#EAPM: All pull together to halt the march of cancer

According to the World Health Organization, new cases of cancer globally are expected to increase by 70% over the next 20 years, from around 14 million to 25 million, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

Readers will probably not be surprised to hear that, within the EU, lung cancer is the biggest killer of all cancers, responsible for almost 270,000 annual deaths. That’s huge by any standards and is only one form of cancer.  So, although we’ve come a long way since then-US President Richard Nixon signed the National Cancer Act in 1971, thus launching the so-called war on cancer, the task remains immense.

Over here in the European Union there have been many initiatives down the years, including National Cancer Plans in many member states, the European Partnership for Action Against Cancer, CANCON and Brussels-led legislation on clinical trials and data sharing.  Unfortunately, given that all 28 member states have competency for their own healthcare systems, there is a lack of a common strategy in Europe to fight this terrible disease that comes in so many forms.

There is certainly much good will out there, but without a tangible, achievable, linked-up plan involving co-ordination, collaboration and solid action then we will get nowhere fast.  The population is ageing and co-morbidity is on the rise. As noted, cancer will skyrocket over the coming decades and tackling it often seems to resemble the task of Sisyphus - the king of Ephyra from Greek mythology doomed to forever roll an immense boulder up a hill, only to watch it come back down again, as he repeats the action for eternity.

The phrase ‘Sisyphean task’ has come to mean either ‘laborious’ or ‘futile’, but the Brussels-based European Alliance for Personalised Medicine (EAPM) would reject the latter modern-day description. Arduous the task may be, but it is not futile if stakeholders choose to act in unison.

But to do this, one could argue that the EU needs a ‘big idea’ - a way of pulling together all the separate elements to save lives. Improved data sharing is one example - there is not enough of it due to various reasons, whether it be silo thinking, interoperability of systems or even short-sighted lawmaking that blocks the exchange of information vital for researchers, healthcare professionals and pharmaceutical companies.  As mentioned above, many individual EU countries are striving to do their bit separately through National Cancer Plans, or NCPs.

Yet given the process of modern medicine, it is unfortunate to say the least that few of these NCPs incorporate personalised medicine. This is primarily because the breakthrough new sciences (genetics, for example) were in their infancy when most NCPs were established.

Member states may need support in developing their own cancer plans to incorporate biomarker testing as an essential and standard part of best clinical practice.  Generally speaking, depending on the type and stage of the cancer, patients may be treated with surgery, radiation therapy, chemotherapy, targeted therapy and/or palliative therapies. Some may receive more than one or a combination of these treatments.

So, of course, the financial burden of cancer remains huge (and is growing) and there is still a clear need for new therapies and the identification of novel therapeutic targets in an attempt to improve standards and treatments.  Also, with the various treatments available, patients need to know and understand their options in order to be involved in the decisions that will affect themselves and their families.

In all cases, doctors need to be aware of developments through up-to-the-minute training and improvements in communication skills. Personalised medicine holds great promise for many forms of cancer, but is still in the early stages of aiming to tackle the rarer diseases. It is believed that the results of molecular profiling may help to determine the best treatment options, including appropriate clinical trials. These trials are often an excellent option but awareness needs to be raised among patients and front-line clinicians.

Put simply, to address these issues and lower the immense burden on society, it is necessary to develop comprehensive cancer research communities and provide the tools and resources this community needs in order to make scientific breakthroughs.  This will clearly require increased investment in research through member state and EU public funding programmes, as well as in the private sector, through NGOs, industry and others. Improvements will also require greater collaboration between member states and across the health-care sector, while there also needs to be an agreed approach to tackling it through NCPs.

Vitally, all collaborations should include patients, caregivers and patient organisations, who have an indispensable contribution to make. Nixon’s 1971 initiative was a breakthrough moment at the time. But that was more than 45 years ago. The battle against this range of killer diseases, whether lung, prostate, breast, brain or the rarer cancers needs to take a new turn.  Today, EAPM and its members and stakeholders strive to bring together experts from all groups in healthcare to examine the way forward. It has already identified that here is clearly a need to raise awareness among policymakers about the needs of modern-day patients and how personalised medicine has the potential to change healthcare for the better.

The Alliance strongly believes that there needs to be concrete actions at the EU and member state levels, to take advantage of new research directions, in part based on the successful outcome of the landmark Human Genome Project, which changed the world of medicine forever.

Such cutting-edge research has seen (and will continue to see) the development of further ground-breaking diagnostics, therapies, preventative measures, and early detection ability.

But all of this will only result in more lives being saved if the nations of Europe can build on their common achievements through working together, and forming an alliance in a modern-day vanguard with the clear aim of halting the march of cancer.

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