I feel privileged to have received an ESMO Fellowship not once, but twice. I was awarded my first – a translational research fellowship – back in 2005, when I was a young general oncology resident and really wanted to gain some experience in the area of translational oncology. My project focused on identifying the differences in biology of lung adenocarcinoma between smokers and never smokers. It was the era when oncologists started to realise that lung cancer in these settings were a completely different disease entity due to the presence of distinct mutations.
When I applied for the fellowship, I knew I wanted to get a more international perspective of oncology and to spend some time working in a world-renowned centre in a different country. The fellowship enabled me to go to Villejuif, in France, to conduct research at the Institut Gustave Roussy (IGR). I did not realise it at the time, but the year I spent at IGR under the mentorship of Jean-Charles Soria would mark the start of my interest in thoracic oncology. Now, as one of the coordinators of the Lung Cancer Working Group of the Hellenic Co-operative Oncology Group (HeCOG) and in charge of a number of lung cancer clinical trials in my home country, Greece, my passion for lung cancer continues to flourish. This first experience also gave me the valuable opportunity to present our work at ESMO 2006 in Istanbul and results were also published in Clinical Cancer Research in 2007. Based on these data my mentor and I were also invited to write a review for Nature Reviews Clinical Oncology which was published in 2007.
In 2009 a second fellowship, this time in clinical research, provided me with experience from a very different perspective. It focused on the biology of bone metastasis in patients with solid tumours. With a team at the University of Athens, we measured the levels of several markers of bone metabolism in patients with lung, breast and prostate cancer before, during and after treatment with bisphosphonates (BPN). The results of this study were published in Scandinavian Journal Acta Oncologica and in Annals of Translational Medicine. These data, among others, led to the identification of the PANKL/OPG axis as an important determinant of bone metabolism and paved the way to the discovery of denosumab, a RANKL inhibitor.
Both fellowships have helped to foster my career. The first gave me a wider perspective of oncology and taught me how to work as part of a multidisciplinary team. I learnt how to interact effectively on a day-to-day basis with technicians, biologists and statisticians. I also had the opportunity to conduct weekly discussions with the whole study team regarding progress and challenges. It was also a great networking experience; many of the international collaborations I still have today are with colleagues I met when I was in France.
I have to be honest and say that there can be some additional challenges to working abroad. For me it was initially language. I had spent several months learning French before I went to Villejuif, only to find that the academic version my tutor had been teaching me was certainly not the language spoken in my daily life in Paris. However, four months into my stay I knew that I was fluent in the language when I had my first dream in French! Luckily, whichever country you are from, oncologists have a common language of cancer, a common goal to pursue, and this is something that unites us.
The ESMO Fellowship Programme gives young oncologists an exciting opportunity to cross multicultural boundaries. Working abroad for a time forces you to step back from your own country and to see the oncology landscape from different perspectives. I am extremely grateful to ESMO for these fellowships and for helping me take my first steps at an international level. My main advice for young oncologists willing to apply for a fellowship is to work hard and if unsuccessful the first time not to be disappointed by initial rejection and apply again. This is what I did and it worked!
Giannis Mountzios among tutors and colleagues, during his Thesis presentation at the Institut Gustave Roussy, France, in October 2006.