Management of second ipsilateral breast cancer events (iBCEs) remains controversial, and there is a need to collate existing evidence and international guidance on patient selection and local treatment strategies. This project, endorsed by US and European surgical and radiation oncology societies, aimed to gather expert consensus on these issues. A questionnaire on second iBCE local treatment was developed and reviewed by a core group of eight experts, and Delphi methodology was applied over two rounds to 36 panellists, including radiation oncologists, breast surgeons, a plastic surgeon, and medical physicists. Consensus was predefined as agreement of 75% or higher. After two rounds, consensus was reached for 78 (80%) of 97 items. Panellists agreed that patient preferences are central to decision making (100%) and that a second breast-conserving therapy represents a reasonable option for selected patients (100%). Criteria associated with greater suitability for second breast-conserving therapy included an interval between surgeries of at least 60 months, low-risk accelerated partial breast irradiation classification, luminal molecular profile, and no grade 3 late toxicity related to the first breast-conserving therapy. HER2 (also known as ERBB2)-positive or triple negative subtypes were not viewed as absolute contraindications. Strong consensus was also observed regarding the importance of tumour-to-breast volume ratio, clear surgical margins, and tumour bed reirradiation. For patients undergoing mastectomy, immediate autologous reconstruction was preferred (94%) over implant-based approaches (75%). This international Delphi consensus offers structured guidance for the local management of second iBCE and supports shared decision making and individualised treatment planning.

The rigorous conduct of well designed clinical trials is critical to improving outcomes for patients with gynaecological cancers. The Gynecologic Cancer InterGroup (GCIG) has promoted collaboration and harmonisation to guide clinical trials in ovarian and endometrial cancer through a series of consensus meetings with published statements. GCIG convened the inaugural Cervical Cancer Consensus Conference in Clinical Research in Dublin, Ireland, on Oct 14-15, 2024, to develop a consensus on design elements, essential questions, and unmet needs in cervical cancer research. All 33 GCIG member groups and additional representatives from patient advocates, young investigators, investigators from low-income and middle-income countries, and the Cervical Cancer Research Network participated in developing, refining, and adopting 16 statements within four topic groups: diagnosis and staging, early-stage disease, locally advanced disease, and persistent or recurrent disease. Consensus was obtained for all statements. Areas of unmet need were identified and tabulated. The high agreement rates generated through a process of debates, discussions, and consensus represent a positive commitment that incorporates harmonisation, inclusion, and pragmatism in the conduct of academic clinical trials globally.

Cancer incidence and mortality are rising globally, with their burden falling disproportionately on low-income and middle-income countries. Africa faces major gaps in oncology education and workforce development, limiting access to high-quality cancer care. Focusing on efforts relevant to oncology in Africa, we provide an overview of existing programmes and models for educating health-care personnel in resource-constrained regions, highlighting challenges and effective strategies. Current efforts described include formal curricula, fellowship programmes, mentorship networks, and technology-driven solutions such as e-learning and telemedicine. Funding, language and cultural barriers, and policy gaps pose persistent obstacles to the creation and effective implementation of oncology education and workforce development initiatives. Emerging technological innovations for education, such as artificial intelligence-driven learning, virtual reality, and adaptive platforms, offer scalable opportunities for advancement. Keys to success include sustainable, interdisciplinary, and international collaborations within and across sectors; close tailoring of initiatives to local needs; as well as policy advocacy and alignment with national and international health policy frameworks.