Cancer Prevention and Control: a Case of Policy, Science and Economics
04.02.16
Nevertheless, today, on World Cancer Day 2016, we can say with no small amount of confidence, that many cancers no longer represent the death sentence they were once thought to be. In fact, significant therapeutic advances mean that people with many different types of cancer now live longer and have a better quality of life. What’s more, pharmaceutical companies are continuously investigating new medicines and novel therapies, such as gene therapy to reduce the toll of cancer on patients and families.
On the policy front, it is abundantly clear that Europe has not been idle. In fact, since 1985, cancer has been a priority issue within EU public health policy. In the same year, at the European Council, 12 Heads of State representing the European Community – the EU’s forerunner – decided to launch the first “Europe Against Cancer” programme, which became operational in 1987.
Moreover, in 2014, the European Commission established the Group of Experts on Cancer Control, designed to offer a much-needed boost to EU cancer policy. It reasoned that the only effective way of implementing a cancer control programme would be to launch a co-ordinated approach between EU authorities, Member States and the relevant and numerous stakeholders in the cancer field.
This thinking offered a perfect stage on which the world’s largest public private partnership, the Innovative Medicines Initiative, could address the scientific challenges that cancer presents and showcase its pooled expertise and scientific excellence.
IMI certainly hasn’t disappointed, recently providing use with three extremely promising projects.
Studying cancer in a lab is difficult: tumour samples in petri dishes don’t behave in the same way as tumour cells in the body. Complex systems that model pathology usually means using more animals, which is very expensive. IMI’s PREDECT project therefore aims to improve these over-simplistic lab-based models by designing complex 3-D models that include cells from the body’s connective tissues that interact with the tumour. Analysis shows that this method better reflects cancer’s activity in the body.
PREDECT is also looking to improve ways of studying slices of tumours in the laboratory. Tumour slices provide a lot of information on the architecture and make-up of complex tumours, but creating a slice and keeping it alive can affect the cells’ behaviour. Scientists from PREDECT have found ways to get round some of these issues to create samples that give more reliable results. Most notably, their complexity means scientists will be able to study tumours in the lab in unprecedented detail, and this will reduce their reliance on animal models.
The second breakthrough project focuses on imaging which, when used well, can show whether or not a patient is responding to treatment within days of the therapy first being administered. Where it identifies an ineffectual product, this may also save patients from unnecessary, negative side-effects.
Currently, though, problems exist with the use of imaging in clinical trials, such as variability in the quality of data it produces. The trick, in cancer clinical trials, is to strike the right balance between maximising data quality, while minimising cost.
Scientists attached to IMI’s QuIC-ConCePT project are therefore working on a practical, risk-based framework and recommendations on the use of imaging as a marker of how well a treatment is working. By carrying out a risk assessment plan before the study starts, and reviewing and updating the risk it throughout the trial, could help in prioritising, reducing costs, and decreasing attrition rates. Crucially, the QuIC-ConCePT approach recognises that other stakeholders, including regulatory bodies, pharmaceutical companies, and patients also play essential roles in the conduct of these trials.’
Last, but by no means least, IMI’s OncoTrack, a project designed to improve the diagnosis and treatment of colon cancer, will focus on identifying biological markers that can predict patient response and help us monitor therapeutic efficacy. The aim is to validate available and predicted biomarkers in large studies, which ultimately will produce useable data in a suitable format for point-of-care diagnostic tools.
Across the water, in the US, similar efforts are being made. The National Immunotherapy Coalition: Cancer MoonShot 2020 represents an unprecedented collaboration of multinational pharmaceutical, biotechnology companies, academic centers and community oncologists set to make possible access to over 60+ novel and approved agents under exploration in the war against cancer.
Closer to home, though, while science and policy appear to be heading in the right direction in Europe, we have to acknowledge that little progress can be made without proper, effective investment and cooperation of various stakeholders. The success of IMI, funded jointly by the EU and the pharmaceutical industry, just proves this point.
As the World Cancer Day campaign suggests: making the economic case for effective investment is essential to change mind-sets around the value of investing in cancer prevention and control, thereby allowing governments to justify placing cancer control at the heart of their national health plans.
