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Europe’s Beating #Cancer Plan

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Europe’s Beating Cancer Plan will form a core part of Health Commissioner Stella Kyriakiades’ term in office. A pan-European strategy to combat cancer is long overdue and we welcome Commissioner Kyriakiades’ initiative in tackling what is the second leading cause of death in Europe, write Dr Delon Human and Dr Anders Milton.

On 10 September, the Commission held a town hall on the Beating Cancer Plan. Unfortunately, this town hall did not fill us with hope - it seems that the Commission may be about to miss out on the chance of a lifetime and fail to sufficiently tackle preventable cancers in Europe.

Not only did the town hall fail to pay heed to the most obvious preventable cause of cancer in smoking, it seemed to disregard the opinion of EU citizens. Of the submissions to the Plan’s public consultation, nearly 20% supported the adoption of harm reduction plans for alcohol and tobacco. One in every six recommended policies which encourage the use of reduced risk nicotine products by smokers, such as e-cigarettes.

As stated at the launch of the consultation by the Commission, 3.5 million people in the EU are diagnosed with cancer annually, and 1.3 million die from it, yet over 40% of cancer cases are preventable.

The WHO estimates that one in every two smokers will develop a tobacco-related disease with 700,000 Europeans dying from smoking every year. 90% of lung cancers alone can be prevented by eliminating tobacco use in Europe.

What is often forgotten, however, is that smokers consume cigarettes for nicotine but get cancer from the tobacco, tar and thousands of other additives in cigarettes. Nicotine itself is not a carcinogen. This raises the question; what if there was a way to offer smokers the nicotine they desire while removing carcinogens?

Tobacco harm reduction presents the clear and obvious answer to this question. The use of alternative, potentially reduced risk products, like e-cigarettes, could eliminate smoking induced cancer in Europe within a generation.

A study of the results of the 2014 Eurobarometer survey by several European academics emphasised this point. The study found that the vast majority of EU citizens consuming e-cigarettes on a regular basis were former smokers or smokers attempting to quit.

Countries like Sweden have shown a way forward for Europe to reduce tobacco-induced cancers through the adoption of science-based approaches to reduce smoking prevalence and smoking-related deaths. Sweden offers tobacco alternatives like snus and this has helped them to achieve the lowest tobacco-related mortality rate of all EU countries relative to its population size.

In an attempt to mitigate the devastating effects of the pandemic, which has so far taken the lives of almost 200,000 Europeans, EU institutions and member state governments immediately turned to science and evidence to inform policy. Lockdowns, social distancing and working from home have all become normalised as part of the effort to overcome COVID-19.

This sense of pragmatism and efficiency must be mirrored by the Commission’s Beating Cancer Plan.

Harm reduction policy, particularly tobacco harm reduction, has extraordinary potential to reduce avoidable smoking induced cancers. It can save the lives of countless Europeans. We are calling on the Commission to recognize this potential, to hear the voices of European citizens, and leave no stone unturned in the fight to beat cancer.

Delon Human M.B.Ch.B., M.Prax.Med, MFGP, DCH, MBA is a French citizen and physician qualified in family medicine and child health, with an MBA from the Edinburgh Business School. He has acted as adviser to WHO Director-Generals and UN Secretary-General Ban Ki Moon. Formerly, he was secretary-general of the World Medical Association (WMA), the global representative body for physicians and thereafter Secretary General of the International Food and Beverage Alliance (IFBA).
Anders Milton B.Sc., M.D., Ph.D. is the president of ERNA, a member of the government appointed Catastrophe Commission and a consultant within the health care sector. He has previously been both CEO and secretary general of the Swedish Medical Association, chairman of the Council of the World Medical Association, chairman of the Swedish Red Cross and chairman of the Swedish Confederation of Professional Associations (SACO), as well as government appointed co-ordinator of psychiatric services in Sweden.

Cancer

#EuropeanParliament lit up in gold to support children fighting cancer

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Parliament's building in Brussels is lit up in gold to raise awareness about childhood cancer 

Parliament has joined the global Gold September campaign to raise awareness about childhood cancer by lighting up its Brussels building in gold on 1-6 September. Every year, more than 35,000  children are diagnosed with cancer in Europe. Although the average survival rate at five years is 80%, there are significant differences between European countries due to unequal access to the best care and expertise.

Leukaemia appears to be the most frequent and most lethal cancer in children, accounting for more than 30% of new cases and deaths per year.

Fighting cancer is a priority for the EU. In June, the European Parliament set up a special committee to look at how the EU can take concrete measures to help beat cancer.

The special committee on beating cancer will evaluate:
  • The possibility of improving quality of life for patients and families;
  • scientific knowledge on prevention and specific action on tobacco, obesity, alcohol, pollution etc;
  • how to support research into prevention, diagnosis and treatment of childhood and rare cancers, where an EU approach offers the best chance of success;
  • early detection and screening programmes;
  • how to support non-profit clinical trials, and;
  • possible EU action to facilitate the transparency of treatment prices to improve affordability and access.

Polish EPP member Ewa Kopacz, who is the Parliament coordinator on children's rights, said: "While we should strive for the prevention of paediatric cancer, we must also work to ensure that all children facing a cancer diagnosis have equal access to treatment and proper care throughout their treatment and recovery."

The Parliament Vice-President, who is a former paediatrician and health minister, added: "By lightning the European Parliament in gold we send a strong signal of solidarity and support to children and adolescents fighting cancer, their families, childhood cancer survivors and professionals serving them. "

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Antitrust: Commission seeks feedback on commitments offered by #Aspen to reduce prices for six off-patent cancer medicines by 73% to address Commission's concerns over excessive pricing

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The European Commission invites comments from all interested parties on commitments offered by Aspen to address the Commission's concerns over excessive pricing. Aspen proposes to reduce its prices in Europe for six critical cancer medicines by 73% on average. In addition, Aspen proposes to ensure the continued supply of these off-patent medicines for a significant period. Following a formal investigation opened on 15 May 2017, the Commission has serious concerns that Aspen has been abusing its dominant position in numerous national markets by charging excessive prices for critical off-patent cancer medicines. Aspen's practices concern a number of cancer medicines mainly used in the treatment of leukaemia and other haematological cancers. Aspen's behaviour may be in breach of the EU's antitrust rules.

The Commission invites all interested parties to submit their views on Aspen's proposed commitments within two months from their publication in the Official Journal. Taking into account all comments received, the Commission will then take a final view as to whether the commitments sufficiently address competition concerns. If this is the case, the Commission may adopt a decision making the proposed commitments legally binding on Aspen under Article 9 of the EU's antitrust Regulation (Council Regulation 1/2003).

Executive Vice President Margrethe Vestager, in charge of competition policy, said: “Pharmaceutical companies often bring innovative medicines to the market and they should be rewarded for that. However, they sometimes also use their dominant position to increase prices of old but critical medicines by several hundred percent without any real justification. The Commission has concerns that Aspen's conduct in this case amounts to excessive pricing by a dominant firm, which is prohibited by EU competition rules. To remove these concerns Aspen proposes to radically reduce its prices and to guarantee the supply of six critical cancer medicines. We now reach out to the stakeholders to hear their views on whether the commitments adequately address our concerns and benefit patients and health budgets across Europe.”

The full press release and Questions and Answers are available online.

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Cancer

Europe’s Beating Cancer Plan - #EITHealth shares five reasons to be optimistic about current cancer innovation

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With the launch of the EU-wide public consultation on Europe’s Beating Cancer Plan on 4 February 2020, European Commission President, Ursula von der Leyen, said that an estimated 40% of all cancers could be prevented if we put into practice what we have learnt from decades’ worth of research, data and innovation in the disease area.

Health Commissioner Stella Kyriakides, speaking at the same event, highlighted that the Beating Cancer Plan must tackle every key stage of the disease – from prevention and diagnosis, treatment, life as a survivor, to palliative care, as well as research and innovation. One of the ways that scientists and medical clinicians are collaborating in the fight against cancer is in setting up a Common Health Data Space. This key infrastructure will be where both can store clinical and research data, and access research contributed by other scientists.

This pooling of resources across Europe using big data is a primary focus of EIT Health, whose EU-backed mission is to enable European citizens to lead longer, healthier lives. As a result, it actively develops patient-centered innovations that aim to improve the prevention, detection and treatment of cancer. Through connecting leading organisations from the worlds of business, research, education and healthcare delivery, and providing funding and support to the most promising, cutting-edge solutions, EIT Health plays a vital role in bringing innovations in cancer to the patients who need them.

These innovations range from a blood-based prostate cancer test that predicts the risk for aggressive prostate cancer to a potential new novel cancer treatment that selectively targets a protein shared only by cancer cells, therefore avoiding any effect on healthy tissue. Stella Kyriakides added that at the heart of the plan must be a focus on innovations that are accessible - stressing that “innovation is pointless unless it’s available to patients”. EIT Health is committed to helping life-changing ideas overcome barriers to get to market and become accessible to patients.

They also believe it is critical that it is critical that innovation is patient-centered and that patients are involved in the process. EIT Health CEO Jan-Philipp Beck comments: “Patient-centered innovation is key to the development of ground-breaking solutions to arm us in the fight against cancer. We believe that by joining efforts across Europe and working in collaboration across borders we can reach a point where we can reduce the impact of cancer on patients and health-care systems alike through earlier and more accurate diagnosis, faster and more effective treatment and better support for those living with cancer.”

They also believe it is critical that it is critical that innovation is patient-centered and that patients are involved in the process. EIT Health CEO Jan-Philipp Beck comments: “Patient-centered innovation is key to the development of ground-breaking solutions to arm us in the fight against cancer. We believe that by joining efforts across Europe and working in collaboration across borders we can reach a point where we can reduce the impact of cancer on patients and health-care systems alike through earlier and more accurate diagnosis, faster and more effective treatment and better support for those living with cancer.”

To mark the launch of EU’s Beating Cancer plan, EIT Health shares five reasons to be optimistic about the outcomes of collaboration in cancer innovation:

  1. Artificial Intelligence is transforming diagnosis

There have been significant advances in the use of AI to diagnose and grade cancers, which has the potential to improve detection and treatment of the disease. EIT Health project, OncoWatch, an AI system, has been proven to be equivalent to experts in prostate cancer diagnosis. In a study published in The Lancet Oncology, it was comparable with international, leading uropathologists in determining the Gleason score, the most important prognostic marker for prostate cancer.

OncoWatch therefore has the potential to significantly reduce the workload of uropathologists, allowing them to focus on the most difficult cases and at the same time acting as a safety net to improve the standardisation of diagnoses. It also has the potential to speed up prostate cancer diagnostics and reduce the costs for health-care services. A first CE-marked product of OncoWatch is expected to launch in Europe by the end of the year.

  1. A promising new cancer therapy is starting human clinical trials

EIT Health supported start-up, Peptomyc is leading globally renowned research into an innovative new therapy which has the potential to transform cancer treatment for patients with many different types of cancer. Their research into inhibiting a protein called Myc, which plays an important role in cancer cells’ survival and proliferation, showed that not only was it feasible to inhibit it, but in doing so it has a therapeutic impact against cancer without damaging healthy tissue.

Peptomyc is now completing the industrial production of their medicine and is planning to start human clinical trials in patients in 2020. Their research has since paved the way for many more groups around the world who are now developing their own Myc inhibitors.

  1. A new blood test is improving the detection of prostate cancer so that it can be diagnosed earlier 

EIT Health backed project, Stockholm3, is a blood test that analyses five protein markers and over 100 genetic markers, along with clinical data, to accurately predict the risk of aggressive prostate cancer, providing an informative indication about whether a biopsy is needed. It is currently used in clinical practice in Sweden, Norway, Finland and Denmark and is in the process of expanding further across Europe and the rest of the world.

Stockholm3 could potentially replace or complement the current PSA test, which can be unreliable, meaning that aggressive forms of prostate cancer can go undetected, thus missing the opportunity for effective early treatment. ,

Launching Stockholm3 in further markets provides the opportunity to reduce the number of men unnecessarily undergoing biopsy and treatment and identify aggressive cancers earlier, boosting survival rates and reducing healthcare costs.

  1. We are using data to learn more about patient responses to new and emerging immunotherapies

Immunotherapy is a revolutionary approach to cancer treatment that helps your immune system fight cancer, but health professionals still don’t understand why some patients respond to it and others do not.

I4PCM is an EIT Health-backed project that unites several EU cancer care centres in an effort to improve the way they share data and thus improve personalised care. The project launched a central database or “Virtual European Cancer Institute” with collective information from the centres about clinical research and patient responses to these new immunotherapies.

By joining efforts to pool information from their clinical, environmental, genomic, imaging and immune biology databases, the data sharing will help to transform clinicians’ and researchers’ approach to cancer research, thereby allowing a deeper understanding of immunotherapy responses than any single centre could achieve on its own.

  1. New, non-invasive tests are being created for early intervention in the third most common type of cancer 

Colorectal cancer (CRC) is the third most common cancer in men and second most common in women, with 450,000 new patients in Europe annually.  Even after successful tumour treatment, 50% of patients will develop colorectal liver metastases (CRLM), a severe and often fatal condition.

COLO-MET are developing a non-invasive and cost-effective urine test, which, combined with the blood test, can specifically detect CRLM, allowing early intervention of colorectal cancer and earlier treatment.

OncoWatch therefore has the potential to significantly reduce the workload of uropathologists, allowing them to focus on the most difficult cases and at the same time acting as a safety net to improve the standardisation of diagnoses. It also has the potential to speed up prostate cancer diagnostics and reduce the costs for health-care services. A first CE-marked product of OncoWatch is expected to launch in Europe by the end of the year.

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