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Background The study examines two meso-strategic cancer networks, exploring to what extent collaboration can strengthen or hamper network effectiveness. Unlike macro-strategic networks, meso-strategic networks have no hierarchical governance structures nor are they institutionalised within healthcare services’ delivery systems. This study aims to analyse the models of professional cooperation and the tools developed for managing clinical practice within two meso-strategic, European cancer networks. Methods Multiple case study design based on the comparative analysis of two cancer networks: Iridium, in Antwerp, Belgium and the Institut Català d’Oncologia in Catalonia, Spain. The case studies applied mixed methods, with qualitative research based on semi-structured interviews (n = 35) together with case-site observation and material collection. Results The analysis identified four levels of collaborative intensity within medical specialties as well as in multidisciplinary settings, which became both platforms for crosscutting clinical work between hubs’ experts and local care teams and the levers for network-based tools development. The organisation of clinical practice relied on professional-based cooperative processes and tiers, lacking vertical integration mechanisms. Conclusions The intensity of professional linkages largely shaped the potential of meso-strategic cancer networks to influence clinical practice organisation. Conversely, the introduction of managerial techniques or network governance structures, without introducing vertical hierarchies, was found to be critical solutions. [ABSTRACT FROM AUTHOR]

Background: Cisplatin (CDDP) resistance in testicular germ cell tumors (GCTs) is still a clinical challenge, and one associated with poor prognosis. The purpose of this work was to test pazopanib, an anti-tumoral and anti-angiogenic multikinase inhibitor, and its combination with lapatinib (an anti-ErbB inhibitor) in mouse orthotopic models of human testicular GCTs.Methods: We used two different models of human testicular GCTs orthotopically grown in nude mice; a CDDP-sensitive choriocarcinoma (TGT38) and a new orthotopic model generated from a metastatic GCT refractory to first-line CDDP chemotherapy (TGT44). Nude mice implanted with these orthotopic tumors were treated with the inhibitors and the effect on tumoral growth and angiogenesis was evaluated.Results: TGT44 refractory tumor had an immunohistochemical profile similar to the original metastasis, with characteristics of yolk sac tumor. TGT44 did not respond when treated with cisplatin. In contrast, pazopanib had an anti-angiogenic effect and anti-tumor efficacy in this model. Pazopanib in combination with lapatinib in TGT38, an orthotopic model of choriocarcinoma had an additive effect blocking tumor growth.Conclusions: We present pazopanib as a possible agent for the alternative treatment of CDDP-sensitive and CDDP-refractory GCT patients, alone or in combination with anti-ErbB therapies. [ABSTRACT FROM AUTHOR]