Catalysing Hope: My Takeaway from the 9th Annual World Cancer Series: Europe and the Beating Cancer Plan

'It is not only what we do, but also what we do not do, for which we are accountable' - Molière

I am grateful for the opportunity to participate in the 9th annual World Cancer Series: Europe. The issue of cancer is deeply personal for me. In 2020, I tragically lost a dear friend to triple-negative breast cancer (TNBC). She was a young mother of three. Currently we are witnessing a close family member ongoing battle with liposarcoma. He has undergone five serious operations and is still fighting. It's a challenging situation, and we often wonder if it's a matter of bad genes, bad luck, or both.

In 2020, cancer had a significant impact in the European Union, with 2.7 million people diagnosed and 1.3 million lives lost. Disturbingly, projections from the International Agency for Research on Cancer (IARC) indicate that cancer-related deaths are set to rise by over 24% by 2035, making it the leading cause of death in the EU. It carries an estimated annual economic impact of over €100 billion.

The European Union's commitment to combating cancer, as outlined in Europe's Beating Cancer Plan, spans the entire disease pathway. This includes prevention, early detection, diagnosis, treatment, and care, with a strong focus on enhancing the quality of life for cancer patients and survivors.

During the event, I had the privilege of participating in several enlightening sessions and roundtable discussions. Here are some of my personal views and takeaways:

1. Innovative Solutions & Policy: Europe must embrace more innovative solutions to address unmet patient needs. The commercial innovation can be facilitated through harmonized policy across Europe and the EMA regulatory guidelines. Early dialogue with regulatory authorities from early product development to marketing authorization and post-approval requirements is crucial, also in the context of sustainable healthcare systems.
2. Support for Developers: Support for both commercial and non-commercial developers is essential to accelerate innovation. This support includes incentives and substantial scientific regulatory guidance during the product development lifecycle.
3. Prevention and Early Diagnosis: Robust and sensitive standardized methodologies are needed to provide scientific evidence regarding the safety and efficiency of potential novel treatments.  But isn’t it better to prevent than treat? Prevention and early diagnosis are central to the EU's cancer mission. The 2022 'Independent Expert Report 'Cancer Screening in the European Union' highlights the substantial economic impact of cancer in Europe and recommends that early diagnosis solutions provide the best chances for patient survival. As a society we also need to ensure a sustainable and healthy lifestyle.
4. EU Cancer Screening Scheme: The new EU cancer screening scheme, implemented as a population-based screening program, could guarantee that 90% of the target population receives breast, cervical, and colorectal cancer screening services by 2025. However, we need to ensure, based on scientific evidence, that extending population-screening programs for various cancers demonstrates a favorable harm-benefit ratio and cost-efficiency, among various indicators.
5. Role of Emerging Technologies: I anticipate that emerging technologies, such as molecular biomarkers, genomic data analysis, liquid biopsy, and artificial intelligence, will play a crucial role in advancing cancer screening methods.
6. Personalization and Patient Voice: Personalization is key in terms of targeted therapy, and incorporating omics, e.g. genomics or radiomics. Additionally, it's essential to listen to patients' voices, involving patients as equal partners in early discussions with regulatory and technology developers, during product co-design and co-development, and when creating “living guidelines”.
7. Improving Clinical Trials and Access: Rigorous inclusion/exclusion criteria are significant barriers to patient participation. Novel medicinal solutions require a 'fresh' perspective on clinical trial design, reimbursement, and pricing strategies across countries. The implementation of novel technologies, real-world data evidence (RWE), single-arm clinical trials, long-term patient monitoring, telemedicine, AI, and automation is fundamental.
8. Addressing Access Disparities: Access to treatments across Europe varies significantly, with notable differences in cancer survival rates exceeding 25%, as indicated in the report issued by Medicines for Europe titled 'Removing Access Barriers in Central and Eastern Europe: Ensuring Equitable Access to Medicines for All European Patients.' The number of standard units (where 1 standard unit equals 1 tablet/syringe) per capita for biological molecules in all Central and Eastern European countries falls below the average of the Nordic countries. This situation highlights the need for the implementation of long-term sustainable policies, clear incentives, and less restrictive prescription guidelines upon the entry of off-patent medicines to secure equitable access for all European patients.
9. W.A.I.T. Indicator: According to the EFPIA Patients W.A.I.T. Indicator 2022 Survey, access to innovative products in Europe varies significantly, with an over 80% difference between Northern/Western and Southern/Eastern European countries, which impacts the availability of new medicines and oncology products. In 2022, the average availability rate for oncology products, measured as the time between marketing authorization and patient availability, was 50% (a decrease from 59% in 2021), with an average time to availability of 517 days. Poland had a median availability time of 827 days between 2018 and 2021, whereas Germany had only 37 days, and the Netherlands had 296 days.
10. Holistic Patient Care: Patient care should extend beyond drug administrations. Patients deserve holistic care, including timely access to psych-oncology support, nutritional advice, and rehabilitation.
11. Radiology's Potential: Radiology holds promise as a diagnostic tool and in radiotherapeutics, offering cost-saving opportunities. However, it remains heavily underinvested. Despite the fact that approximately 50% of all European cancer patients could benefit from radiotherapy at least once during their illness, more than one out of four cancer patients in Europe does not receive the necessary radiotherapy. According to a study by E. Zubizarreta and colleagues titled 'Analysis of Global Radiotherapy Needs and Costs by Geographic Region and Income Level,' published in Clinical Oncology, the cost of radiotherapy represents only a small fraction of the total healthcare budget in High-Income Countries (HICs). While cancer consumes about 5–10% of the global healthcare budget, radiotherapy accounts for just about 5% of that budget, equating to approximately 0.25 - 0.5% of the total healthcare budget.

I wish to extend my heartfelt appreciation to the event organizers, the team at Economist Impact, and the diverse group of stakeholders for providing a truly rewarding experience!