Leave No One Behind - Delivering Innovation in Lung Cancer Care. Action Report

21 January 2021

The Community 365 Roundtable Meeting on Lung Cancer, which took place on 7 December 2020, brought together leading policy-makers, politicians, oncology experts, industry partners and advocates to mark the launch of the European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer, published in the journal Lung Cancer,[1] and to discuss this important area of cancer care.

Lung cancer is typically associated with late diagnosis and, consequently, poor outcomes and high mortality rates. There are challenges around the identification of patients at an early stage in their disease course and in getting patients, once they are diagnosed, into adequate treatment. Moreover, there is a stigma around the disease that stems from a lingering assumption that it is self-inflicted.

Despite this, there have been great strides in the diagnosis, assessment and management of lung cancer in recent years, with the introduction of immunotherapy and innovations in the molecular diagnosis and profiling of tumours, leading to the development of effective targeted therapies. Together, these offer patients the opportunity to receive innovative treatments with greater benefits and lower toxicities than traditional therapy combinations.

Yet patients all across Europe face issues in accessing these innovations due to variations not only in their availability but also in the organisation of care. This means many do not reap the rewards of decades of research and are left with suboptimal care. The result is that the potential for improvements in lung cancer outcomes and survival is not being realised.

In response, the European Cancer Organisation developed the ERQCC: Lung Cancer, the latest in our series of publications on the Essential Requirements of Quality Cancer Care.[2] Written by European experts representing all disciplines involved in cancer care, including our Member Societies, as well as patient representatives, the ERQCC papers provide roadmaps to high-quality multidisciplinary cancer care, which is at the heart of the European Cancer Organisation’s guiding mission:

“To reduce the burden of cancer, improve outcomes and the quality of care for cancer patients, through multidisciplinarity and multiprofessionalism”.

Access to Quality Care

The Community 365 Roundtable Meeting opened with a presentation and discussion of the ERQCC: Lung Cancer. This sets out how it aims to help countries bridge the gap in providing access to multidisciplinary management for lung cancer patients by focusing on care pathways and appropriate timelines, the multidisciplinary team, and performance indicators, among other key aspects. In this sense, it provides organisational specifications, not clinical guidelines, and is intended to give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high-quality care throughout the patient journey.

This was followed by a session, co-chaired by Françoise Bartoli, Vice-President, Head of Europe and Canada, Oncology Business, AstraZeneca, on the need for early diagnosis and screening in lung cancer. This highlighted how, although questions remain over what form screening should take on the ground and how to target and recruit the most appropriate individuals, implementation roadmaps need to be developed across Europe to improve early diagnosis rates.

Next, there was a session on molecular diagnostics in lung cancer and its relevance for appropriate treatment selection, co-chaired by Geoff Oxnard, Vice President, Global Medical Lead, Liquid Franchise at Foundation Medicine. This focused on next-generation sequencing of tumours and liquid biopsies, which offer the opportunity for greater precision in the diagnosis and profiling of lung cancers. This can be used in many cases to guide treatment and better characterise a patient’s prognosis. However, equitable access to these technologies, as well as the overall care framework in which they are used, remains an issue all across Europe.

Finally, a case study on the importance of quality indicators was presented in a session co-chaired by Ouzna Morsli, EMEAC Oncology Medical Lead at MSD. This looked at the Dutch Lung Cancer Audit, which has grown over the past few years to include all patients with lung cancer in the Netherlands and has already begun to have an impact on key measures of quality care.

Through success stories such as these, and by making screening and innovations in diagnosis and tumour profiling available to all patients across Europe, we can make a real difference to the lives of lung cancer patients and their families. They cannot wait any longer. The time is now.