The Brussels-based European Alliance for Personalised Medicine (EAPM) has held a key round table at the ESMO Congress in Madrid. The report is available by clicking here, writes EAPM Executive Director Denis Horgan.

The high-level discussions under the banner ‘EAPM seeks innovative solutions at ESMO for cancer patients’ held virtually in the Spanish capital, represented the eight such roundtables conducted by the Alliance at the Congress.   This type of interaction is one key aspect of EAPM’s stated goals - to engage with the medical community whenever possible, and at every level.

The round table comes at a crucial time as Europe deploys new efforts to bring innovation into healthcare systems and to establish strategic co-operation. EAPM is actively engaged in discussions with stakeholders and with policymakers on the emerging Beating Cancer Plan and the CancerMission, the promised EU health Data Space, the review of research incentives in its orphan drug rules, the overarching Pharmaceutical Strategy scheduled to appear before the end of 2020, and the new determination– announced in mid-September - to go beyond the draft EU4 Health programme and create a genuine European Health Union.

Attendees at the round table included patients, European Parliament politicians, European Medicine Agency, public health experts, economists, industry representatives from ICT and pharma-ceutical companies, and other specialists from across multiple disciplines.

EDUCATION: EAPM’s multi-stakeholder, high-diversity meeting took into account the fact that new discoveries - generated from a deeper understanding of the human genome.  This shift is rapidly progressing in oncology but is slower in other areas. And, while there are many barriers to innova-tion in clinical practice - including market access, scientific, and/or regulatory challenges - the big-gest challenge across the healthcare system is continuing medical education for healthcare professionals. The report is available by clicking here. 

MOLECULAR DIAGNOSTICS, INCENTIVES AND MORE:  Topics discussed in depth were incentives and molecular diagnostics which were underpinned by our recent academic publication entitled: Bringing Greater Accuracy to Europe’s Health -care Systems: The Unexploited Potential of Biomarker Testing in Oncology, is already winning plaudits, and it can be read here.   This took into account the ongoing developments in the field of personalised medicine, such as DNA profiling, concepts of ‘va-lue’ and biomarkers and, because of the diversity of the disciplines of the delegates attending, the meeting constituted a bridge between new developments and those that will implement them, as well as the patients who will eventually benefit.

A CHANGING SOCIETY, WITH CHANGING NEEDS: As we all know, a key difference between personalised medicine and conventional methods of treating patients is the setting aside of a ‘one-size-fits-all’ philosophy in favour of a much more targeted process.   A major reason for this is the fact that patients respond differently to the same medicine being used to treat the ‘same’ disease.

Cancer patients overall have a non-response rate of a massive 75 percent. This is for a disease that is the biggest healthcare cost burden of all, as well as being the biggest killer.  Meanwhile, sickness and disability costs form a large portion of GDP and government social spending while overall healthcare costs are rising all the time with Europe’s ageing population. Indeed, the average lifespan has increased by around 25 years in the space of a century.  Better adoption of molecular Diagnostic and early diagnosis can ensure a better rational allocation of resources in society to tackle this societal burden.

INNOVATION IS KEY: Tumour Agnostics and RWE

A major pillar in bringing new, targeted medicines to patients is, of course, innovation. This, in the realm of health, means the translation of knowledge and insight into what we can call ‘value’. And that value covers the value to patients but also has to take into account value to healthcare systems, society and, of course, the manufacturers. 

In the context of tumour agnostics, fittingly described by many speakers as a paradigm shift in cancer care,  tumour agnostic therapies present a new promise of precision medicine – and accordingly, as was frequently argued during the discussion, they require a new way of thinking about cancer care. They offer new opportunities for patients with rare mutations, and the pipeline of potential tumour agnostic therapies/ indications is growing rapidly.  

For the RWE evidence session, the discussion made clear that the simplicity of the concept of using RWE in healthcare belies the many complexities underlying its exploitation. Harnessing health data from many sources in real time should help faster and better medical decision-making. But it will not happen automatically, as the roundtable made clear

For each of the three round tables, the report includes recommendations.  Here is that link to the report again by clicking here. 

After more than seven years of steady rule, Shinzo Abe’s (pictured) resignation as Japan’s prime minister has once again put the country’s foreign policy into the world’s spotlight. With the Liberal Democratic Party (LDP) racing for the selection of new party leader and later on, the nation’s prime minister, several possible candidates have come to the fore. Apart from the ambitious Shigeru Ishiba who attempted to challenge Abe for the party’s leadership in the past, others such as Yoshihide Suga (current Cabinet Secretary) and Fumio Kishida, are expected to stand as contenders for the top post within the LDP as well as the government.

First, the perception of China within the Japanese public and LDP, has been at a low level even before the COVID-19 pandemic struck Japan. According to Pew Research Center’s Global Attitudes survey in late 2019, as much as 85% of Japanese public viewed China negatively ⸺ a figure that put Japan as the country which had the most negative view of China among the 32 countries polled that year. More importantly, such survey was conducted months before the three events: the spread of COVID-19 pandemic, the passing of the Hong Kong security law and the continuing dispute of the Senkaku (or Diaoyu) Islands. With all these three issues involving China converging at the same time, it will be challenging to expect the Japanese public will have a more positive view of Beijing this year.

The US-China rivalry today has also entered uncharted waters in which military conflict is no longer a distant dream for many. Given its vested relationships with both US and China, such challenge remains to be the most difficult for Abe’s successor to grapple with. On one hand, Tokyo has to safeguard its close trade ties with China while on the other, the former has to depend on its security alliance with the US to safeguard both national and regional security against hypothetical threats (including China). As reported by Kyodo News in last July, Suga himself was aware of such dilemma as a middle power and even recognised that the balance of power strategy might not be suitable anymore given the current freefall relationship between Washington and Beijing. Instead, Suga alerted of the possibility in siding with one of the two powers as the eventual option for Japan in the near future. While he did not mention which country to side in case such scenario becomes a reality, political observers should not be too conclusive in that he will choose China as opposed to the US if he becomes the new Japanese prime minister.

Last, Abe’s successor inherits his legacy of Japan as a proactive leader in the Southeast Asia region. As a person without much experience in foreign policy, it is challenging for Suga (more than Kishida and Ishiba) to preserve Japan’s leadership status in Asia without heavy reliance on the foreign policy establishment. That said, the current Abe administration’s policy of encouraging its manufacturers to shift production from China into either Japan’s own shores or Southeast Asian countries, will likely to be continued in consideration of the urgency compounded by the COVID-19 pandemic and the freefalling US-China relations.

With Japan’s collective pursuit with the US, India and Australia for the Free and Open Indo-Pacific (FOIP) vision as a security counter against Beijing in Southeast Asia, on top of Tokyo’s national economic interest to reduce its overdependence on China, the country fits well into the sort of external power needed by the ASEAN member states.

ANBOUND Research Center (Malaysia) is an independent think tank situated in Kuala Lumpur, registered (1006190-U) with laws and regulations of Malaysia. The think tank also provides advisory service related to regional economic development and policy solution. For any feedback, please contact: [email protected].  

The opinions expressed in the above article are those of the author alone, and do not reflect any opinions on the part of EU Reporter.