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EU politicians are planning an extensive targeted research program – or moon shot – aimed at injecting more urgency into the development of new, more effective cancer treatments. The goal, they say, is to aim big, to be inventive and to get things done.
Veterans of cancer research say that the goal requires a broad attack on many fronts and a huge amount of money.
Here are some of the things we know about the developing plan.
Why cancer?
With more people surviving in old age, cancer rates are increasing everywhere. Europe has less than 10% of the world's population, but more than a quarter of all cancer cases. Cancer now kills 1.9 million people a year in Europe, according to data from the World Health Organization. By the year 2030, there will be more than 22 million new cancer cases a year, almost double the number recorded in 2012, according to the International Agency for Research on Cancer. The most common cancers in Europe are breast, followed by colorectal cancer, lung cancer and prostate cancer.
What are the ingredients of a mission?
European Research Commissioner Carlos Moedas has made the mission a catalyst for enabling patients to make decisive progress more quickly. "Cancer has evolved and we need new tactics to adapt it. We need the scale and critical mass at the EU level to give the best of ourselves. We want to set ourselves an inspiring goal, to direct our research efforts towards a concrete goal, "said the Commissioner.
According to the current thinking of the European Commission, the mission should be ambitious, even risky, but also achievable. The model par excellence is the commitment of US President John F. Kennedy in 1961 to send a man to the moon and send him away safely (this mission was accomplished eight years later).
In the EU's view, a mission-based approach must clearly define the expected outcome. However, the path to reach this endpoint must not follow a single path, nor use a single technology. Missions need a clear schedule – long enough to allow searches to mature, while having a specific delivery date. Crucially, it must be possible to say definitively whether the mission was carried out or not. The mission would involve a range of financing, including grants, prices and financial instruments.
Progress in the fight against the disease could be much faster if scientists had the means and the resources to work closely together, says Moedas. The mission would remove barriers between academic disciplines, between different pharmaceutical companies, between pharmaceutical companies and researchers, as well as between all and the EU governments. "Focusing on oncologists is not enough for cancer treatment. We need oncologists, nutritionists, economists and patients themselves. We should take advantage of the European networks we already have on cancer, "said the Commissioner.
How much money?
The budget for a cancer control mission would be considerable. Moreover, decisive political leadership – not only from the European Commission, but from all the Member States – is needed to bring disparate parties together.
To date, no budget has been allocated to EU development research missions. Discussions on the size of any lunar cancer strike will be part of a broader negotiation on the overall structure of the EU Horizon Europe research program, which will run from 2021 to 2027. In addition to cancer, other Such ambitious proposals are under consideration, including the reduction of plastic pollution in the oceans and the construction of the world's first quantum computer.
Calculating how much the EU is already spending on cancer research is complicated because such expenses are hidden in many budgets. The Commission states that, as part of its current seven – year Horizon 2020 research program, it has already committed € 1.2 billion to 980 projects. According to the researchers, a mission would require at least as much funding.
Christian Ehler, one of the main drafters of the European Parliament's next research program, said that a larger global research budget would be needed to carry out a mission. If the budget of Horizon Europe does not exceed the proposed 94.1 billion euros, "you do not see the missions. With 125 billion euros, you can see the missions, with 160 billion euros, you can start fighting Alzheimer's disease, "said Ehler.
In the expensive world of biomedical research, researchers will question the real impact of this amount. One thing is certain: it will be necessary to target precisely.
Where should the money go?
Developing a cancer plan in Europe would involve difficult choices about the funding goal.
One of the first proposals from the Commission was to focus resources on childhood cancers (An internal document last year set the following goal: "Overcoming cancer: curing cancer in children. # 39; child of 20xx ".). But since then the plan has changed and politicians are now talking about fighting cancer more generally. It is understandable that several delegations of Member States participating in negotiating missions do not wish to set general cancer targets. According to them, unless the target is specific, it would not be feasible.
However, most agree that the plan requires a broad attack on several fronts. "It's about detecting early, treating side effects and keeping the patients active," says Moedas. Others argue that the goal should be to encourage people to quit smoking and eat healthy.
The researchers are unanimous on one point: one of the major objectives of any European plan against cancer must be to share more patient data.
Why is data sharing important?
Cancer experts agree that better coordination of data is a medically effective way to fight the disease. There are many objects of this type, but few mechanisms to combine them.
Rare diseases, including rare cancers, affect up to 36 million European citizens. "But meaningful research can not begin without a critical mass of patient data. And this is simply not possible at Member State level, "says Moedas.
According to the Commissioner, researchers need access to more central resources, including virtual networks linking databases, patient registries and biobanks.
Removing barriers to cross-border data sharing "would be a great help," says Emile Voest, medical director of the Dutch Cancer Institute. "Imagine the power of a database of all European cancer patients, clinically annotated and containing information on biomarkers," he said. "This can help identify patients early on when a cure is possible and refine the selection of patients for treatment."
Moedas says that he wants to see more applications for cancer. "I know that a phone will never replace an MRI machine. But the applications developed have incredible potential. Apps that help with early detection, create care plans, help us manage side effects. Putting cancer treatment literally in the hands of patients gives them the power, "he says.
What do veterans say about cancer research?
The specialists keep their feet on the ground: a mission will not find the ultimate cure, they say.
Progress will continue to be gradual; Controlling cancer is "an extremely large and complex undertaking – so you have to reduce the number of problems to focus on a few issues," said Nobel laureate Harold Varmus, former director of the US National Cancer Institute and the National Institutes. of Health.
The countless organizations and institutions that make up the cancer control community in Europe are showing the first signs of mobilization.
Cancer Core Europe, an association of seven European cancer centers, was first designated as the "ideal engine" of the cancer control mission. The group is made up of Cancer Research UK Cambridge Center; the German Center for Cancer Research and the National Center for Tumor Diseases; Gustave Roussy; the National Institute of Tumors of Milan; the Karolinska Institute; the Dutch Cancer Institute; and the Vall d'Hebron Oncology Institute.
In a recent article, the group argues that "it is clear that there is still much work to be done to successfully integrate the various components of a cancer mission." Such integration will require collaborations with a variety of networks. The unique character of Cancer Core Europe makes it the ideal "driver" for a cancer mission. "
Manfred Weber, the German MEP, candidate for the succession of Jean-Claude Juncker to the presidency of the European Commission at the end of the year 2019, supports the anti-cancer plan. "I want the Europeans to be the first ones to heal cancer, imagine that we combine all our resources, knowledge and databases." Its goal is to double the amount the EU spends on cancer research . He made this goal clear when he officially kicked off the campaign on April 23rd.
Elsewhere, politicians present at the next European elections are being asked to join a manifesto to fight the disease. He presented a list of demands that he hoped the new Parliament would respond to after the May elections, notably to improve access to high-quality cancer treatment and to implement measures to reduce occupational and environmental exposure. harmful to carcinogens.
Would the EU plan be similar to that of the US Cancer Cancer Moon?
Researchers do not know how much an EU effort should be modeled on the American cancer clearing. In 2016, 45 years after President Richard Nixon's "war on cancer," President Barack Obama announced the lunar coup, led by Vice President Joe Biden. It's a personal mission for Biden, who has lost his son Beau, who has brain cancer at the age of 46.
This initiative injects $ 1.8 billion into an orchestrated research program that aims to achieve in five years what would otherwise have taken a decade.
Roger Appelqvist, a researcher and one of the leaders of the Moon Shot team at Lund University, involved in US initiative projects, says: "Copy the American concept and destroy the walls between the research groups. Do not have the attitude that "it's mine, it's yours".
But other researchers doubt that Europe can – or should – adopt the US approach. "We are not a federation like the United States. There are different rules and regulations in the European Union, so it's more complex overall, "said Sakari Karjalainen, General Secretary of the Cancer Society of Finland. "But it is certainly possible to copy the ideas and principles of the American initiative."
And if the plan of the EU failed?
The very ambitious and misleading "wars" of the US government of the past (against poverty, against cancer, against terrorism) are largely in vain. Would an EU mission be better off? Maybe not, but even in case of failure, it is possible to obtain unexpected and positive results, according to Moedas. "Some people are skeptical. They think that if the mission fails, all our efforts are in vain. I think it's short-sighted. "
"Nixon is often criticized for not finding a cure for cancer. But the scientific discoveries made as a result of this mission paved the way for breakthroughs in other areas, such as HIV treatments, "he said.
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