Volume 10, Issue 1

 

ITMIG Announcements & Highlights

 

New Leadership

by Edith Marom, former ITMIG President

In October 2020 we welcomed a new president, Nicolas Girard. Nicolas is a medical oncologist at the Institute Curie in Paris, France and leads the Rhythmic group in France (a national organized care delivery system for thymic tumors). He has been a prominent member of ITMIG since the beginning and served as Vice President from 2010-14. He has also been leading the ITMIG Database, the Virtual Tumor Bank and the Biology Working Group. He has devoted his career to rare malignancies, especially thymic malignancies and has been instrumental in developing platforms that can improve care.

 

Webinar 2020 Series

by Malgorzata Szolkowska

SARS-CoV-2 pandemic precluded organizing the ITMIG Annual Meeting in Warsaw in 2020 but it has not stopped the activity of our members. A Webinar Committee led by Malgorzata Szolkowska, Pam Bruce and Edith Marom proposed the program this last Fall for patients and a series of webinars for physicians dealing with mediastinal tumors. This was the first time ITMIG has offered a series of this kind. All webinars were recorded and recordings have been published on the ITMIG website. All recorded sessions are available free to members to view.

In September a webinar for patients, ”The questions I Would Like to Ask My Doctor”, was held. Medical oncologist, Arun Rajan, and thoracic surgeon, Joshua Sonett, answered the questions submitted by patients before and during the meeting, e.g.:

• Does removing the thymus make our immunity weakened?
• What are the indications and contraindications for thymoma/thymic carcinoma treatment in pregnancy?
• What is the current view on immunotherapy for those with thymic carcinoma?
• Is chemotherapy recommended in metastatic thymoma accompanied by Good syndrome?

Registration for the webinar was free of charge. The webinar was attended by 44 participants. Responses not given during the webinar and a link to the recording are available here: https://itmig.org/for-patients/for-patients-webinar-2020-09-22/.

A series of six webinars for physicians on Diagnosis and Treatment of Thymic Epithelial Tumors was held from October to December. These Webinars have been certified by Queen’s University Office of CPD as an Accredited Group Learning Activity. Registration for ITMIG members was free of charge. One hundred and seven participants, members and non-members have registered for at least one webinar. Over half registered for the whole series. Each webinar has been attended by 25 to 39 registrants. All webinars were multidisciplinary.

In the first, “Tumor Board – True-Life Cases”, two interesting clinical-radiological-pathological cases were presented and discussed by a panel of experts.

The next webinars were:

“Surgical-Pathological-Oncological Dictionary”

“Myasthenia Gravis in Thymoma Patients”

“Imaging of Thymic Lesions: Indications and Limitations

“Neoadjuvant Therapy in Thymic Epithelial Tumors”

“Thymic Tumor with Pleural Dissemination”

The series of lectures addressed many important and practical issues in thymic diseases. All webinars were followed by a lively Q&A discussion that usually extended well past the fifteen minutes scheduled. The large number of questions reflected the great interest expressed by attendees.  The webinars were very well received by participants and most declared interest in future ITMIG webinars. All webinars together with Q&A session were recorded and are available for ITMIG regular members at https://itmig.org/webinars-2020-recordings/. The recordings are uploaded on the ITMIG channel on YouTube on and have from 15 to over 70 views!

Positive feedback for the webinars has encouraged the Webinars Committee to continue its work. In the first half of 2021, the Committee is going to organize 1-2 webinars for physicians and the same for patients.

 

Virtual ITMIG 2021 Annual Meeting

by Malgorzata Szolkowska

Due to the uncertain times planning an in-person annual meeting this year does not seem to be a viable option for us. However, we do not want to miss another year of our scientific program. This year we will have our annual meting for two days virtually! The date for the meeting will be:

Saturday-Sunday, October 16-17, 2021.

Save the date!

A Program Committee will begin to plan a robust program. We will send notices of the program and will keep our website up to date on the developments. Hope to see you in October!

 

ITMIG and WHO

by Pam Bruce

We are proud to announce the editors of the WHO Classification of Tumours, 5th edition Thoracic Tumours book would like to acknowledge The International Thymic Malignancy Interest Group (ITMIG) for their collaboration on this volume.

 

Webpage, emails, YouTube channel

by Malgorzata Szolkowska

2020 is a year of profound change in ITMIG’s virtual image and means of communication. A new webpage based on WordPress platform has been created. The main advantage of this change is easy access by ITMIG administrators for updating website content. The domain name, logo and characteristic blue banner will remain unchanged. The old content has been updated and will continually be developed and improved.

The new webpage includes a free access part and content dedicated to specialists which will be available to ITMIG members. Those who are not members but wish to subscribe to ITMIG news and notifications can submit their email addresses via a short form on the home page.

Subscribers will also notice a novel form of direct mailing communication based on a professional multifunctional mailing platform. The platform enables not only fast creating of nice looking emails but also clear ordering the contacts, constructing the surveys and composing registration forms that were crucial for organizing the webinars. The platform is administered by the Communication Committee.

In 2020 the Communication Committee created a special channel for ITMIG videos on youtube.com. All webinar recordings have been uploaded on this account and are available via special links for ITMIG members or webinar registrants. Open access videos promoting ITMIG activities will be available soon.

 

Members Database

by Malgorzata Szolkowska

The new webpage includes a members’ database that has been updated and reorganized. Currently, ITMIG has 127 active members, including 37 new registrants since September 2020.

In the new database ITMIG has resigned from “free membership” accounts. Prior free members are cordially invited to upgrade their registrations to the “regular” category that provides a lot of privileges; e.g., discounted registration rates for the ITMIG Annual Meetings, discounted registration rates for ITMIG webinars, access to the recordings of webinars, access to the educational and professional content of the ITMIG webpage. The regular membership fee is only 150 USD per year. Those who do not wish to become regular members, may still receive the ITMIG newsletters and activity notifications.

Due to the General Data Protection Regulation (GDRP) personal data of registered members are invisible, however, those, who wish to be found by other members may agree to reveal their data by completing the form https://itmig.org/members-list/. Interpersonal communication within society is crucial for developing common multi-institutional and international projects; thus, we strongly encourage each member to join this list. A separate list of those members (doctors), who agreed to reveal their data to patients is available in the open access “Patient’s area” section (https://itmig.org/members-list-for-patients/). Members, who wish to join this list may complete the form  https://itmig.org/members-list/ and mark the appropriate consent.

 

ITMIG Tumor Board

by Pam Bruce

Our Tumor Board meets on the first Thursday of each month at 7 AM EST. Additional times/dates can be arranged with notice. The board reviews and gives input on hard to treat cases. If you have a case to present please register: https://itmig.org/virtual-tumor-board-registration-form/. We will contact you with further information.

All members are welcome to listen to the reviews via phone or computer via meeting platform (WebEx). Please let Pam Bruce know if you would like to be added to the reviews. We will continue to send monthly emails calling for cases to be reviewed.

 

ITMIG and The Society of Thoracic Radiology (STR)

by Pam Bruce

ITMIG has signed an agreement to facilitate research collaborations between ITMIG members and those of the Society of Thoracic Radiology (STR). ITMIG members are now able to increase their collaborators in multidisciplinary studies and help study Thymic malignancies. This is another step in learning how to combat this disease. Both organizations are committed to supporting the endeavors of each organization. Please see below for an upcoming event the STR will be hosting in March:

 

The Society of Thoracic Radiology (STR) is pleased to announce:

Annual Meeting and Postgraduate Course, 

March 6-10, 2021

The STR is a leading subspecialty society in the United States which focuses on cardiothoracic imaging. This year’s meeting will be presented virtually March 6-10 with live Q/A sessions and Panel Sessions.

The sessions will primarily focus on the diagnosis of Cardiothoracic conditions using radiography, CT and MR. Discussions will also include focused discussions of PET and advancing technologies, such as AI and Dual-energy CT. Special sessions will highlight the diagnosis of diffuse lung diseases, cardiac conditions, trauma imaging and lung cancer imaging.

For those who would like a more general review, on March 6 we will be offering a one day course which includes a bootcamp of thoracic conditions, including mediastinal masses and a seminar on basics of HRCT.

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Committee and Working Group Updates

Webinar Committee

Finance Committee

by Josh Sonett

The committee has ongoing discussions about ways to help with ITMIG’s visibility including raising awareness about ITMIG while at the same time educating about thymic cancer.

The Finance Committee continues to support its goals to ensure we raise funds for the organization and sponsorship for our annual meetings (virtual or in person). This is part of our ongoing mission to help collaborate and foster relationships with potential company sponsors. The annual meeting is paid for through registration fees and sponsorship funds; not with money from donations or ITMIG general funds that help run the organization.

 

Education Committee

by Co-Chairs Mirella Marino and Brett W. Carter

Our main Goals for 2020, decided with the ITMIG President and the members of the Education Committee, were:

• To update the ITMIG Standards and Definitions to share on the ITMIG website;
• To edit the ITMIG  2019 Annual Meeting invited conferences paper collection to be published on “Mediastinum”.

The ITMIG Standards and Definitions of the different subspecialties were updated and are available for ITMIG members on the ITMIG website. Scientific presentations and tumor board reviews from the 10th International Malignancy Interest Group (ITMIG 2019, Niagara on the Lake) will be published in Mediastinum soon.

Plans for the future: ITMIG is planning to involve Neurologists treating paraneoplastic syndromes associated to thymic epithelial tumors in the establishment of consensus-based diagnostic and therapeutical procedures to be shared along with ITMIG standards and definitions of other subspecialties on the website. Moreover, the Education Committee planned to establish on the website an atlas, which is in progress, of microphotographs of thymic epithelial tumors. ITMIG is also planning to set own updated guidelines of diagnosis and treatment of Thymic epithelial tumors.

 

Thymic Carcinoma Working Group

by Anja C. Roden

We had some very productive meetings during the last couple of months. A big thank you to everyone who participated. We are working on ongoing projects and brainstorming new ideas. Ongoing projects include:

1. Definitive radiation failure patterns in thymic carcinomas (led by Dr. Charles Simone)
2. Patterns of recurrence after thymic carcinoma (independent of initial treatment) – we envision this project to be a large collaborative study and would like to include many ITMIG members of various specialties and our collaborators from the Society of Thoracic Radiology
3. Definitive radiation therapy outcomes (+/- chemotherapy) for thymic tumors (led by Dr. Andreas Rimner)
4. Radiation therapy for recurrent thymic tumors (led by Dr. Annemarie Shepherd)
5. Postoperative radiation therapy analysis of thymic carcinomas from the ITMIG retrospective database; this project is in its final stage (led by Dr. Andreas Rimner)

We also considered two types of review papers:

1. A precise review focused on developments in thymomas and thymic carcinomas over the past 4-5 years; each specialty would provide a relatively short paragraph
2. Review of current pathology and radiology management of thymic carcinomas and status of immunotherapy in part based on a survey of the membership (these aspects were not included in the survey that was published by ITMIG led by Dr. Annemarie Shepard in 2017, PMID: 27876674)

We brainstormed a project on the pathologic (and possibly radiographic) evaluation on tumor regression (grading) in resection specimens after neoadjuvant therapy and its correlation with outcome.

We would like to invite you to join our working group. We are looking for ITMIG members of any specialty interested in thymic carcinomas. Please contact Anja Roden. roden.anja@mayo.edu.

 

Mediastinal Working Group

by Anja C. Roden

We would like to welcome our new Working Group members from the Society of Thoracic Radiology. Together we are brainstorming imaging-related projects that might provide us with a better understanding of the evolution of mediastinal lesions the results of which would be useful for the management of patients. If you would like to join the discussion or have ideas for potential projects, please contact us (see below).

Our project “Distribution of mediastinal lesions across multi-institutional international radiology databases” has been published in the Journal of Thoracic Oncology in April of 2020 (PMID: 31870881). That project included over 3,300 patients from 11 institutions from 3 continents and was a collaborative work of 9 radiologists, 3 thoracic surgeons, 2 radiation oncologists, 2 medical oncologists, 2 pathologists, and a statistician. Thank you very much and congratulations to everyone who was involved in that endeavor.

Currently we are working on the diagnostic (pathologic and radiologic) features of thymolipomas and lipofibroadenomas, their clinical presentation and outcome. Scanned pathology slides are reviewed by multiple pathologists during web meetings. Imaging features are reviewed by local radiologists. Clinical findings at time of presentation, surgery and follow up are collected. Many cases will be eventually reviewed together by pathologists and radiologists to identify distinct diagnostic features of these lesions. A part of that project aims to identify how thymolipomas or lipofibroadenomas can be distinguished by imaging from other adipose lesions in the prevascular mediastinum such as lipomas, liposarcomas and teratomas. This project is a collaborative effort of many specialties. If you are interested in joining the project and/or would like to contribute cases, specifically thymolipomas and lipofibroadenomas from which you have pathology slides, imaging and clinical data including outcome, please contact us ASAP (see below).

While we are currently working on the thymolipoma/lipofibroadenoma project, our other proposed project on clinical features and pathologic and radiologic findings of mediastinal germ cell tumors has not been forgotten. Germ cell tumors are another group of rare mediastinal tumors with unique radiologic and pathologic findings. We are planning to create a database and a central review of radiologic images and pathology slides.

If you are interested in joining us in any of the projects please contact Anja Roden roden.anja@mayo.edu. We would be happy to welcome you to our group.

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2 March 2021