e n t r e l e o n b e r a r d . f r