Improvement of the Neoplazic pathology management through the development and implementation of cross border medical excellence center

The project aims to develop and implement centers of excellence in complementary and synergistic medicine, in Timisoara and Požarevac, in order to develop the infrastructure and the human resource at the level of performance and competitiveness of EU hospitals. Considering the high incidence and mortality of colorectal and breast cancers in the CB area, it is necessary to adopt modern screening tests that allow genetic risk analysis. In order to assess the evolution/prognosis and the administration of the high precision oriented treatment in breast cancer, the anatomopathology services of the modernized specialized units benefiting from the respective endowment analyze by immnunohistochemical techniques. In patients where anatomopathogenic diagnosis shows a limiting situation where it is not clear whether chemotherapy is or is not indicated, a molecular gene prediction test is recommended. The activity of the project will include enrolling patients in the study and DNA isolation from blood, tissue and paraffin embedded samples (the RO partner will train personnel from SE to manually isolate DNA). Samples processed in SE throughout the project will be kept cold and sent for analysis in RO (monthly). Genetic diagnostic tests will be performed for patients: for breast cancer, the genes will be analyzed: BRCA1 / BRCA2 in all patients enrolled in study, and in case of inconclusive immunohistochemical diagnosis (performed by the RS partner) the genes Her / Neu, ER, PR will be analyzed. For colorectal cancers the following genes will be analyzed by sequencing: KRAS, BRAF, NRAS and PTEN. Also, Activity 3.4 will screen for genes of interest BRCA1 / BRCA2, KRAS, BRAF, NRAS and PTEN. Acquisition of the equipment would lead to an improved access of the population from the CB area to correct and fine diagnosis as well as to administration of optimal medication. Setting a precision treatment personalized to each patient's molecular status will reduce the costs of cross-border healthcare providers in the long run,. A total of 700 patients will be enrolled in the study, of which more than 50% will be women, about 50% of all patients will have low incomes and approximately 25% will be roma. Dissemination of results through information campaigns will allow people from the border area, particularly disadvantaged people, to access to accurate medical informations about modern diagnostic and therapeutic options. Building of web pages will help to inform the population, to spread beyond geographical and ethnical boundaries. Nowadays, most students and doctors know the practical application of the human genome sequencing project, their practical skills are limited due to the lack of access to such methods of analysis. Practical workshops and training will enable specialists and students (290 medical) to acquire practical skills and expertise in sequencing technology, thus overcoming the differences in molecular diagnostic training. Information added on 2020-05-12, regarding the mitigation of the effects of COVID-19 (the corona virus pandemic that started in 2019) (English language only): The project aims to develop and implement centers of excellence in complementary and synergistic medicine, in Timisoara and Požarevac, in order to develop the infrastructure and the human resource. Main outputs are Health facility equipments (immunohistochemical analysis technique and modern diagnostic and genetic screening equipment) and citizens involved in project activities in social health care services.

At present there are discrepancies in the development of medical services in Timisoara and Pozarevac compared to medical services in the EU. The Pozarevac hospital does not have an immunohistochemical analysis technique. In Timisoara, the medical analysis compartments in the hospital units lack modern diagnostic and genetic screening equipment. Acquisition of the equipment would lead to an improved access of the population from the cross-border area to correct and fine diagnosis as well as to administration of optimal medication. On the other hand, setting a precision treatment personalized to each patient's molecular status will reduce the costs of cross-border healthcare providers in the long run. Also, accessing funds from national cancer programs will allow the access of disadvantaged people to a modern medical act of prevention, diagnosis and treatment, in line with EU recommendations.