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Berns A. Academia and society should join forces to make anti-cancer treatments more affordable. Mol Oncol 2024; 18:1351-1354. [PMID: 38634213 PMCID: PMC11161723 DOI: 10.1002/1878-0261.13651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
Discovery research is the starting point for the development of more effective anti-cancer treatments. It requires an interdisciplinary research environment with first-class infrastructural support in which curiosity-driven research can lead to new concepts for treating cancer. Translating such research findings to clinical practice requires complementary skills and infrastructures, including high-quality clinical facilities, access to patient cohorts and participation of pharma. This complex ecosystem has yielded many new but also "me too" treatment regimens, especially in immuno-oncology resulting in an extremely high pricing of anti-cancer agents. The costs of antibodies, vaccines, and cell therapies charged by pharma stand out although the concepts and methodologies have been largely developed in academia, financed from public funds. Comprehensive Cancer Centres (CCCs) covering a coherent stretch of the cancer research continuum are well-positioned to make these personalized treatments more affordable, but this will require restructuring of the way the translational cancer research continuum is funded.
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Affiliation(s)
- Anton Berns
- Division of Molecular GeneticsThe Netherlands Cancer InstituteAmsterdamThe Netherlands
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2
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Masucci M, Karlsson C, Blomqvist L, Ernberg I. Bridging the Divide: A Review on the Implementation of Personalized Cancer Medicine. J Pers Med 2024; 14:561. [PMID: 38929782 PMCID: PMC11204735 DOI: 10.3390/jpm14060561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
The shift towards personalized cancer medicine (PCM) represents a significant transformation in cancer care, emphasizing tailored treatments based on the genetic understanding of cancer at the cellular level. This review draws on recent literature to explore key factors influencing PCM implementation, highlighting the role of innovative leadership, interdisciplinary collaboration, and coordinated funding and regulatory strategies. Success in PCM relies on overcoming challenges such as integrating diverse medical disciplines, securing sustainable investment for shared infrastructures, and navigating complex regulatory landscapes. Effective leadership is crucial for fostering a culture of innovation and teamwork, essential for translating complex biological insights into personalized treatment strategies. The transition to PCM necessitates not only organizational adaptation but also the development of new professional roles and training programs, underscoring the need for a multidisciplinary approach and the importance of team science in overcoming the limitations of traditional medical paradigms. The conclusion underscores that PCM's success hinges on creating collaborative environments that support innovation, adaptability, and shared vision among all stakeholders involved in cancer care.
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Affiliation(s)
- Michele Masucci
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18B, 171 65 Solna, Sweden
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Solnavägen 9, 171 65 Solna, Sweden
| | - Claes Karlsson
- Department of Oncology-Pathology (Onc-Pat), Karolinska Institutet, Anna Steckséns gata 30A, D2:04, 171 65 Solna, Sweden;
| | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery (MMK), Karolinska Institutet, Anna Steckséns gata 53, 171 65 Solna, Sweden;
| | - Ingemar Ernberg
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Solnavägen 9, 171 65 Solna, Sweden
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3
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Ringborg U, von Braun J, Celis J, Baumann M, Berns A, Eggermont A, Heard E, Heitor M, Chandy M, Chen C, Costa A, De Lorenzo F, De Robertis EM, Dubee FC, Ernberg I, Gabriel M, Helland Å, Henrique R, Jönsson B, Kallioniemi O, Korbel J, Krause M, Lowy DR, Michielin O, Nagy P, Oberst S, Paglia V, Parker MI, Ryan K, Sawyers CL, Schüz J, Silkaitis K, Solary E, Thomas D, Turkson P, Weiderpass E, Yang H. Strategies to decrease inequalities in cancer therapeutics, care and prevention: Proceedings on a conference organized by the Pontifical Academy of Sciences and the European Academy of Cancer Sciences, Vatican City, February 23-24, 2023. Mol Oncol 2024; 18:245-279. [PMID: 38135904 PMCID: PMC10850793 DOI: 10.1002/1878-0261.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 12/24/2023] Open
Abstract
Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. The development of basic technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the USA-Cancer Moonshot and the EU-Mission on Cancer and Europe's Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organized by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research defined as a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention modalities. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and clinical research, as for ensuring state-of-the-art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost-effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivizing research aimed at prevention and cancer therapeutics/care with an increased focus on patients' needs and cost-effective healthcare.
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4
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Bocquet F, Raimbourg J, Bigot F, Simmet V, Campone M, Frenel JS. Opportunities and Obstacles to the Development of Health Data Warehouses in Hospitals in France: The Recent Experience of Comprehensive Cancer Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1645. [PMID: 36674399 PMCID: PMC9861145 DOI: 10.3390/ijerph20021645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Big Data and Artificial Intelligence can profoundly transform medical practices, particularly in oncology. Comprehensive Cancer Centers have a major role to play in this revolution. With the purpose of advancing our knowledge and accelerating cancer research, it is urgent to make this pool of data usable through the development of robust and effective data warehouses. Through the recent experience of Comprehensive Cancer Centers in France, this article shows that, while the use of hospital data warehouses can be a source of progress by taking into account multisource, multidomain and multiscale data for the benefit of knowledge and patients, it nevertheless raises technical, organizational and legal issues that still need to be addressed. The objectives of this article are threefold: 1. to provide insight on public health stakes of development in Comprehensive Cancer Centers to manage cancer patients comprehensively; 2. to set out a challenge of structuring the data from within them; 3. to outline the legal issues of implementation to carry out real-world evidence studies. To meet objective 1, this article firstly proposed a discussion on the relevance of an integrated approach to manage cancer and the formidable tool that data warehouses represent to achieve this. To address objective 2, we carried out a literature review to screen the articles published in PubMed and Google Scholar through the end of 2022 on the use of data warehouses in French Comprehensive Cancer Centers. Seven publications dealing specifically with the issue of data structuring were selected. To achieve objective 3, we presented and commented on the main aspects of French and European legislation and regulations in the field of health data, hospital data warehouses and real-world evidence.
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Affiliation(s)
- François Bocquet
- Data Factory & Analytics Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Law and Social Change Laboratory, Faculty of Law and Political Sciences, CNRS UMR 6297, Nantes University, 44313 Nantes, France
| | - Judith Raimbourg
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
| | - Frédéric Bigot
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
| | - Victor Simmet
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
| | - Mario Campone
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
| | - Jean-Sébastien Frenel
- Oncology Department, Institut de Cancérologie de l’Ouest, 44805 Nantes-Angers, France
- Center for Research in Cancerology and Immunology Nantes-Angers, INSERM UMR 1232, Nantes University and Angers University, 44035 Nantes-Angers, France
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5
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Lawler M, Davies L, Oberst S, Oliver K, Eggermont A, Schmutz A, La Vecchia C, Allemani C, Lievens Y, Naredi P, Cufer T, Aggarwal A, Aapro M, Apostolidis K, Baird AM, Cardoso F, Charalambous A, Coleman MP, Costa A, Crul M, Dégi CL, Di Nicolantonio F, Erdem S, Geanta M, Geissler J, Jassem J, Jagielska B, Jonsson B, Kelly D, Kelm O, Kolarova T, Kutluk T, Lewison G, Meunier F, Pelouchova J, Philip T, Price R, Rau B, Rubio IT, Selby P, Južnič Sotlar M, Spurrier-Bernard G, van Hoeve JC, Vrdoljak E, Westerhuis W, Wojciechowska U, Sullivan R. European Groundshot-addressing Europe's cancer research challenges: a Lancet Oncology Commission. Lancet Oncol 2023; 24:e11-e56. [PMID: 36400101 DOI: 10.1016/s1470-2045(22)00540-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022]
Abstract
Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average 10-year survival for all European cancer patients by 2035.
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Affiliation(s)
- Mark Lawler
- Patrick G Johnston Centre for Cancer Research, Faculty of Medicine, Health and Life Sciences, Queen's University Belfast, Belfast, UK.
| | - Lynne Davies
- International Cancer Research Partnership, International House, Cardiff, UK
| | - Simon Oberst
- Organisation of European Cancer Institutes, Brussels, Belgium
| | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, UK; European Cancer Organisation Patient Advisory Committee, Brussels, Belgium
| | - Alexander Eggermont
- Faculty of Medicine, Utrecht University Medical Center, Utrecht, Netherlands; Princess Máxima Centrum, Utrecht, Netherlands
| | - Anna Schmutz
- International Agency for Cancer Research, Lyon, France
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Peter Naredi
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tanja Cufer
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ajay Aggarwal
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK; Institute of Cancer Policy, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matti Aapro
- Genolier Cancer Center, Genolier, Switzerland
| | - Kathi Apostolidis
- Hellenic Cancer Federation, Athens, Greece; European Cancer Patient Coalition, Brussels, Belgium
| | - Anne-Marie Baird
- Lung Cancer Europe, Bern, Switzerland; Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Fatima Cardoso
- Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Andreas Charalambous
- European Cancer Organisation Brussels, Brussels, Belgium; Department of Nursing, Cyprus University of Technology, Limassol, Cyprus; Department of Oncology, University of Turku, Turku, Finland
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Csaba L Dégi
- Faculty of Sociology and Social Work, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Federica Di Nicolantonio
- Department of Oncology, University of Turin, Turin, Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Sema Erdem
- European Cancer Organisation Patient Advisory Committee, Europa Donna, Istanbul, Türkiye
| | - Marius Geanta
- Centre for Innovation in Medicine and Kol Medical Media, Bucharest, Romania
| | - Jan Geissler
- Patvocates and CML Advocates Network, Leukaemie-Online (LeukaNET), Munich, Germany
| | | | - Beata Jagielska
- Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Olaf Kelm
- International Agency for Research on Cancer, Lyon, France
| | | | - Tezer Kutluk
- Faculty of Medicine & Cancer Institute, Hacettepe University, Ankara, Türkiye
| | - Grant Lewison
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
| | | | | | - Thierry Philip
- Organisation of European Cancer Institutes, Brussels, Belgium; Institut Curie, Paris, France
| | - Richard Price
- European Cancer Organisation Brussels, Brussels, Belgium
| | - Beate Rau
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Peter Selby
- School of Medicine, University of Leeds, Leeds, UK
| | | | | | - Jolanda C van Hoeve
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Eduard Vrdoljak
- Department of Oncology, University Hospital Center Split, School of Medicine, University of Split, Split, Croatia
| | - Willien Westerhuis
- Organisation of European Cancer Institutes, Brussels, Belgium; Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | | | - Richard Sullivan
- Institute of Cancer Policy, School of Cancer Sciences, Kings College London, London, UK
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6
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Wind A, Oberst S, Westerhuis W, Blaauwgeers H, Sæter G, de Paoli P, Nagy P, Burrion JB, Jolly E, Lovey J, van Harten W. Evaluating comprehensive cancer networks; a review of standards and evaluation methods for care networks to inform a comparison with the OECI comprehensive cancer network standards. Acta Oncol 2023; 62:15-24. [PMID: 36786345 DOI: 10.1080/0284186x.2023.2170275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
INTRODUCTION To ensure that all citizens have equal access to high-quality cancer diagnosis and care, the EU4Health Programme, Europe's Beating Cancer Plan, and Horizon Europe's Cancer Mission propose Comprehensive Cancer Infrastructures in every European Union Member State. It is therefore important to establish the basic principles for high-performing cancer networks and a methodology for evaluating their quality and effectiveness. This article describes methods and standards/indicators for network evaluation found in literature, gives a comparative overview of the new OECI European Cancer Network Quality standards, and proposes principles for evaluating the performance of Comprehensive Cancer Networks as a basis for continuous improvement. MATERIALS AND METHODS We performed a scoping literature review on methods and standards/indicators for care-network evaluation. We then compared the OECI set with literature findings, categorised standards that were similar, reflected on standards that were different, and deduced principles for quality standards for cancer networks. RESULTS Of 1002 articles identified, 17 reported on evaluation methods and/or (mostly) qualitative indicators. Sixteen studies described indicators/standards for evaluating care networks, critical success factors or desirable outcomes. Of the 54 present OECI standards, 32 had a literature equivalent. No literature equivalent was found for 22 standards, especially on those related to the combination of care and research. The proposed OECI evaluation methods (survey, document review, and interviews) were all reported in the literature. From the conformity of these results, we deduced 8 principles for standards evaluating the effectiveness of Comprehensive Cancer Networks. CONCLUSIONS Research on the evaluation of the effectiveness of care networks is scarce. Evaluation methods vary and are often single time-point assessments. The OECI set contributes to establishing clear principles and standards to evaluate the effectiveness of Comprehensive Cancer Networks.
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Affiliation(s)
- Anke Wind
- Rijnstate Hospital, Arnhem, The Netherlands
| | - Simon Oberst
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium
| | - Willien Westerhuis
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,The Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Harriet Blaauwgeers
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,The Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Gunnar Sæter
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Paolo de Paoli
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,Alliance Against Cancer, Rome, Italy
| | - Péter Nagy
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,National Institute of Oncology, Budapest, Hungary
| | - Jean-Benoit Burrion
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,Institut Jules Bordet, Brussels, Belgium
| | - Eva Jolly
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - József Lovey
- Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,National Institute of Oncology, Budapest, Hungary
| | - Wim van Harten
- Rijnstate Hospital, Arnhem, The Netherlands.,Accreditation and Designation, Organisation of European Cancer Institutes, Brussels, Belgium.,Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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7
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Kehrloesser S, Oberst S, Westerhuis W, Wendler A, Wind A, Blaauwgeers H, Burrion JB, Nagy P, Saeter G, Gustafsson E, De Paoli P, Lovey J, Lombardo C, Philip T, de Valeriola D, Docter M, Boomsma F, Saghatchian M, Svoboda M, Philip I, Monetti F, Hummel H, McVie G, Otter R, van Harten W. Analysing the attributes of Comprehensive Cancer Centres and Cancer Centres across Europe to identify key hallmarks. Mol Oncol 2021; 15:1277-1288. [PMID: 33734563 PMCID: PMC8096787 DOI: 10.1002/1878-0261.12950] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/06/2021] [Accepted: 03/17/2021] [Indexed: 12/22/2022] Open
Abstract
There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high‐quality cancer care. European policy (EU Cancer Mission and Europe’s Beating Cancer Plan) is currently moving towards a mission‐oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes’ Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high‐impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.
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Affiliation(s)
- Sebastian Kehrloesser
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, UK
| | - Simon Oberst
- Organisation of European Cancer Institutes, Brussels, Belgium.,Cancer Research UK Cambridge Centre, University of Cambridge, UK
| | - Willien Westerhuis
- the Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Astrid Wendler
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, UK
| | - Anke Wind
- Rijnstate Hospital, Arnhem, The Netherlands
| | - Harriët Blaauwgeers
- the Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | | | - Péter Nagy
- National Institute of Oncology, Budapest, Hungary
| | - Gunnar Saeter
- Organisation of European Cancer Institutes, Brussels, Belgium.,Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Eva Gustafsson
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
| | | | - József Lovey
- Organisation of European Cancer Institutes, Brussels, Belgium.,National Institute of Oncology, Budapest, Hungary
| | | | - Thierry Philip
- Organisation of European Cancer Institutes, Brussels, Belgium.,Institut Curie, Paris Cedex 05, France
| | - Dominique de Valeriola
- Organisation of European Cancer Institutes, Brussels, Belgium.,Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Femke Boomsma
- Radiotherapeutisch Instituut Friesland, Leeuwarden, The Netherlands
| | - Mahasti Saghatchian
- Institut Gustave Roussy, Villejuif, France.,American Hospital of Paris, Neuilly-sur-Seine, France
| | - Marek Svoboda
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | | | - Henk Hummel
- the Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | | | | | - Wim van Harten
- Organisation of European Cancer Institutes, Brussels, Belgium.,Rijnstate Hospital, Arnhem, The Netherlands.,The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
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8
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100 European core quality standards for cancer care and research centres. Lancet Oncol 2020; 21:1009-1011. [PMID: 32758458 DOI: 10.1016/s1470-2045(20)30318-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 11/21/2022]
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9
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Berns A, Ringborg U, Celis JE, Heitor M, Aaronson NK, Abou‐Zeid N, Adami H, Apostolidis K, Baumann M, Bardelli A, Bernards R, Brandberg Y, Caldas C, Calvo F, Dive C, Eggert A, Eggermont A, Espina C, Falkenburg F, Foucaud J, Hanahan D, Helbig U, Jönsson B, Kalager M, Karjalainen S, Kásler M, Kearns P, Kärre K, Lacombe D, de Lorenzo F, Meunier F, Nettekoven G, Oberst S, Nagy P, Philip T, Price R, Schüz J, Solary E, Strang P, Tabernero J, Voest E. Towards a cancer mission in Horizon Europe: recommendations. Mol Oncol 2020; 14:1589-1615. [PMID: 32749074 PMCID: PMC7400777 DOI: 10.1002/1878-0261.12763] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/26/2022] Open
Abstract
A comprehensive translational cancer research approach focused on personalized and precision medicine, and covering the entire cancer research-care-prevention continuum has the potential to achieve in 2030 a 10-year cancer-specific survival for 75% of patients diagnosed in European Union (EU) member states with a well-developed healthcare system. Concerted actions across this continuum that spans from basic and preclinical research through clinical and prevention research to outcomes research, along with the establishment of interconnected high-quality infrastructures for translational research, clinical and prevention trials and outcomes research, will ensure that science-driven and social innovations benefit patients and individuals at risk across the EU. European infrastructures involving comprehensive cancer centres (CCCs) and CCC-like entities will provide researchers with access to the required critical mass of patients, biological materials and technological resources and can bridge research with healthcare systems. Here, we prioritize research areas to ensure a balanced research portfolio and provide recommendations for achieving key targets. Meeting these targets will require harmonization of EU and national priorities and policies, improved research coordination at the national, regional and EU level and increasingly efficient and flexible funding mechanisms. Long-term support by the EU and commitment of Member States to specialized schemes are also needed for the establishment and sustainability of trans-border infrastructures and networks. In addition to effectively engaging policymakers, all relevant stakeholders within the entire continuum should consensually inform policy through evidence-based advice.
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10
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Philip T, Karjalainen S, De Lorenzo F, Apostolidis K, Lombardo C, Nilbert M, Lacombe D, Poortmans P, Albreht T, Kearns P, Vassal G. What could be a cancer mission objective if we join our forces in the fight against cancer? TUMORI JOURNAL 2019; 105:447-455. [PMID: 31718477 PMCID: PMC6952939 DOI: 10.1177/0300891619886351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The European cancer burden is growing rapidly, with an estimated 2 million deaths a year according to the latest research. As almost half of cancers are diagnosed after the age of 65, and considering the aging European population, a tidal wave of cancer cases will sweep across Europe within the coming decades. Without major action, the additional number of annual cancer cases is expected to rise from 4.2 million to 5.2 million by 2040. If we are to reach plateauing numbers by 2040 (as a minimum goal), this would require 0.75% annual reduction in risk and 1% reduction in risk of death. These challenges call for attack from various angles, coordinated efforts, rational strategies, initiatives throughout the cancer trajectory, activities to reduce inequities, and implementation of evidence-based measures. In order to defeat the societal challenges of cancer through innovation, Europe will need to join forces and connect the European Commission and the member states, politicians and citizens, industries and patient associations. A cancer mission should thus unite the public and patient viewpoint to the perspective of cancer professionals. The authors describe a plan that has been agreed upon among some of the major European Cancer organizations and associations. This plan uses a cancer mission as a tool and must deliver robust medical evidence to patients and doctors through high-quality research delivering sustainable and affordable strategies for prevention, treatment, and follow-up.
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Affiliation(s)
- Thierry Philip
- Organisation of European Cancer
Institutes, Brussels, Belgium
| | | | | | | | | | | | - Denis Lacombe
- European Organisation for Research and
Treatment of Cancer, Brussels, Belgium
| | - Philip Poortmans
- European Cancer Organisation, Brussels,
Belgium
- European Society for Radiotherapy &
Oncology, Brussels, Belgium
| | - Tit Albreht
- Innovative Partnership for Action
Against Cancer, Ljubljana, Slovenia
| | - Pamela Kearns
- European Society for Paediatric
Oncology, Birmingham, UK
| | - Gilles Vassal
- European Society for Paediatric
Oncology, Birmingham, UK
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11
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Ringborg U, Celis JE, Baumann M, Eggermont A, Wild CP, Berns A. Boosting the social impact of innovative cancer research - towards a mission-oriented approach to cancer. Mol Oncol 2019; 13:497-501. [PMID: 30811864 PMCID: PMC6396369 DOI: 10.1002/1878-0261.12464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ulrik Ringborg
- Cancer Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Julio E Celis
- European Academy of Cancer Sciences, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Michael Baumann
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | | | - Anton Berns
- Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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12
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Ringborg U. Translational cancer research - a coherent cancer research continuum. Mol Oncol 2019; 13:517-520. [PMID: 30657250 PMCID: PMC6396568 DOI: 10.1002/1878-0261.12450] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 11/09/2022] Open
Abstract
The main components of the cancer research continuum are basic/preclinical research, early and late clinical research and, after the adoption of an innovation by the healthcare or health organisations, outcomes research. Translational cancer research, defined as a coherent cancer research continuum, is mandatory to address the increasing burden of cancer effectively. The growing cancer problem can only be significantly modified by concerted action involving prevention to decrease incidence, early detection and treatment to increase the cure rate, and personalised/precision cancer medicine to adapt early detection and treatment to the biology of a tumour with the aim of increasing the cure rate, prolonging survival and improving health-related quality of life. By definition, translational cancer research for therapeutics has a focus on patients' needs and for prevention for individuals at-risk. Consequently, to increase the effectiveness of translational research, the different components of the cancer research continuum need to be better connected to the fundamental aim of a mission-oriented approach to cancer (Celis and Pavalkis, ).
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Affiliation(s)
- Ulrik Ringborg
- Cancer Center KarolinskaKarolinska University Hospital SolnaStockholmSweden
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13
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Berns A. Quality-assured research environments for translational cancer research. Mol Oncol 2019; 13:543-548. [PMID: 30628170 PMCID: PMC6396364 DOI: 10.1002/1878-0261.12441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 11/06/2022] Open
Abstract
In order to secure high-quality cancer care for increasing numbers of cancer patients in the upcoming decades, the complete continuum of cancer research and cancer care needs a thorough overhaul, with more emphasis on prevention and early detection, and a greater focus on the development of innovative treatments that are also scrutinised for effectiveness and quality-of-life aspects. Therefore, under-resourced research areas, such as primary prevention, early diagnosis/secondary prevention (Song et al., ; Wild et al., ) and outcomes research (Cavers et al., ), should be given more emphasis, whereas basic, preclinical and clinical cancer research requires more innovation and effective collaboration to develop more effective treatments at an affordable cost. Innovative collaborative research in this translational trajectory requires the participation of well-resourced and well-organised institutions that are committed to high scientific and ethical standards. Offering focused funding to distinct segments of this research continuum concomitant with incentives to aspire to high-quality standards is the most effective route to achieve these goals. Therefore, a rigorous quality assessment system for institutions operating in this research continuum is a high priority.
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Affiliation(s)
- Anton Berns
- Oncode InstituteThe Netherlands Cancer InstituteAmsterdamThe Netherlands
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14
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Ernberg I. Education aimed at increasing international collaboration and decreasing inequalities. Mol Oncol 2019; 13:648-652. [PMID: 30677237 PMCID: PMC6396351 DOI: 10.1002/1878-0261.12460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/22/2019] [Indexed: 11/10/2022] Open
Abstract
Educational initiatives in cancer research have to align with the needs of patients, individuals at risk, healthcare systems and public health organisations. The above interests demand strong translational interactions between basic research, clinical/prevention research and entrepreneurship. The resulting synergy between these three entities is expected to stimulate identification of unresolved issues in cancer biology, as well as unmet needs in diagnostics, treatment and prevention. It will also encourage the development of international research collaborations and, in turn, improve access to innovative research infrastructures. Education and dissemination of knowledge and technologies must be a cornerstone of any future European mission-oriented approach to cancer, as it will ensure that new cancer treatments reach all patients within the European Union, and also help reduce gross inequalities in cancer incidence and mortality. A large number of educational institutions ranging from local universities to pan-European organisations have developed excellent educational activities. However, a cancer mission will highlight additional roles for higher education that will complement and provide novel approaches. Educational and training activities should target the general public (dissemination) for primary cancer prevention, as well as the next generation of cancer researchers in basic and clinical research all over Europe. The experiences of patients are also needed to improve health-related quality-of-life and outcomes research. A mission approach to cancer would enhance the exchange of researchers within Europe and worldwide, and prioritise collaborations between Western/Central and Eastern Europe countries. The Comprehensive Cancer Centres (CCCs) will be crucial to train scientific staff in established centres as well as in candidate centres aspiring to join networks of CCCs. In addition, CCCs will have an important role to play by offering educational programmes for the next generation of clinical/research leaders.
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Affiliation(s)
- Ingemar Ernberg
- Department of Microbiology, Tumor Biology and Cell BiologyKarolinska InstitutetStockholmSweden
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15
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Celis JE, Heitor M. Towards a mission-oriented approach to cancer in Europe: an unmet need in cancer research policy. Mol Oncol 2019; 13:502-510. [PMID: 30657635 PMCID: PMC6396358 DOI: 10.1002/1878-0261.12452] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/15/2019] [Indexed: 11/13/2022] Open
Abstract
Today, cancer is a significant challenge for society, healthcare systems and the growing number of affected patients and their families. This article argues that new paradigms and conditions for responsible science and innovation policy across the European Union (EU) require (i) the collective action of Research & Development institutions, (ii) a system approach to health systems, higher education and patient organizations, and (iii) new initiatives to encourage international cooperation across an enlarged Europe; no single country can successfully fight the disease(s) on its own. Recently, a cancer mission was proposed (Celis and Pavalski, ), the origins of which are rooted in the continuous efforts of the research community, cancer patient organizations, member states and the European Commission during nearly two decades to address the fragmentation and lack of coordination of European cancer research; these efforts led to the creation of Cancer Core Europe and Cancer Prevention Europe, consortia aimed at linking therapeutic and prevention geometries. Ultimately, the platform/infrastructure will be composed of networks of Comprehensive Cancer Centres and cancer research centres across Europe to reach the critical mass of expertise, patients and collaborative portfolio of projects that are necessary to promote science-driven and social innovations in the era of personalized (precision) cancer medicine. Employing a mission-oriented approach to achieve the goal of ensuring a long life expectancy for three out of four cancer patients by 2030 is likely to have a particularly positive impact on the way European citizens' value science and knowledge. It will change the lives of many families across Europe and beyond and should be oriented to ensure that Europe is at the forefront when it comes to quality of life. It is our collective responsibility to ensure that not a single person or region in Europe is left behind.
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Affiliation(s)
- Julio E. Celis
- European Academy of Cancer SciencesDanish Cancer Society Research CentreCopenhagenDenmark
| | - Manuel Heitor
- Minister for Science, Technology and Higher EducationPortugal
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