Vast, multi-pronged push to tackle the EU’s second biggest killer will be underpinned by moves to promote sharing of anonymised patient data and the creation of a network of 27 national cancer centres
The EU on Wednesday set out a €4 billion Beating Cancer plan, including the most concerted push ever for research and its translation through to better treatments.
The plan, an all-hands-on-deck effort across the commission with a focus on 10 top line priorities, will fund technology development, create new research networks, improve access to therapies, promote disease prevention and early detection and offer better support for people who survive cancer.
Repurposing medicines to fight cancer and developing new artificial intelligence (AI) applications to detect tumours faster also make the list, as does a broader push to increase skills, among other recommendations. Underpinning the whole is a focus on greater data sharing and collaboration.
One of the first actions, the European Cancer Imaging Initiative in 2022 will compile a tumour atlas of anonymised cancer scans that can be used by researchers and hospitals to train diagnostic AI tools, improving their accuracy and reliability.
“Early detection saves lives. We need to screen more and screen better. This means adopting better technology,” EU health chief Stella Kyriakides said.
Supporting this, a new Knowledge Centre on Cancer will be launched this year within the Joint Research Centre, the EU’s in-house science service, to help coordinate scientific and technical cancer-related initiatives. The centre brief is to act as a ‘knowledge broker’, issuing guidelines to inform the design and rollout of the plan.
Later this year the Innovative Medicines Initiative, the EU’s public private partnership in medical research, will launch projects on the use of AI to support health workers, carers and patients in prevention, diagnosis and treatment, and projects on overcoming cancer drug resistance.
Meanwhile, the European Health Data Space, set to be up and running by 2025, will “enable cancer patients to securely access and share their health data between healthcare providers and across borders in the EU.”
Europe accounts for a tenth of the global population, but a quarter of the world's cancer cases. It is not one disease but essentially hundreds. It is the second biggest killer after cardiovascular disease, but by 2035, cases are set to increase by almost 25%, making it the leading cause of death. There is also increasing concern about the economic costs of cancer, which have risen to more than €100 billion a year across the EU.
There are huge disparities in access to cancer services across the EU, with a recent Eurostat study showing that in one member state, 82% of women aged 50-69 had a mammogram within the last two years, while in another the figure stands at 0.2%.
A cancer inequality registry will be set up by 2022 to help member states identify problem areas and where to direct support, Kyriakides said.
Currently the COVID-19 pandemic is the number one health priority in Europe. But over one million people died of cancer on the continent last year, roughly twice the COVID-19 death rate. The pandemic has severely affected cancer care, disrupting treatment, delaying diagnosis, and affecting access to medicines. “This in itself is very worrying,” said Kyriakides.
At the centre of the EU’s cancer plan is a large and targeted programme of research – or moonshot - to inject more urgency into the development of more effective cancer therapies.
The EU Mission on Cancer, part of the €95.5 billion Horizon Europe science programme, will be the main budget line for research, investing up to €2 billion over the next seven years.
The effort draws inspiration from the US Cancer Moonshot. In 2016, 45 years after Richard Nixon’s “war on cancer”, President Barack Obama announced the moonshot, with the then vice president Joe Biden at its head.
The Trump administration chose not to continue the federal Moonshot programme, but funding continued, with the initiative injecting $1.8 billion into an orchestrated programme of research that has the aim of achieving in five years what would otherwise have taken a decade. Some researchers are already eyeing up a successor programme.
On top of the mission funding, research money in the Beating Cancer plan will flow through several other pots, including the expanded EU health programme, called EU4Health, and the Digital Europe programme.
The Marie Skłodowska-Curie Actions, the Horizon Europe programme that provides grants for work and research placements, will continue developing cancer researchers’ skills.
The Digital Europe programme will offer up to €250 million for cancer-related digital projects. Meanwhile, funding from the EU4Health programme will go towards the development of an app that tells people how to reduce their cancer risks.
There will also be special grants under the Euratom nuclear research programme for research to improve radiotherapy.
Member states will be encouraged to spend EU regional funds on cancer services, for instance on mobile healthcare units for cancer screening, or new laboratory diagnostics. “This is particularly important for those living in the most deprived and isolated communities with restricted access to large urban centres,” the plan says.
Calculating how much the EU normally already spends on cancer research is complicated, because so much expenditure is tucked into so many budgets. The Commission says that, under Horizon 2020, it awarded over €1 billion in cancer research grants for roughly 1,000 cancer-related research projects from 2014 - 2020.
More data, more sharing
Among other initiatives in the plan, the Commission pledges a big drive to repurpose approved drugs. “Building on experiences with repurposing of medicines to treat COVID-19, an additional project will be launched that uses high-performance computing to rapidly test existing molecules and new drug combinations,” the plan says.
Towards the end of the year, the Commission will announce the ‘Cancer Diagnostic and Treatment for All’ initiative, which will drive investment into next generation sequencing of tumour cells, a field that is both rapidly advancing cancer research and supporting the use of therapies targeted at particular genetic defects.
Getting the National Comprehensive Cancer Centres in every member country to work more closely together is a key part of the plan. “We need to bring all of this together,” Kyriakides said. Many believe a stumbling block to advances in cancer research may be poor collaboration among researchers.
The Commission promises a network, pegged for 2025, to better link the 27 national centres. Officials say this will look something like the European Reference Networks, which were set up in 2017 allow clinicians to pool their knowledge of rare diseases.
Also foreseen is the European Initiative to Understand Cancer – a broad research effort that will look at how cancers develop, and help identify individuals at high risk.
The existing European Cancer Information System, which monitors the cancer burden in Europe, will be expanded in 2021 to include new indicators, and a new section on childhood cancers.
Looking after cancer survivors
Another offshoot of the Beating Cancer plan will provide resources to improve life for cancer survivors.
By 2022, a ‘Cancer Survivor Smart-Card’ will be available for patients to summarise their clinical history and aid follow-up care. This personalised and voluntary system, which could in fact be an app, will connect the patient directly with doctors, the Commission said.
It will come alongside a new ‘European Cancer Patient Digital Centre’, to be created under the cancer mission that will foster the voluntary exchange of patient data. The added objective of these initiatives is to collect a wider pool of data for researchers.
The Commission will also use the plan to set public health targets, such as getting tobacco use down by 20 per cent in the EU by 2040, and harmful drinking to drop 10 per cent in the same period.
Cigarette smoking and other forms of tobacco use is responsible for 15-20% of all European cancer cases, making this the top avoidable risk factor, an EU policy document said. The continent has the highest levels of alcohol consumption in the world, meaning alcohol-attributable cancer is also high.
The EU will also spend money on healthy diet promotion, and require member states to put new warning labels on alcohol.