On December 6, with the support of Todua Clinic, the Georgian School of Oncology (GSO), and the Georgian Association of Molecular Diagnostics, hosted the first large-scale international conference titled “Rare Tumors and Precision Medicine.” At the event, international experts shared the latest approaches and advances in oncology. It included innovative diagnostic technologies and genomic medicine, which were relevant to the management of rare malignancies.
Experts were invited from leading oncology centers, including: The Christie NHS Foundation Trust (United Kingdom), The Royal Marsden NHS Foundation Trust (United Kingdom), Imperial College London (United Kingdom), Fondazione IRCCS Istituto Nazionale dei Tumori (Italy), Cambridge University Hospitals NHS Foundation Trust (United Kingdom), Sorbonne University / Pitié-Salpêtrière Hospital (France), and Queen Mary University of London (United Kingdom).
The conference consisted of three sessions, with a primary focus on sharing contemporary research findings and practical clinical experience. The first session was dedicated to a less common form of melanoma—uveal melanoma. The program also addressed therapeutic strategies for Kaposi sarcoma and the role of cellular therapies in oncology. In the discussion of uveal melanoma, particular emphasis was placed on the role of genetic and molecular biomarkers in assessing metastatic risk. It was highlighted that radiological studies often do not accurately reflect the true prognosis for patients with this rare malignancy, underscoring the need for additional genetic testing as part of the diagnostic process.
The subsequent presentation focused on locally advanced cutaneous melanoma. Dr. Alice Indini noted that this tumor type is frequently associated with brain metastases, and that the majority of patients who present to an oncologist are already diagnosed with metastatic disease. This represents one of the most complex manifestations of melanoma and poses significant challenges for clinical management.
Claudia Fulgenzi, a speaker invited from Imperial College London, focused on Kaposi sarcoma, a malignancy associated with viral infections. She emphasized that the disease follows a particularly aggressive course in patients with HIV infection and concomitant human herpesvirus 8 (HHV-8) infection. Although treatment of this condition remains challenging, ongoing immunotherapy research is showing promising potential.
Within the session, CAR-T cell therapy drew particular attention among innovative treatment modalities. Professor Jonathan Lim from the University of Manchester provided a detailed explanation of the principles underlying the genetic modification of T cells, the primary goal of which is their targeted “programming” to recognize and eliminate malignant cells. Although this approach represents a significant advancement in the field of immunotherapy, its integration into routine clinical practice still requires further investigation, both in terms of safety and long-term efficacy.
“Such a large-scale conference on rare tumors was held in Georgia for the first time at the initiative of Todua Clinic. We hosted experts from leading oncology centers across Europe… We residents presented clinical cases based on real patients, followed by intensive discussions and practical recommendations from international specialists. This experience has significantly contributed to the professional development of the Georgian team.” — Elene Kekelia, Oncology Resident, Todua Clinic.
The second session focused on innovative anticancer vaccines of DNA, RNA, and peptide-based types, their role in modern medicine, and the challenges currently facing the field. In discussing personalized vaccines, it was noted that they are highly specific; however, their development requires 6–8 weeks and depends on obtaining a sufficient quantity of intact tumor tissue. The speaker emphasized that the efficacy of cancer vaccines is strongly influenced by the selection of antigens and the precise alignment of the design algorithm. Integration of vaccines into combination therapy regimens was also discussed. Currently, mRNA vaccines are considered the most promising, although they remain under investigation.
In the discussion of neuroendocrine tumors, emphasis was placed on the importance of liver-directed therapies. The role of biomarkers in guiding treatment strategies was also highlighted, although further research in this area is needed. It was noted at the conference that immunotherapy (anti–CTLA-4 and anti–PD-1/PD-L1) generally shows limited efficacy in low-grade neuroendocrine tumors, underscoring the need for additional studies.
Particular attention was given to cancer of unknown primary (CUP). Recent studies presented at the conference demonstrated that locally tailored therapy targeted to the site of metastatic spread can significantly improve patient prognosis. Modern diagnostic approaches, such as detailed gene expression profiling and liquid biopsy, offer new opportunities for both diagnosis and the assessment of therapeutic response and treatment strategy.
The third session was dedicated to breast cancer, the role of genetic testing in its diagnosis, and personalized management strategies for brain tumors.
“It was a great honor for me to serve as one of the organizers, as conferences of this kind play a significant role in the advancement of oncology. Until now, most conferences in Georgia have primarily focused on breast and lung cancer, which is, of course, essential; however, we wanted to be innovators and draw attention to areas that are less frequently highlighted. The theme and concept of the conference were initiated by Todua Clinic’s General Manager, Giorgi Diasamidze. Rare cancers, due to their complex diagnostics and treatment, particularly benefit from the sharing of clinical experience.”
— Elene Kekelia, Oncology Resident, Todua Clinic.
“There is a common misconception that ‘rare’ means ‘insignificant.’ In reality, rare tumors account for approximately 20% of all cancer diagnoses. These cases are often among the most biologically challenging we encounter. Rare tumors are characterized by unique molecular driver alterations, which complicates both their diagnosis and treatment using standard protocols. This is precisely why this conference is so critically important. By bringing leading oncology experts directly to Tbilisi from the United Kingdom and France, we are not only exchanging knowledge but also effectively building a bridge between Georgian oncology and the highest standards of Western medicine. We strive to align our clinical practice with the latest European protocols. For Todua Clinic, and for Georgia as a whole, the health of oncology patients is paramount, and conferences of this type provide a tangible, life-saving contribution to the advancement of oncology. Our goal is to ensure that no Georgian patient needs to travel abroad to receive world-class, personalized cancer care. We are leaving behind the era of ‘one-size-fits-all’ medicine. This event is more than a series of lectures—it marks the beginning of a new, life-critical dialogue and the establishment of strategic international alliances. Together, we are creating a framework that will allow us to move forward, expand boundaries, and save more lives.” — David Kvaratskhelia, Oncology Resident, Todua Clinic, in an interview with MedScriptum.
The conference was conducted in an interactive format. Oncology residents from Todua Clinic presented complex clinical cases, which were subsequently discussed by the conference participants. Attendees had the opportunity to hear insights on therapeutic approaches from both Georgian oncologists and invited international experts. This format provided a unique opportunity for the exchange of knowledge and offered visiting professionals an informative experience, allowing them to gain insight into the clinical reasoning processes of Georgian oncologists and their approaches to patient management in practice.
