By Mary Rice, EORTC Communication Consultant
‘Strengthening Europe in the fight against cancer’, a report requested by the European Parliament’s Committee on the Environment, Public Health, and Food Safety provides an important overview of the current state of play. Produced by the Policy Department for Economic, Scientific, and Quality of Life Policies and authored by Norbert Couespel and Richard Price, from the European Cancer Organisation, together with contributors from many bodies involved in cancer at European level, it tackles many difficult issues and provides recommendations for improvement.
EORTC Director General Denis Lacombe, who contributed to the section on research, said: «I welcome this report, which underlines the importance of treatment optimisation and calls for the continued development of the regulatory structure in order to expand access to effective therapies to all of those they will benefit.»
The report calls for an EU Cancer Mission, accompanied by a long-term vision for cancer research in Europe. This should include addressing how the EU can accelerate the translation of cancer research into real-life practice improvement; how to tackle research disparity across Europe; and how the power of stronger data collaboration across Europe can enhance and accelerate cancer research.
Specific recommendations on clinical research include broadening the landscape for research in Europe by identifying and exploiting opportunities to rebalance clinical cancer research activities towards the full spectrum of cancer control, including all treatment modalities, and providing much-needed support to academic, independent cancer clinical research activities.
The authors call for treatment optimisation to ensure optimal administration of personalised medicine therapies, and the avoidance of unnecessary toxicity and negative impacts on healthcare budgets. « The creation and implementation of a new EU Pharmaceutical Strategy should be utilised as a crucial opportunity for securing a new era for treatment optimisation in cancer care in the decades ahead, » they say.
EU research programmes should also keep in mind the importance of funding for non-systemic treatments trials. Sustained public funding for research in areas such as surgery, radiation therapy, and interventional oncology is needed, the report says.
Patient-reported outcomes is another area where the current regulatory landscape can help rather than hinder, says Denis Lacombe. «It is vitally important to include these in all cancer research studies, not to just to ensure that the issues that really matter to patients, such as quality of life, are part of treatment decision-making, but also to help ensure that limited research resources are not wasted. EORTC is pleased to see the report call for a greater use of patient-reported outcome measures in clinical research.”
Finally, the clinical research chapter of the report discusses cross-border access to clinical trials citing a report in which EORTC was involved and which found a number of barriers that hinder patients from accessing innovative treatment across borders1. Further efforts are needed at European and national levels to reduce these barriers, say the authors. “In the absence of EU legislation or guidelines to facilitate patients’ participation in trials in locations outside their particular country, patients who travel to another country for clinical trials face issues such as the lack of clarity on protocols for follow-up after their return home, and how national insurance covers costs associated with their participation in the trial. These obstacles could be addressed through a possible revision of the EU Directive on patients’ rights in cross-border healthcare.”
“This is a very important issue’” says Denis Lacombe. “We know, for example, that the organisation of European trials for non-systemic treatment options such as surgery carry specific challenges and that this affects recruitment. EORTC strongly supports the report’s call for a review of the Cross-Border Healthcare Directive in order to give European citizens a better opportunity to participate in clinical trials across borders. This does not mean, of course, that we should not make every effort to bring clinical trials to European citizens wherever they are, rather than imposing an additional burden of traveling.”
The report, which focuses on four main areas: causation of cancer; cancer screening and early diagnosis; access to cancer treatment, care and research; and rare and childhood cancers, is available at https://www.europarl.europa.eu/RegData/etudes/STUD/2020/642388/IPOL_STU(2020)642388_EN.pdf
1Cross-Border Access to Clinical Trials in the EU: Exploratory Study on Needs and Reality. Lalova, T., Padeanu, C., Negrouk, A., Lacombe, D., Geissler, J., Klingmann, I., Huys, I. with Klingmann, I. (joint last author), Huys, I. (joint last author) (2020). Frontiers In Medicine, 7. doi: 10.3389/fmed.2020.585722 https://www.frontiersin.org/articles/10.3389/fmed.2020.585722/full