PM+: Global cancer research era offers patients new hope

Written by Fortunato Ciardiello and Alexandru Eniu on 17 July 2015 in Opinion Plus
Opinion Plus

Cancer is a global scourge requiring a global solution, say ESMO's Fortunato Ciardiello and Alexandru Eniu.

Cancer doesn't care about someone's nationality. In fact it exhibits a total disregard for borders, geographic boundaries, or socioeconomic status.

It strikes on every continent without discrimination. Cancer is a global scourge, and so requires a global solution. For a long time cancer research projects were nurtured within individual laboratories, each striving to be the first to achieve a ground breaking discovery.

But the advent of the internet is allowing and encouraging cancer researchers around the world to join forces to bring the best quality medicine to patients.


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Big data is transforming so many aspects of life, so it should come as no surprise that it is doing the same for cancer research. No longer are we restricted to working with limited patient data from within our own borders.

As information and communication technology transcends those borders, researchers are now able to access and share vast amounts of data, and to find meaningful answers to questions that we were never able to pose in the past because the information simply wasn't there.

This new global era of cancer research is working hand in hand with the development of personalised cancer therapies, offering hope to patients with relatively rare cancers and cancer subtypes.

Our rapidly advancing knowledge of the pathophysiology of cancer and techniques mean that for the first time, we have treatments that can help these patients. However, researchers still face the often insurmountable challenge of finding enough rare patients to participate in clinical trials of relevant targeted treatments.

But by expanding cancer research networks globally, we can find these patients wherever they live, and through collaboration with local oncology researchers and research institutions, bring these isolated individuals into large, suitable-powered clinical trials. This global approach is also important in expanding cancer research and treatment into populations that have been previously neglected.

In the past, cancer research often focused on populations in the developed world, in big industrialised nations. As a result there has been a gap in our understanding of cancer biology, particularly for cancers that are more prevalent in emerging economies.

It has also meant that cancer patients in these developing nations have been missing out on many of the advances that cancer patients in the developed world now take for granted. This disparity between rich and poor has denied many patients access to the treatments viewed as the basic standard of care. Clinical trials therefore not only provide an opportunity for research in these underrepresented populations but also give patients in developing nations access to the highest standards of care available across the world.

It's not only patients who are benefiting from increased collaboration across borders. Young oncologists now have access to training from the very best specialists around the world, through training and educational initiatives such as the European Society for Medical Oncology's (ESMO) fellowships programmes.

This new era of trans-national collaboration is not without its challenges, while cultural and linguistic boundaries will continue to make some collaboration more difficult than others. In some parts of the world, patients still view clinical trials with suspicion and are reluctant to volunteer themselves as guinea pigs. Doctors also may face the difficulty of entrenched beliefs in traditional and alternative healing practices that often mean patients hesitate to even consult a doctor in the first place.

However, organisations such as ESMO are well placed to help researchers overcome these issues. With its territory spanning so many countries, cultures, languages and ethnicities, we have unique cross-cultural experience.

Expanding the horizons of cancer research to regions such as Asia and Africa is no more challenging than working through the differences from one side of Europe to the other.

We are also well placed to work with organisations around the world to harmonise the laws governing clinical research and data protection, which have been a sticking point for many cancer researchers trying to access de-identified patient data for retrospective analysis.

As an organisation representing members from over 130 countries, ESMO can uniquely serve as a multi-national and multi-cultural voice for the cancer community: serving researchers, clinicians, and through them, cancer patients. We have already invested in initiatives such as the first ESMO Asia Congress in Singapore in December 2015 and the emerging countries committee.

With its feet firmly planted in Europe, we believe that ESMO is at the forefront of this new global movement of cancer collaboration.

About the author

Fortunato Ciardiello, MD, PhD is Professor of Medical Oncology at Seconda Università di Napoli in Naples, Italy. He is currently also the Director of the Specialty Programme in Medical Oncology and ESMO President-elect.

Alexandru Eniu is a senior medical oncologist at the department of breast tumours at the Cancer Institute "Ion Chiricuta" in Cluj-Napoca, Romania, where he is also the head of the day hospital unit.

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