What do Breast Cancer (BC) and papillary Renal Cell Carcinoma type 1(pRCC1) have in common?
Not much! The first is very frequent and the second very rare, but both are on the research agenda of the European Organisation for Research and Treatment of Cancer (EORTC) in its longstanding efforts to bring precision medicine to patients by prioritizing patient-centric research regardless of the incidence of tumors. EORTC’s innovative programs tackle complex studies and bring therapeutic progress to patients with frequent and rare tumors at the annual meeting of the American Association for Cancer Research (AACR) in New Orleans earlier this week. Competence and expertise to foster knowledge and therapeutic improvement must be customized to the tumor types when organizing clinical research on a frequent and on a very rare tumor. By making these two announcements simultaneously at the AACR’s annual meeting, EORTC confirms its ability to deliver relevant research results in a rapidly changing environment, which has been its mission over the last 53 years. Its long history paved by many therapeutic breakthroughs continues.
To this day, EORTC remains a unique international, multidisciplinary clinical and translational research organization studying the full range of tumor types.
The pRCC1 study is a cohort embedded in a new form of clinical trials referred to as “basket trials” that addresses a new agent to six independent rare tumor types (the CREATE study coordinated by Professor Patrick Schöffski (Belgium). The BC study (MINDACT coordinated by Professors Martine Piccart, Belgium; Fatima Cardoso, Portugal and Emiel Rutgers, The Netherlands ) is a large intergroup phase III study performed under the umbrella of the Breast International Group (BIG). Both studies, sponsored and conducted by EORTC, capitalize on technologies and translation research. The former focuses on patients with specific molecular alterations and positions a new drug, crizotinib, as a therapeutic option for pRCC1. The second confirms the hypothesis that, among patients with early-stage breast cancer who were considered at high risk for disease recurrence based on clinical and biological criteria, genetic testing can identify a large group of patients for whom five-year distant metastasis–free survival is equally good whether or not they received adjuvant chemotherapy which means that genetic testing resulted in reducing the chemotherapy prescription in these patients without impacting the their outcome. Equally important as shown by both studies, is that precision medicine can bring new treatment options to patients but also spare them unnecessary and toxic treatments.
The MINDACT study included 6,693 breast cancer patients from 112 clinical centers in nine countries through the Breast International Group umbrella, and the CREATE pRCC1 cohort included 41 patients from 13 sites in eight countries. Clearly, planning , organizing and running complex precision medicine studies on such different disease types requires perfect knowledge of the field, excellent coordination abilities (not only for regulatory and ethical requirements but above all for the implementation of solid clinical research methodologies) and robust quality assurance programs. An expertise such as this, that embraces the full capacities of new technologies and precision medicine, can only be found in an inclusive clinical research infrastructure that conducts patient-centric research.
Dr Vassilis Golfinopoulos, Medical Director at the EORTC emphasizes that “These achievements highlight the role of academic groups that are best placed to address specific therapeutic questions. The contribution of the academic sector in positioning new treatments as well as optimizing existing therapeutic strategies should be valued and facilitated by all stakeholders in the field.”
Dr Denis Lacombe, EORTC Director General, points out: “It has been our wish to build a forward-looking clinical research infrastructure to continue bringing therapeutic progress in a rapidly evolving environment. Having made these studies feasible, we are proud that we helped the whole community of researchers, doctors and patients to benefit from such therapeutic results”. However, he warns that “there is a need to better support such infrastructures” and calls “for avoiding useless duplication of clinical research infrastructures”. Finally he points out that “the learnings from such studies and others have encouraged the EORTC to propose a new European vision for a profound transformation of clinical research” and hopes that “the plea will not remain unheard”.
The European Organisation for the Research and Treatment of Cancer (EORTC) brings together European cancer clinical research experts from all disciplines for trans-national collaboration.
Both multinational and multidisciplinary, the EORTC Network comprises more than 4,500 collaborators from all disciplines involved in cancer treatment and research in more than 600 hospitals in over 30 countries.
Through translational and clinical research, the EORTC offers an integrated approach to drug development, drug evaluation programs and medical practices.
EORTC Headquarters, a unique pan European clinical research infrastructure, is based in Brussels, Belgium, from where its various activities are coordinated and run.