Comprehensive Cancer Centre Jean Perrin, Clermont-Ferrand, France; Deputy Chair of UNICANCER and President, Immuno-Oncology Group, UNICANCER; Member of ESMO 2018 Congress Scientific Committee

Frédérique Penault-Llorca, Chief Executive Officer (CEO) of the Comprehensive Cancer Centre Jean Perrin, Clermont-Ferrand and Head of the Department of Pathology and Tumour Biology at the Centre, is passionate about pathology. While having a special interest in oncology since medical school, she didn’t feel emotionally equipped to care for patients with cancer, and instead discovered a love for pathology, research and teaching. Two years of training in medical oncology also provided an important basis for her career as a pathologist where she works closely with medical oncologists and other members of the multidisciplinary team. She believes that the pathology report is the cornerstone of cancer treatment and that it is the pathologist’s responsibility to ensure the information communicated is clear and precise, and is properly interpreted and acted upon. Here she shares some insights into her varied and much-loved career.

Looking back at your career to date, could you describe some of the achievements you are most proud of?

A couple of years ago our university research team ERTICa (University of Auvergne) gained recognition from the French Institute for Medical Research for successful multidisciplinary team work on targets for triple-negative breast cancer. We have an excellent new INSERM UMR1240 ImoST team of chemists, biologists and physicians, among others, who work together very effectively towards a common goal in cancer companion radiotracers and biomarkers. As Deputy Director of this team, I was very proud to receive such high-level recognition for what I considered an extremely important project.

Looking further back, I was very proud to be asked to review the design of the PACS 01 clinical trial for breast cancer from a pathologist’s perspective and to work on ancillary studies prior to initiation of the trial. When the trial was conducted 15 years ago, it was unusual to have any pathology involvement from the conception of a study, so this really marked a turning point; it acknowledged the place of pathologists as part of the multidisciplinary team, not only in the hospital environment but also in clinical research. I was very proud that I was able to convince oncologists of the importance of this.

For the last 10 years, I have worked on the board of the Comprehensive Cancer Centre Jean Perrin, initially as President of the Medical Elected Commission representing medical staff, and subsequently as Medical Director and then Scientific Director of the Centre. Five years ago, the former Director of the hospital stood down and I was elected as the new CEO. One of the goals of my first term as Director was to put the patient at the heart of our organisation, and, pleasingly, we have made improvements in patient access to both hospital and ambulatory care.

What is the most rewarding part of your job?

The most rewarding aspect of my job is linked to the microscope! I love to look at patient cases; while I no longer do this routinely, I am often called for a second opinion or to review more challenging cases. When I say I’m going to the pathology lab my PA wishes me a good vacation and when I return I always have a smile on my face! I especially enjoy my teaching role as Professor of Pathology and love spending time with my students, both in the lab and in the lecture hall. I am also involved with educational projects for ESMO, including Masterclasses and Preceptorship courses focusing on breast cancer. All of these activities give me lots of energy to cope with the challenges I encounter in other areas of my daily work related to running the hospital.

I should also mention that when I decided to apply for the position of CEO of the Jean Perrin Centre, the medical community was very supportive and enthusiastic. It was extremely rewarding to think that my work as a pathologist and on the hospital board was well recognised and valued. I found this very encouraging.

The Comprehensive Cancer Centre Jean Perrin is one of 18 French comprehensive cancer centres that form the not-for-profit UNICANCER hospital network dedicated to cancer treatment. UNICANCER Centres were created in 1945 by General de Gaulle in order to recognise the importance of multidisciplinary hospitals specialising in cancer treatment. The centres are financed by the French National Health Plan and provide public healthcare; private practice is completely forbidden in our hospitals. Patients have access to the latest medical advances and do not have out-of-pocket expenses for their treatment. This is of utmost importance to me and is the reason why I am constantly striving to sustain the UNICANCER model – I would say this is probably my largest ongoing commitment. After 2 years as CEO of the Jean Perrin Centre, I was elected to join the board of UNICANCER as Deputy Director. For the last year I have also been President of the Immuno-Oncology Group of UNICANCER Research and Development. I am optimistic for the future of UNICANCER as we are finding ways to work more efficiently and to provide more innovations for our patients with what we have available, despite reduced government funding.

Could you tell us about your current research interests?

As a pathologist, my main research interests lie with biomarkers in the field of immuno-oncology. My work with the UNICANCER Immuno-Oncology Group involves research into biomarkers for immunotherapy and participation in trials of novel treatments as part of a clinical group. In addition, at the Jean Perrin Centre, I work with a multidisciplinary team investigating nuclear imaging methods involving radioactive markers to monitor response to immunotherapy, focusing on triple negative breast cancers. It is crucial that we find markers that will enable accurate selection of patients who are most likely to benefit from these expensive therapies. I believe we need to work together across disciplines to achieve this – it is one of my major goals.

What extracurricular activities/interests do you enjoy?

I have two main interests that help me to relax: jogging and cooking. I love to spend time in the kitchen preparing good food for my family and friends. In addition, my family and I enjoy watching films and visiting art exhibitions. We also love to travel, and took our fifth trip to Japan this summer to enjoy activities such as hiking and swimming, before heading on to Tokyo. I like to be active on holiday as I’m easily bored!

What are your future plans/aspirations?

My 5-year term as Director of the Comprehensive Cancer Centre Jean Perrin will come to an end this September and I’m planning to re-apply for the position. I would hope to be able to take ambulatory care to a new level so that we have even fewer patients staying in hospital for their treatment. As the hospital was initially designed for in-patient care, this will be a huge project involving extensive reorganisation. I would also like to secure new equipment and to provide better patient access to clinical trials and novel therapies. Looking further into the future, when I have fewer responsibilities at the hospital, I would love to become more involved with ESMO educational activities, possibly by giving extra Masterclasses or Preceptorship courses to help both pathologists and oncologists gain a better understanding of cancer biology. At heart I am a pathologist, and sharing my knowledge with others gives me the greatest pleasure of all.