Towards a cancer mission in Horizon Europe: recommendations

Abstract

A comprehensive translational cancer research approach focused on personalized and precision medicine, and covering the entire cancer research-care-prevention continuum has the potential to achieve in 2030 a 10-year cancer-specific survival for 75% of patients diagnosed in European Union (EU) member states with a well-developed healthcare system. Concerted actions across this continuum that spans from basic and preclinical research through clinical and prevention research to outcomes research, along with the establishment of interconnected high-quality infrastructures for translational research, clinical and prevention trials and outcomes research, will ensure that science-driven and social innovations benefit patients and individuals at risk across the EU. European infrastructures involving comprehensive cancer centres (CCCs) and CCC-like entities will provide researchers with access to the required critical mass of patients, biological materials and technological resources and can bridge research with healthcare systems. Here, we prioritize research areas to ensure a balanced research portfolio and provide recommendations for achieving key targets. Meeting these targets will require harmonization of EU and national priorities and policies, improved research coordination at the national, regional and EU level and increasingly efficient and flexible funding mechanisms. Long-term support by the EU and commitment of Member States to specialized schemes are also needed for the establishment and sustainability of trans-border infrastructures and networks. In addition to effectively engaging policymakers, all relevant stakeholders within the entire continuum should consensually inform policy through evidence-based advice.

Keywords: European healthcare systems; cancer mission; cancer research/care/prevention continuum; comprehensive cancer centres; patient empowerment; science policy.

Fig. 1

Research networks provide cancer researchers with sufficient critical mass of research infrastructures, patients, samples, technology and expertise. (A) Paradigm of a translational research network. Multidisciplinary, patient‐centred institutions, such as CCCs and CCCoEs, each having a broad research scope, interact closely. For example, they collaborate on specific research items (indicatively, on breast cancer (BC), or lung cancer (LC)) and share platform technologies, thereby forming the core components of a translational research infrastructure. CCCs and CCCoEs are best positioned to: (i) support basic and translational research through crosstalk with cancer centres (CCs) and cancer research institutes (CRIs), as well as linking to academic research at universities, for example, research on (bio)chemistry, engineering, genetics, molecular and cell biology, tumour biology, immunology; (ii) exchange data to improve care for patients both at top clinical hospitals and community hospitals; (iii) work closely with start‐ups and offer pharmaceutical and biotechnology industries strategic partnerships; (iv) provide training, capacity building and mobility of researchers and clinicians across Europe through twinning programmes; (v) generate intellectual property and engage in profitable technology transfer, facilitating the communication and dissemination of information. (B) Infrastructures involve interacting networks. These networks too are based on the close collaboration among researchers in CCCs, CCCoEs, clinical CCs, universities and other research organizations (see also panel A). The three suggested types of infrastructures (translational research, clinical and prevention trials, and outcomes research) may in addition include structures addressing specific research requirements. An already‐established paediatric oncology network exemplifies how innovative research and clinical strategies can be delivered, based on strong collaboration across European centres. In the context of a cancer mission, all networks would establish cross‐border relationships with each other, and also with existing independent research clusters and professional clusters focusing, for example, on health economics, computational sciences, psychosocial oncology or palliative care. In addition, strong links to national screening facilities, and EU‐wide patient records, databases and biobanks can be established and maintained.

Fig. 2

Overview of Accredited CCCs and Cancer Centres in Europe.

Fig. 3

Newly diagnosed patients with cancer estimated for the year 2018 and projected for the year 2040 for Europe (UN definition), the predicted new cancer burden for the total period from 2018 to 2040, and the preventable cancer burden in 2018 had primary prevention against the listed established causes of cancer been rigorously implemented [22] (Source: J. Schüz—Modifiable risk factors and prevention: overview of current knowledge and main challenges; European Code against Cancer initiative. Health Working Group; Environment, Public Health and Food Safety (ENVI) Committee of the European Parliament, 18/2/2020: https://www.europarl.europa.eu/cmsdata/196417/Schuz_modifiable%20risk%20factors.pdf).

Fig. 4

ERN PaedCan Network for paediatric cancer. Distribution of members over Europe.