POLICY ARTICLE Towards a Cancer Mission in Horizon Europe Anton Berns1,2, Ulrik Ringborg2,3, Alexander Eggermont4, Michael Baumann5,6 , Fabien Calvo4, Angelika Eggert7, Carolina Espina8, Douglas Hanahan9, Denis Lacombe10, Francesco de Lorenzo11, € z8, Josep Tabernero15 and Julio E. Celis2,16 Simon Oberst12,13, Thierry Philip13,14, Joachim Schu 1 The Netherlands Cancer Institute, Amsterdam, The Netherlands 2 European Academy of Cancer Sciences 3 Cancer Center Karolinska, Karolinska University Hospital, Stockholm, Sweden 4 Gustave Roussy Cancer Campus Grand Paris, Villejuif, France 5 German Cancer Research Center (DKFZ), Heidelberg, Germany 6 German Cancer Consortium (DKTK), Heidelberg, Germany 7 Charite-Universitatsmedizin, Berlin, Germany 8 International Agency for Research on Cancer (IARC/WHO), Lyon, France 9 Swiss Institute for Experimental Cancer Research (ISREC), Federal Institute of Technology in Lausanne (EPFL), and Swiss Cancer Center Leman (SCCL), Lausanne, Switzerland 10 EORTC Headquarters, Brussels, Belgium 11 European Cancer Patient Coalition, Brussels, Belgium 12 Cancer Research UK Cambridge Centre, UK 13 Organisation of European Cancer Institutes (OECI) 14 Institut Curie, Paris, France 15 Medical Oncology Department, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autonoma de Barcelona, Spain 16 Danish Cancer Society Research Centre, Copenhagen, Denmark Correspondence Anton Berns, The Netherlands Cancer Institute, Amsterdam, The Netherlands E-mail: a.berns@nki.nl Ulrik Ringborg, Cancer Center Karolinska, Karolinska University Hospital, Stockholm, Sweden E-mail: ulrik.ringborg@ki.se Julio E. Celis, Danish Cancer Society Research Centre, Copenhagen, Denmark E-mail: jec@cancer.dk doi:10.1002/1878-0261.12585 Ever since former Commissioner for Research Philippe initiative, a consortium of 10 cancer prevention centres Busquin established the European Cancer Research was recently established – Cancer Prevention Europe – Area (ECRA) in 2002 (http://europa.eu/rapid/press-re to reinforce the complete cancer prevention research lease_SPEECH-02-408_en.htm) to address the frag- continuum (Wild et al., 2019). At present, Cancer Core mentation of cancer research in Europe, the cancer Europe and Cancer Prevention Europe are in the pro- community and policymakers have been trying to cess of integrating their strategies to create a coherent develop strategies to bridge the gaps between basic/ plan for prevention, early detection and treatment, and preclinical and clinical research and research and efforts are underway to engage the outcomes research healthcare (Celis and Pavalkis, 2017). These efforts geometry and to network with other infrastructures, culminated in 2014 with the creation of Cancer Core CCCs, and research and clinical centres across Europe Europe (Eggermont et al., 2019), a patient-centred (https://febs.onlinelibrary.wiley.com/toc/18780261/2019/ legal structure on therapeutics that currently consists 13/3). of seven large cancer centres (mainly Comprehensive To date, several prominent scientific cancer organi- Cancer Centres (CCCs, institutions that link research sations and cancer centres are collaborating to develop with the healthcare system; Saghatchian et al., 2008) a unified insight towards a mission-oriented approach across Europe. Inspired by the Cancer Core Europe to cancer. These include Cancer Core Europe, Cancer Molecular Oncology 0 (2019) 2301–2304 ª 2019 The Authors. Published by FEBS Press and John Wiley & Sons Ltd. 2301 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Horizon Europe – Cancer Mission A. Berns et al. Prevention Europe, the Organisation of European (Fr€ohlich et al., 2018). The latter calls for insti- Cancer Institutes (OECI), the European Organisation tutional collaborations as exemplified by Cancer for Research and Treatment of Cancer (EORTC), the Core Europe (therapeutics), Cancer Prevention European Association for Cancer Research (EACR), Europe or SIOP Europe. By generating a coher- the EuroTech Universities Alliance, the European ent cancer research continuum, the infrastruc- Cancer Patient Coalition (ECPC), the European Acad- tures will offer innovative approaches for cancer emy of Cancer Sciences (EACS), and the European research, links to the healthcare and prevention Society for Medical Oncology (ESMO); other organi- systems, development of quality-assured multi- sations are expected to join shortly. Getting where we disciplinary cancer care, as well as the assess- stand today required (a) building communities, (b) ment of long-term outcomes of prevention and working in partnership, (c) engaging key stakeholders, therapeutics. Moreover, they will provide an (d) identifying champions among researchers, clini- ecosystem to support education and training, cians, policymakers and patients, (e) organizing mobility, capacity building and rapid dissemina- science, and (f) providing future perspectives and evi- tion of information and best practices across dence-based advice to inform policy (Celis and Heitor, the European Union. 2019; Celis and Pavalkis, 2017). b Effective collaboration among all the stakeholders The EACS, as an independent organisation com- (basic, translational, and clinical researchers, clini- posed of eminent oncologists and cancer researchers, cal oncologists/healthcare professionals, patholo- has actively supported the creation of a Cancer Mis- gists, radiation oncologists, surgeons, prevention sion (Adami et al., 2018) and, as a result, has been researchers, epidemiologists, patient organisations, requested to coordinate the process of developing such universities, industry and small and medium-sized a joint strategy to speak with a single voice. At a enterprises (SMEs), regulatory bodies and fun- recent meeting organised by the EACS in Brussels, ders). most of the organisations mentioned above met to pre- c Coordinated networks of CCCs1 and research and pare a short document addressing the goals, structur- clinical centres across Europe. ing activities and areas of priority required to d A portfolio of projects/activities across the cancer accomplish the mission. The text, which was recently research/care continuum from basic/preclinical to sent to the Cancer Mission Board, stated: early clinical, late clinical, and outcomes research ‘To have impact on society at large, the Cancer Mis- leading to recommendations for best practices to sion aims at uniting countries to substantially reduce treat patients. the massive EU cancer burden and improve the quality e The use of cohesion funds to ensure the successful of life of patients by promoting cost-effective, evi- participation of central and eastern European dence-based best practices in cancer prevention, treat- member states. ment, and care. Our goal is to achieve 10-year cancer f Active involvement of the cancer research, preven- survival for 3/4 patients by the year 2030. Because tion/health care and cancer patient communities at cancer mortality provides a more timely assessment of all stages of policymaking. progress which also captures advances in primary pre- g Coordinated communication to disseminate infor- vention, it will be important to document the expected mation to cancer patient organisations, national declining trends in age-standardized mortality in each cancer societies, the cancer research community, EU country. policymakers and society at large. h Incentives and funding for structuring activities as Achieving the goals will require: well as for areas of research priority (see below). a Integrated, networked, and distributed infras- Structuring activities will entail: tructures needed to reach the critical mass of resources, multidisciplinary expertise, technolo- a Creating a partnership model of CCCs and CCCs of gies, data, patients and coordinated collabora- Excellence (CCCoE): A network of networks. There tive projects that are essential to promote should be at least one CCC in each EU country. science-driven and social innovations in the era Newly-created and accredited CCCs generated of personalized (precision) cancer medicine through supportive partnership arrangements 1 Comprehensiveness is designated to those centres that have a well-established combination of fundamental and translational cancer research, with a sufficiently large portfolio of clinical trials, and multidisciplinary cancer care services covering the care pathway, and linked with primary care. 2302 Molecular Oncology 0 (2019) 2301–2304 ª 2019 The Authors. Published by FEBS Press and John Wiley & Sons Ltd. A. Berns et al. Horizon Europe – Cancer Mission should result in manageable networks (ideally serv- resistance and to identify therapeutic strategies to ing a population of 5 10 million) of CCC/CCCoE overcome these. and other centres for innovation and high-quality b Primary cancer prevention: a pan-European pro- multidisciplinary cancer research, cancer care, reha- gramme (exposure and lifestyle focused). Cancer bilitation and prevention. CCCs have an outreach prevention and implementation research to be con- role in sharing best practices with local hospitals and centrated in networks with a wide geographical dis- healthcare providers. CCCoE, on the other hand, tribution. Identification of causes of cancer and should serve as sites for advanced infrastructural methodologies to identify individuals at higher risk, provisions. OECI and EACS are to be charged with combined with initiatives to reduce carcinogenic accreditation of the CCC and CCCoE, respectively. exposures and encourage a healthy lifestyle while b Attracting and incentivising the next generation of offering equal access to active primary prevention cancer specialists. Education, training and early (e.g. vaccination, medical prevention). career development for cancer scientists, engineers c Early detection for prevention and treatment. Equal and physicians (PhD studentships, postdoctoral fel- access to effective early diagnosis and treatment lowships, fellowships providing protected time for programs. Development and dissemination of inno- physician scientists, bridge grants for early career vative, more sensitive, and minimally invasive low- development (comparable to the successful NIH cost methodologies for diagnosing cancers, includ- KO8 programs), as well as support for PI projects ing premalignant tumours to improve prevention following the ERC/Synergy concept to generate screening and early treatment of cancer. new insights by “basic and preclinical cancer d Development of new therapies. Increase in the num- research” and serve as “feeder” for the programs ber of academia-initiated clinical trials (including listed. Also, there is a role for professional organi- diagnostics, medical oncology, radiation therapy, sations (e.g. ECCO, ESMO, ESTRO, ESSO, surgery and multimodal treatment) with a clear SIOPE etc.), the EACR and the EACS. aim to improve survival and quality of life, with c Fostering networks of excellence for proof of concept special emphasis on precision medicine and gender- trials and for clinical trials changing practice in pre- specific aspects. vention, therapeutics and outcomes research. This e Outcomes research including health-related quality will require innovative proof of concept trials of life aspects. Outcomes research to assess the embedded in a high-quality translational research effectiveness (decreased mortality, survival benefits, environment to discover the treatments of tomor- health-related quality of life), with links to health row. Attention should be given to rare cancers, economics of primary/secondary prevention and comorbidities and specific clinical needs of particu- therapeutic interventions. Addressing the psychoso- lar patient groups (e.g. geriatric patients). Innova- cial and socioeconomic aspects of cancer, rehabili- tions generated by early prevention/clinical tation, supportive and palliative care, long-term research must demonstrate added value before use follow-up and survivorship including social conse- by the healthcare/prevention organisations. For the quences (societal acceptance, insurance, employ- final assessment of cost-effectiveness, outcomes ment) and health economics aspects. research is required. f Big-data generation and computational science. d Establishment of a policy board to identify best Establishment of EU-wide, shared databases pro- strategies to implement activities effectively. Essen- viding access to standardised patient-derived data tial tasks include the analysis of funding mecha- and genomic/molecular marker information from nisms, organizing the science, addressing ethical wearables. Development of AI paradigms for min- issues, and the establishment of robust governance ing the data to identify new correlations (improve- structures to achieve the set goals. ments in predicting response, relapse, and side effects). Areas of research priority: g Fostering preclinical and clinical research in paedi- atric cancer. Support the further development of a a Fundamental and preclinical research: the engine comprehensive pediatric oncology program by the that fuels innovation in prevention and therapeutics. pediatric oncology community represented by SIOP Fostering innovative research to identify new Europe’. causes of cancer, to develop diagnostic markers for detecting premalignant disease, to elucidate the The document will be updated regularly as new underlying mechanisms of drug and immunotherapy organisations and infrastructures join the platform, Molecular Oncology 0 (2019) 2301–2304 ª 2019 The Authors. Published by FEBS Press and John Wiley & Sons Ltd. 2303 Horizon Europe – Cancer Mission A. Berns et al. and further information becomes available regarding role, he was/is further responsible for commercial tech- governance and the portfolio of projects and activities. nology transfer activities of his institute(s), including the DKFZ-PSMA617 related patent portfolio and sim- ilar IP portfolios. Dr. Baumann confirms that none of Acknowledgements the above funding sources were involved in the prepa- We would like to thank Christina von Gertten for ration of this paper. Other authors declare no conflict coordinating the preparation of the manuscript. We of interest. also like to thank Claudia Mayer for expert support, and Duncan Wright for comments on the article. References Adami O, Berns A, Celis JE, de Vries E, Eggermont A, Conflict of interest Harris A, zur Hausen H, Pelicci G and Ringborg U Carolina Espina and Joachim Sch€ uz state: where (2018) European Academy of Cancer Science-position authors are identified as personnel of the International paper. Mol Oncol 12, 1829–1837. Agency for Research on Cancer / World Health Orga- Celis JE and Heitor M (2019) Towards a mission-oriented nization, the authors alone are responsible for the approach to cancer in Europe: an unmet need in views expressed in this article, and they do not neces- cancer research policy. Mol Oncol 13, 502–510. sarily represent the decisions, policy or views of the Celis JE and Pavalkis D (2017) A mission-oriented approach to cancer in Europe: a joint mission/vision International Agency for Research on Cancer / World 2030. Mol Oncol 11, 1661–1672. Health Organization. Eggermont AMM, Apolone G, Baumann M, Caldas C, Michael Baumann states: In the past 5 years, Dr. Celis JE, de Lorenzo F, Ernberg I, Ringborg U, Baumann attended an advisory board meeting of Rowell J, Tabernero J et al. (2019) Cancer Core MERCK KGaA (Darmstadt), for which the Univer- Europe: a translational research infrastructure for a sity of Dresden received a travel grant. He further European mission on cancer. Mol Oncol 13, 521–527. received funding for his research projects and for edu- Fr€ ohlich H, Balling R, Beerenwinkel N, Kohlbacher O, cational grants to the University of Dresden by Teu- Kumar S, Lengauer T, Maathuis MH, Moreau Y, topharma GmbH (2011–2015), IBA (2016), Bayer AG Murphy SA, Przytycka TM et al. (2018) From hype to (2016–2018), Merck KGaA (2014–2030), Medipan reality: data science enabling personalized medicine. GmbH (2014–2018). For the German Cancer Research BMC Med 16, 150. Center (DKFZ, Heidelberg) Dr. Baumann is on the Saghatchian M, Hummel H, Otter R, de Valeriola D, Van supervisory boards of HI-STEM gGmbH (Heidelberg). Harten W, Paradiso A, Koot B, Ringborg U and Tursz T Dr. Baumann, as former chair of OncoRay (Dresden) (2008) Towards quality, comprehensiveness and excellence. and present CEO and Scientific Chair of the German The accreditation project of the Organisation of European Cancer Research Center (DKFZ, Heidelberg), was or Cancer Institutes (OECI). Tumori 94, 164–171. is responsible for collaborations with a multitude of Wild CP, Espina C, Bauld L, Bonanni B, Brenner H, companies and institutions, worldwide. In this capac- Brown K, Dillner J, Forman D, Kampman E, Nilbert ity, he has signed/signs contracts for his institute(s) M et al. (2019) Cancer prevention Europe. Mol Oncol and for the staff for research funding and/or collabo- 13, 528–534. rations with industry and academia, worldwide. In this 2304 Molecular Oncology 0 (2019) 2301–2304 ª 2019 The Authors. Published by FEBS Press and John Wiley & Sons Ltd.