Comprehensive cancer centres (CCCs) are at the heart of the landscape of cancer research, education and care in Europe. They are vital hubs where the historic gaps in the research to clinical care ...continuum are bridged. CCCs have established hallmarks, but a greater emphasis is needed in Europe to create more effective CCCs using the partnership model of university medical centres and university research departments and institutes. This review will summarise the organisational structures and processes essential for producing quality outcomes for patients and effectiveness in the translational process. The Organisation of European Cancer Institutes and European Academy of Cancer Sciences have established complementary quality accreditations systems to test the clinical and research excellence of CCCs. The EU should have an ambition to create more CCCs based on university hospitals, for each 5–10 million population and in every Member State.
Comprehensive cancer centres (CCCs) are recognised as beacons of excellence in care, translational research and innovation. This review summarises the hallmarks of CCCs, the organisation structures essential for producing quality outcomes for patients and effectiveness in the translational process, and the accreditation systems necessary for improving quality.
This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ...ESMO.
To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.•The centrepiece of this article is the requirements section, comprising definitions; multidisciplinary structure; minimum case, procedure and staffing volumes; and detailed descriptions of the skills of, and resources needed by, members and specialisms in the multidisciplinary team in a breast centre.•These requirements are positioned within narrative on European breast cancer epidemiology, the standard of care, challenges to delivering this standard, and supporting evidence, to enable a broad audience to appreciate the importance of establishing these requirements in specialist breast centres.
A comprehensive cancer approach covering the entire research–care–prevention continuum can achieve a 10‐year cancer‐specific survival for 75% of patients diagnosed in EU member states with ...well‐developed health care by 2030. To ensure access to a critical mass of patient biological and technological resources, infrastructures for translational research, clinical and prevention trials, and outcomes research are needed. Here, we provide recommendations for achieving key targets and prioritize research areas.
A comprehensive translational cancer research approach focused on personalized and precision medicine, and covering the entire cancer research–care–prevention continuum has the potential to achieve in 2030 a 10‐year cancer‐specific survival for 75% of patients diagnosed in European Union (EU) member states with a well‐developed healthcare system. Concerted actions across this continuum that spans from basic and preclinical research through clinical and prevention research to outcomes research, along with the establishment of interconnected high‐quality infrastructures for translational research, clinical and prevention trials and outcomes research, will ensure that science‐driven and social innovations benefit patients and individuals at risk across the EU. European infrastructures involving comprehensive cancer centres (CCCs) and CCC‐like entities will provide researchers with access to the required critical mass of patients, biological materials and technological resources and can bridge research with healthcare systems. Here, we prioritize research areas to ensure a balanced research portfolio and provide recommendations for achieving key targets. Meeting these targets will require harmonization of EU and national priorities and policies, improved research coordination at the national, regional and EU level and increasingly efficient and flexible funding mechanisms. Long‐term support by the EU and commitment of Member States to specialized schemes are also needed for the establishment and sustainability of trans‐border infrastructures and networks. In addition to effectively engaging policymakers, all relevant stakeholders within the entire continuum should consensually inform policy through evidence‐based advice.
Analyses of inequalities related to prevention and cancer therapeutics/care show disparities between countries with different economic standing, and within countries with high Gross Domestic Product. ...The development of basic technological and biological research provides clinical and prevention opportunities that make their implementation into healthcare systems more complex, mainly due to the growth of Personalized/Precision Cancer Medicine (PCM). Initiatives like the USA‐Cancer Moonshot and the EU‐Mission on Cancer and Europe's Beating Cancer Plan are initiated to boost cancer prevention and therapeutics/care innovation and to mitigate present inequalities. The conference organized by the Pontifical Academy of Sciences in collaboration with the European Academy of Cancer Sciences discussed the inequality problem, dependent on the economic status of a country, the increasing demands for infrastructure supportive of innovative research and its implementation in healthcare and prevention programs. Establishing translational research defined as a coherent cancer research continuum is still a challenge. Research has to cover the entire continuum from basic to outcomes research for clinical and prevention modalities. Comprehensive Cancer Centres (CCCs) are of critical importance for integrating research innovations to preclinical and clinical research, as for ensuring state‐of‐the‐art patient care within healthcare systems. International collaborative networks between CCCs are necessary to reach the critical mass of infrastructures and patients for PCM research, and for introducing prevention modalities and new treatments effectively. Outcomes and health economics research are required to assess the cost‐effectiveness of new interventions, currently a missing element in the research portfolio. Data sharing and critical mass are essential for innovative research to develop PCM. Despite advances in cancer research, cancer incidence and prevalence is growing. Making cancer research infrastructures accessible for all patients, considering the increasing inequalities, requires science policy actions incentivizing research aimed at prevention and cancer therapeutics/care with an increased focus on patients' needs and cost‐effective healthcare.
Here we summarize the conference proceedings of the second meeting on Cancer organized by the Pontifical Academy of Sciences together with the European Academy of Cancer Sciences. Despite the growing advances in cancer research, cancer incidence and prevalence are on the rise especially in countries with poor economic standing, which leads to a global inequality problem. The increasing demands for infrastructure support in innovative research and implementation of research outcomes in healthcare and prevention programs were discussed at the meeting. Establishing infrastructures in translational research that are sustainable and accessible for all patients is crucial in addressing inequalities in cancer treatment.
European cancer research stakeholders met in October 2022 in Heidelberg, Germany, at the 5th Gago conference on European Cancer Policy, to discuss the current cancer research and cancer care policy ...landscape in Europe. Meeting participants highlighted gaps in the existing European programmes focusing on cancer research, including Europe's Beating Cancer Plan (EBCP), the Mission on Cancer (MoC), Understanding Cancer (UNCAN.eu), and the joint action CRANE, and put forward the next priorities, in the form of the Heidelberg Manifesto for cancer research. This meeting report presents all discussions that shed light on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public. In addition, we summarize recommendations on how to introduce frameworks for the digitalization of European cancer research. Finally, we discuss what structures, commitment, and resources are needed to establish a collaborative cancer research environment in Europe to achieve the scale required for innovation.
European cancer research stakeholders met in October 2022 at the 5th Gago conference on European Cancer Policy. This meeting report presents all discussions on how infrastructures can be effectively shaped for translational, prevention, clinical and outcomes cancer research, with a focus on implementation and sustainability and while engaging patients and the public.
There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high‐quality cancer care. European ...policy (EU Cancer Mission and Europe’s Beating Cancer Plan) is currently moving towards a mission‐oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes’ Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high‐impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals.
This study reveals the attributes of cancer centres based on data from 40 large European cancer centres, showing that Comprehensive Cancer Centres have significantly greater output of peer‐reviewed publications and clinical trials than other centres, and that the quality of multidisciplinarity is well established in all accredited cancer centres.
Towards a Cancer Mission in Horizon Europe Berns, Anton; Ringborg, Ulrik; Eggermont, Alexander ...
Molecular oncology,
November 2019, Volume:
13, Issue:
11
Journal Article
Peer reviewed
Open access
Because cancer mortality provides a more timely assessment of progress which also captures advances in primary prevention, it will be important to document the expected declining trends in ...age‐standardized mortality in each EU country. By generating a coherent cancer research continuum, the infrastructures will offer innovative approaches for cancer research, links to the healthcare and prevention systems, development of quality‐assured multidisciplinary cancer care, as well as the assessment of long‐term outcomes of prevention and therapeutics. ...they will provide an ecosystem to support education and training, mobility, capacity building and rapid dissemination of information and best practices across the European Union. Education, training and early career development for cancer scientists, engineers and physicians (PhD studentships, postdoctoral fellowships, fellowships providing protected time for physician scientists, bridge grants for early career development (comparable to the successful NIH KO8 programs), as well as support for PI projects following the ERC/Synergy concept to generate new insights by “basic and preclinical cancer research” and serve as “feeder” for the programs listed. Increase in the number of academia‐initiated clinical trials (including diagnostics, medical oncology, radiation therapy, surgery and multimodal treatment) with a clear aim to improve survival and quality of life, with special emphasis on precision medicine and gender‐specific aspects.
The financial sustainability of cancer services as part of national health systems is a major challenge;1 oncology consumes up to 30% of total hospital expenditure and the amount spent on expensive ...cancer drugs is rising fast.2 In view of the pipeline of new drugs, these costs are likely to continue to grow.3 Apart from the risk of unequal access between European countries, burdening health systems with fast-growing costs for these drugs means that the sustainability of cancer care could be compromised. Some respondents referred to sensitivity around research funding; the centres that treat most patients with cancer are often cooperating closely with the pharmaceutical industry in undertaking translational drug research, and are at the same time confronted with the drug cost issue. ...we noted substantial price differences in the prices of cancer drugs in this illustrative example from 15 European countries. Lithuania Spain (n=2) France (n=2) The Netherlands (n=3) GDP per person 12 400 22 800 32 200 39 300 One 420 mg vial pertuzumab* Actual price N/A 2590·18 2891·10 3000·00 List or official price N/A 2910·58 2891·10 3000·00 One 100 mg vial rituximab* Actual price N/A 210·56 266·44 271·13 List or official price N/A 238·06 266·44 279·27 One 50 mg vial ipilimumab* Actual...
•ECCO essential requirements for quality cancer care (ERQCC) are position papers on delivering high-quality.•Each paper focuses on a cancer type, in this case oesophageal-gastric ...cancer.•Oesophageal-gastric cancers are highly demanding and complex to treat.•High-quality care can only be a carried out in specialised units or centres.•The essential, multidisciplinary details for such centres are set out by the ERQCC expert group.
ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe.
•Oesophageal and gastric (OG) cancers are a challenging tumour group with a poor prognosis and wide variation in outcomes among European countries. Increasing numbers of older people are contracting the diseases, and treatments and care pathways are becoming more complex in both curative and palliative settings.•High-quality care can only be a carried out in specialised OG cancer units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries.•It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality OG cancer service. The ERQCC expert group is aware that it is not possible to propose a ‘one size fits all’ system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with OG cancer.
...a cancer mission is being drafted by the European Commission,2 with some objectives most likely to be focused on the need to ensure quality of treatment, care, and research, and to create more ...comprehensive cancer centres and infrastructure.3,4 In Europe, many cancer centres, which act as hubs of interlocking clinical research networks, provide state-of-the-art cancer services. ...mechanisms for monitoring compliance with high-quality standards of care and translational research for cancer centres across Europe are crucial. Furthermore, some EU member states lag behind in the formation of comprehensive cancer centres. ...an aim for both the cancer mission and Beating Cancer Plan could be to establish at least one comprehensive cancer centre or large clinical centre in each small EU member state, and to have one comprehensive cancer centre for every 5–10 million people in the population in larger EU member states, as part of an integrated infrastructure.5 In 2008, the Organisation of European Cancer Institutes (OECI) created a quality assurance Accreditation and Designation Programme for cancer centres,6 which includes 50 of the largest cancer centres in 14 of 27 EU member states, plus Norway and the UK. The 100 OECI core standards are designed to cover essential requirements for the whole patient pathway from commencement in a cancer centre or hospital, to all forms of treatment and aftercare, education and training, and research which is crucial to accelerate changes in clinical practice.
PDF
