Getting personal: Accelerating personalised and precision medicine integration into clinical cancer

7 Jun 2024
Getting personal: Accelerating personalised and precision medicine integration into clinical cancer

Strong commitment to translational research over the last 10 years has led to many of the personalised medicine innovations being introduced today.

While these innovations are being introduced to the market, they are not getting to patients fast enough, if at all. Many of these innovations are supported by robust evidence published in top-tiered journals and presented at major congresses, but information on the applicationof these innovations is not getting disseminated fast enough, in the right context, nor to the right audiences.

This interview sees Denis Horgan, Executive Director of the European Alliance for Personalised Medicine talk to Giuseppe Curigliano, Chief of the Division of Early Drug Development, European Institute of Oncology, Italy on the topic of translational innovation

You mention innovation in your presidential mission statement. Everyone talks about embracing innovation, so what is your take on it?

You saw what was announced at ASCO last week? Real promise from two radical new treatments for NSCLC. That is real innovation in hardware. But what counts now is how soon that is translated into better outcomes for patients beyond the world of clinical trials – how soon the innovative hardware is brought into the healthcare system. And this is where years are wasted, because systems are not geared to grasping the significance of new treatment
options, and often fail to adopt them promptly – and particularly in Europe.

What do you see as the role of an ESMO president in easing that delay?

Effecting positive change in any area of healthcare in Europe is inevitably complex because of diverse national approaches and split responsibilities – as I know well from more than a decade of high-level engagement in European science and medical organisations. The key is collaboration among those whose goals overlap, even though they may not be identical. The challenges are so wide that no single organisation – not even one as powerful and
influential as ESMO – can do it alone.- In talking of leveraging technology and innovation we are talking of enhancing healthcare infrastructure, capacity-building, promoting artificial intelligence, precision medicine, digital health solutions, optimizing treatment strategies – and funding access. This is why I emphasise teamwork, both within ESMO and between ESMO and other significant players in the European healthcare scene.

Give me examples of shared interest and teamwork.

Alongside scientific and medical collaboration, tackling policy issues are essential to reach that goal of better patient care. So ESMO has been working together with organisations such as the European Alliance for Personalised Medicine – a multi-stakeholder group of scientists, patients and technology developers – which helps to get personalised medicine on the political agenda at EU level, and in keeping the person in personalised medicine in EU
healthcare discussions. The coincidence of the European Parliament elections with the ESMO presidential election is a timely reminder of the constantly changing political context that affects all our work – and over the coming months Europe will also appoint a new European Commission and make strategic decisions over its priorities for the next decade.

How does that relate to ESMO?

My extensive exposure to European decision-making has convinced me of the need for ESMO – and the cancer community – to be politically aware and active. Just last week, controversy over the balance between regulatory rigour and encouraging innovation emerged from uncertainties at the EMA (where I have served myself on scientific committees) over evaluation of orphan drugs: Eurordis (the major rare disease patients group), called for the European Commission to organise a public discussion to ventilate the issue. This is precisely the sort of discussion where ESMO should be involved – and that
requires teamwork and partnerships. Again, consultations are ongoing at present on the final shape of new European legislation on health technology assessment – a crucial element in making innovations available to patients. This too is where ESMO must contribute.

Give me more examples of how you plan to foster innovation in cancer care.

I have also been closely involved in workforce development, and as ESMO president I would expand ESMO's educational programs, bringing to bear comprehensive resources and opportunities for continuous learning and skill enhancement. This is not only to improve individuals' career development, but because clinicians need to understand the power of novel approaches, and they need guidelines and training facilities to provide continual updating. Otherwise they will not be integrating valuable options into their diagnosis and care.

Similarly, I have consistently advocated – and implemented – collaborations designed to overcome challenges in integrating diverse oncology disciplines and in ensuring effective links to other key stakeholder groups with similar aims, including patients and industry.

What about the rest of the world? You speak in your manifesto of "ensuring optimal care for cancer patients, worldwide."

The challenges are of course wider than Europe and the richer countries of the world. Advances in care options offer profound advantages to poorer countries too – on condition that they are made available there. This is why I have worked for years on the ESMO Global Policy Committee and the International Cardio-Oncology Society, and why my global network provides me with channels of contact with and attention to low- and middle-
income countries. It is also why one of my declared mission intentions is to establish an ESMO hub dedicated to fostering opportunities and advancing careers of young oncologists equalizing the playing field for talented oncologists worldwide.