Mission-Driven Cancer Research

Matti Aapro, President of the European Cancer Organisation and Member of the EU Cancer Mission Assembly, opened the session on the EU Cancer Mission,[19] subtitled All Together as One. He indicated that the Mission has as one of its priorities the joining of forces between basic research and clinic to achieve the goal of preventing cancer and treating it the best way possible, with each patient seen as a human and not an anonymous entity.

Row 1 - Caroline Dive (European Association for Cancer Research); Nathalie Moll (European Federation of Pharmaceutical Industries and Associations); Walter Ricciardi (Chair, EU Cancer Mission Board). Row 2 - Christine Chomienne (Vice-Chair, EU Cancer Mission Board); Manfred Weber MEP (EPP Group); Bettina Ryll (EU Cancer Mission Board; European Cancer Organisation’s Patient Advisory Committee). Row 3 - Mariya Gabriel (EU Commissioner for Innovation, Research, Culture, Education and Youth); Matti Aapro (European Cancer Organisation; EU Cancer Mission Assembly).

A Mission Founded on Three Pillars

Walter Ricciardi, Chair of the EU Cancer Mission Board, explained the Mission was inspired by John F. Kennedy’s launch of the mission to the moon in 1961, and it is an ambitious but feasible project set out over seven years.

Cancer is one of Europe’s major societal challenges, and it is estimated half of all cancer cases will be in Europe by 2035. The goals of the Mission are therefore to direct research and innovation to achieve tangible results for European citizens and stakeholders, making sure everyone will have equal access.

The Mission has had 15 Board meetings and published a report,[25] and is now working on its governance and implementation. It contains three pillars—prevention; diagnostics and treatment; and quality of life—capped by equitable access and underpinned by understanding. Within that, thirteen bold actions focus on aspects such as the advanced implementation of personalised medicine and the greater use of minimally invasive technologies.

It is also recommended that there be a digital centre to deposit data for personalised care. Every single cancer patient in Europe will own their data but be able to share it to improve research. This may be important for smaller countries and those lagging behind to improve inequities within and across all EU Member States, as where research is carried out, treatment is better.

Another focus is childhood cancer, which must be cured as a priority with better patient outcomes, as well as stronger public-private initiatives. The aim is to transform the cancer culture among professionals, managers, politicians and patients.

More than Technological Research

Stefan Gijssels, Co-Chair of the European Cancer Organisation’s Patient Advisory Committee, commented that research is needed to identify what organisational and information aspects lead to the best outcomes. These include shared-decision-making, health literacy, social initiatives, patient organisation membership, nutrition and physical activity. New technology is needed, but not only technology can solve the issues that patients face. 

Another critical area, little studied, is behavioural research into participation in lifestyle interventions and screening programmes, and follow-up after positive screening tests.

European Nations Working Together

Manfred Weber MEP, Chairman of the EPP Group in the European Parliament, said COVID-19 has been a big game-changer. It is now clear health has to be tackled on a European level, with Member States not in competition but working together. 

The European Parliament has voted to increase the Horizon Europe by €5 billion and to raise the EU4Health budget back up to the originally proposed €9.4 billion,[26] demonstrating the unity of parliamentarians in the fight for an ambitious approach to health. He agreed that data access is a crucial element of strengthening research but may be limited by the interpretation of present data protection rules. However, a middle way has to be found and a firm basis for data sharing created. 

The strong East-West divide, highlighted in the European Cancer Organisation’s recent Action Report,[3] is unacceptable. The same level of knowledge and access to state-of-the-art care is needed across Europe, and there is a strong political will to tackle this issue. These opportunities need to be seized to ensure health and cancer remain at the heart of Europe.

Harnessing New Discoveries

Mariya Gabriel, EU Commissioner for Innovation, Research, Culture, Education and Youth, said stakeholders all over Europe will join forces to tackle cancer, and the EU Cancer Mission is key to that. It sets clear and ambitious targets to translate ideas into action, a process that will be accelerated by Europe’s Beating Cancer Plan.

But it goes beyond that. There is policy support to cope with the effects of the environment, food production, climate and lifestyles, and the Mission will generate evidence-based knowledge to decrease cancer risk, working with patients to involve them in the decision-making process and tailored care to their needs and wants. 

Solutions must be available to all patients across Europe, and the challenges faced by cancer survivors must be addressed, including quality of life, late treatment effects, comorbidities and mental and reproductive health. 

Much has been achieved but more must be done. A more coherent approach is needed, building links with a coalition of implementers, including civil society organisations, general practitioners and nurses. Actions must be combined at a national and European level, and the link between the EU Cancer Mission and Europe’s Beating Cancer Plan includes citizen engagement.

Bridging the Research Gap

Caroline Dive, President of the European Association for Cancer Research, said well-supported basic science is central to tackling cancer in Europe, with researchers from all backgrounds, working in conjunction with translational scientists, included in curiosity-driven basic research.

COVID-19 has shown how knowledge can be disseminated and shared to less well-resourced areas of Europe, and was a graphic illustration of how to bridge the gap between basic science and clinical research. Patient and public involvement will be needed to achieve personalised treatment, and it is crucial that basic scientists embrace discussion and inclusion.

A New Way of Thinking

Bettina Ryll, Member of the EU Cancer Mission Board and Founder of MPNE, said the Mission is helping to move research thinking away from a silo approach towards a systems approach, where researchers seek interaction and collaboration. However, the hard part is the implementation.

She believes a continuous feedback loop is required so basic researchers see the fruits of their labours. That requires data and access, which means the ownership of data needs to be examined. Once this can be overcome, it will be possible to learn what patients actually want. When a level playing field can be created and the system can take advantage of brilliant people, true progress will be achieved.

The Need for Solidarity and Trust

Nathalie Moll, Director General at EFPIA, said it is important the EU Cancer Mission has a structured and integrated approach that includes the whole treatment pathway. Moreover, the three pillars are a sensitive way of achieving the overall objective, and the focus on patient outcomes is crucial.

Although cancer treatment has improved, there is much more to do around advancing quality of live and survival. However, spending on cancer remains fairly static and reflects neither the burden of the disease nor patients’ expectations. Stronger political support is needed and all funding mechanisms, not just the Mission and related programmes, should be explored at national and international level.

Through the COVID-19 pandemic, we have learned the need for solidarity but also to trust each other, as we achieve more when we work together. Patients also need to be involved from the beginning of the research continuum, which is already a focus in industry, to incorporate their needs and develop personalised care solutions for today and tomorrow.

It was also suggested in the comments that patients be included in debates over cancer care budgets, with engagement at the highest level in Europe to ensure that decisions are more precise and directed towards relevant action.

Simultaneous and Ambitious Research

Christine Chomienne, Vice-Chair of the EU Cancer Mission Board said the Mission offers a guarantee to be able to make an impact, but underlined that a multidisciplinary approach to science is key.

It is crucial to begin with the needs of citizens. Research projects must be conducted simultaneously and with clear and ambitious objectives and well-supported actions to ensure rapid results. Another key aspect is capacity building and communication to ensure that actions and their implementation are seen by each citizen. The Mission will be adapted to them and flexibility in delivering the solutions is an important part of its work.