Following more than two decades of extraordinary developments and advancements in cancer research – from molecular mechanisms to clinical care to new enabling technologies, we are better equipped than ever before to deliver a much more personalised, targeted form of cancer treatment and care. We continue to make tremendous progress in both fine-tuning diagnosis and treatment strategies matched to the unique molecular make-up of an increasing number of patients. In parallel, we are also achieving a deeper understanding of basic cancer biology.
Similarly, the design and development of data rich, dynamic next-generation studies, such as the Cancer Core Europe’s EU Horizon 2020-supported Building Data Rich Clinical Trials Consortium (CCE-DART), promote the optimisation of biomarker-drug co-development. These ‘smarter’ contenders should more effectively identify the optimal treatment for the right patient, at the right time, and overcome certain limitations of traditional randomised designs.
But all is not rosy.
Despite these undeniable achievements, we still have a very long road to travel if we are to more effectively improve outcomes for an increasing number of our patients, everywhere.
The latest GLOBOCAN report (CA Cancer J Clin. 2021 Feb 4), produced by the International Agency for Research on Cancer, estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths globally, with the global cancer burden expected to be 28.4 million cases in 2040, a 47% rise from 2020.
If we look at Europe, although survival rates across several tumor types have improved over the last decades, cancer still claims the lives of over 1.2 million people each year in the EU-27. Concrete actions set out in the Horizon Europe Framework Programme for Research and Innovation’s Cancer Mission aim to address this state of affairs by better understanding cancer, its risk factors and impact; preventing what is preventable; optimiing diagnostics and treatment; and supporting the quality of life of people living with and after cancer, while ensuring equitable access for all (Conquering cancer: Mission possible. Interim report of the Mission Board for Cancer).
Its ambitious 13-point comprehensive plan, whilst absolutely essential, also serves as a sobering reminder of just how much work still needs to be done in order to reach the Mission on Cancer Board’s bold - By 2030, more than 3 million lives saved, living longer and better. As the three main Mission pillars, core areas of intervention are prevention, diagnostics and treatment of cancer, and the quality of life of cancer patients, survivors, and their families and carers.
To spur much needed progress, I also believe that the true value of cancer discovery is found in its applicability and broad scale, cross-border implementation. Last month, I was honoured to participate at the virtual European Cancer Research Summit. Panelists identified, discussed the myriad challenges that must be resolved if we are to build stronger, common EU infrastructures to harness, measure and more rapidly exploit existing opportunities in precision oncology, as well as those on stream.
The good news is that many ‘working’ platforms and initiatives are already in place, such as the European Organisation for Research and Treatment of Cancer’s (EORTC) SPECTA. Other available resources include ESMO’s Scale for Clinical Actionability of molecular Targets (ESCAT) that provides a superb framework for the ranking of genomic alterations as targets for cancer precision medicine.
Concerning accessibility to cancer medicines, which is at the heart of ESMO’s mission (Lancet Oncol. 2019 May;20(5):e224-e225), participants proposed potential strategies and policies to accelerate timely diagnosis, and improve access to optimal cancer care for all patients. These collective undertakings will be hugely challenging but, to paraphrase Albert Einstein, in the middle of every challenge lies opportunity.
Conquering Cancer: an attainable goal? If we can successfully translate current challenges in the oncology space into opportunities for all patients, then my answer is an optimistic ‘yes’.
The Last Word.
The COVID-19 pandemic has shone a light on the amazing ability of medical science to identify and combat a major new issue to public health globally. In less than a year, 12 vaccines and 4 novel therapeutics for COVID-19 were developed and approved. These novel treatments were approved through emergency use authorisations, evidencing regulatory flexibility in the face of the global pandemic to ensure that vaccines and therapies reach patients as swiftly as possible.
I believe that many lessons here could be applied to other diseases including cancer in order to spur progress and accelerate improved clinical outcomes for countless patients worldwide.