Can we beat cancer? Europe’s Beating Cancer Plan moves forward

The only constant in public affairs is change and in cancer, it is no different: Policy formation everywhere and on every issue has to take account of this reality, or it will fail to deliver the best answers. And in beating cancer, of literally vital interest to European citizens, the best answers need to be sought right now if the future is to live up to expectations. The EU Beating Cancer Plan is tackling this issue holistically by optimizing a changing context for the benefit of patients and health-care systems in Europe, writes European Alliance for Personalised Medicine (EAPM) Executive Director Dr. Denis Horgan. 

It is easy to demonstrate that change is a constant as in health and with COVID 19 now.  But can Europe itself shift its dimensions and its character as it has for millennia – now much faster than ever, and often for the better to tackle the potential in science, the willingness of the healthcare community including industry with the support of patients, to curb the epidemic of cancer.  

The potential is great for cancer patients and citizens. The benefits from advanced approaches to healthcare, such as personalised medicine as set out in the plan, will increase as the approach moves from single-test to multitarget profiling of the population, and ultimately to whole genome sequencing. 

A more efficient allocation of health-care resources can be achieved through sharper focus on prevention and prediction of disease, as well as through improving disease management, and the avoidance or delay in more expensive care costs. An effective strategy allows a forward-looking perspective on the value of genomics to the healthcare system. It supports the testing infrastructure towards the development of whole genome sequencing, with benefits to a wide range of conditions, and particularly rare diseases. 

But it requires policy decisions. Realising the potential requires a readiness to take a fresh look at challenges – and to run a fresh search for solutions. So for personalised medicine to get off the ground, for instance, it will be essential to move away from ‘trial-and-error’ prescribing and embrace the more considered initial prescription of optimal therapies. And for benefits of this sort to be delivered, the environment has to keep up with innovation. 

With  its  policy  objectives,  supported  by ten  flagship  initiatives and multiple  supporting actions,  the  Cancer  Plan  aspires to  help  member  states  turn  the  tide  against  cancer.  

Key flagships will be launched, such as the new ‘Cancer Diagnostic and Treatment for All’ initiative, to be launched by end of 2021, which will help improve access to innovative cancer diagnosis and treatments. It will use the ‘next generation sequencing’ technology for quick and efficient genetic profiles of tumour cells, allowing Cancer Centres to share cancer profiles and applying the same or similar diagnostic and therapeutic approaches to patients with comparable cancer profiles. The initiative will ultimately help optimise cancer diagnosis and treatment and reduce unequal access to personalised medicine in cancer care, greatly benefiting patients.   

These are key issues that we worked with our members such as the European Society of Medical Oncology as well as the broader agenda to put on the political agenda. Various academic publications supported this policy. 

On imaging, it was announced that the European Cancer Imaging Initiative will be set up in 2022 to develop an EU ‘atlas’ of cancer-related images, making anonymised images accessible to a wide range of stakeholders across the ecosystem of hospitals, researchers and innovators. 

This was the key issue that we have worked with the European Society of Radiology over the years to bring he attention to this unmet for more coordination at the EU level. 

Lest we forget registries, in 2021, the Commission will establish a Cancer Inequalities Registry. It will identify trends, disparities and inequalities between member states and regions. Alongside regular qualitative assessments of the country-specific situation, the Registry will identify challenges and specific areas of action to guide investment and interventions at EU, national and regional level under Europe’s Beating Cancer Plan.

Of course, partnership will be launched and there will be a new Partnership on Personalised Medicine, due to be set up in 2023 and funded under Horizon Europe, will identify priorities for research and education in personalised medicine, support research projects on cancer prevention, diagnosis and treatment, and make recommendations for the roll-out of personalised medicine approaches in daily medical practice. 

As a preparatory action to the Partnership, the Commission will establish a roadmap to personalised prevention, identifying gaps in research and innovation, and will support an approach to map all known biological anomalies leading to cancer susceptibility, including hereditary cancers. 

This is a critical area that we have put on the political agenda since 2011 and engaged at the country level to make this a reality. 

Building on this, the Commission will launch, the ‘Genomic for Public Health’ project. The project will complement the 1+ Million Genomes Initiative, which has cancer among its main use cases, and is expected to give secure access to large amounts of genomic data for research, prevention and personalised medicine purposes. Actions under the project, funded by the EU4Health programme, will also target the identification of genetic predisposition of individuals to develop cancers, opening new perspectives to personalised risk-assessment and targeted cancer prevention. 

On disease specific issues such Lung Cancer: The Commission will make a proposal by 2022 to update the Council Recommendation on cancer screening to ensure it reflects the latest available scientific evidence. Extending targeted cancer screening beyond breast, colorectal and cervical cancer to include additional cancers, such as prostate and lung.

With the European Respiratory Society as well as with Lung Cancer patients, we have been advocating for this since 2015 with an EU Presidency conference supported by the Maltese Presidency of the EU. 

Moving ahead in such circumstances will depend on the readiness of Europe's politicians and policymakers and prescribing physicians to open up to new ideas, to acknowledge that their way may no longer be the only way, and to contemplate a degree of voluntary collaboration that has until now been largely embryonic.

 On the basis of the debate so far, with only limited progress towards cooperation even on health technology assessment, national sovereignty continues to reign supreme in many member states. Common work does already take place in a limited fashion in some areas and there are some enlightened spirits who are showing a more imaginative approach to the questions that have arisen. But overall it is proving difficult to establish the balance in which the merits of cooperation are seen to weigh as much as the desire for national autonomy.  

The EU Beating Cancer Plan has the potential to allow us to move ahead.   

The prize of adaptability will be better care. But it is a prize that will be won only if national authorities and traditional professionals are prepared to play. If they are not, they will not only lose the prize. They will condemn Europe's cancer patients and citizens to a declining share of innovation and the benefits that go with it in terms of economic prosperity and quality of life. 

The choice is available now. But it will not remain available indefinitely. Europe is living in a changing world, and if it does not choose to change, the world will change around it. 

The aim of Europe’s Beating Cancer Plan is to tackle the entire disease pathway structured around four key action areas where the EU can add the most value: (1) prevention; (2) early  detection;  (3)  diagnosis  and treatment;  and  (4)  quality  of  life  of  cancer  patients  and survivors. 

However, the key will be translating the aims into actions. 

EAPM and its members will be there to support the Commission and members through bottom-up policy support. The EU Beating Cancer Plan is available here.

Have the best weekend possible, and keep safe.