Over four years, 4P-CAN (www.4p-can.eu) will identify barriers to cancer primary prevention measures adoption by studying risk factors for cancer such as smoking, alcohol consumption, physical inactivity, excess body weight, HPV and HBV infections (preventable through vaccination) and environmental pollution. The project will gather evidence around individual adherence to healthy behaviours in countries from Eastern Europe such as Romania, Bulgaria, the Republic of Moldova, North Macedonia, Montenegro, and Ukraine.

“4P-CAN is a very timely project because it’s addressing the primary prevention of cancer in the context of the Cancer Mission recommendations, with the primary aim to develop a new model of personalised primary prevention, based on innovative approaches from the social sciences and humanities. It benefits from the expertise of 17 beneficiaries, from 11 countries. We know that cancer primary prevention is neglected and underfunded – only 5% of the research funds were spent on it in the last decade. On the other side, we have high expectations of the citizens to invest and to come up with more efficient solutions for cancer prevention. 4P-CAN answers to this need and aims to find new effective strategies to approach cancer primary prevention. Moreover, our consortium is highly representative at the European level, mixing Eastern and Western partners, and so being able to understand and address the East-West inequalities in cancer.”

Dr Marius Geanta, 4P-CAN Coordinator, President of the Centre for Innovation in Medicine

The 4P-CAN project is built on an innovative vision that seeks to understand the complex system surrounding the citizen and how it increases the risk of cancer on three levels – macro (at the national level), meso (at the community level), and micro (at the individual level). The project will follow the narrative of the European Code Against Cancer, implementing research, social sciences, and humanities with behavioural sciences to create personalized tools for the primary prevention of cancer. Based on project knowledge and implementation methods, 4P-CAN will establish two living labs, one in Romania and one in Bulgaria, targeting the adoption of preventive behaviours based on the 12 recommendations of the Code.

The 4P-CAN project is a collaboration among 17 organizations from 11 different countries, including the Balkan countries, which are European Union (EU) Member States and non-EU Member States, and Western EU Member States such as Portugal, Italy, France, Ireland, and Belgium.

For more information on the 4P-CAN project, please visit our social media platforms on LinkedIn and Twitter.

Contact: office@ino-med.ro

The #ECHoS consortium has the potential to bring the #CancerMission spirit, vision, and ambition to the Member States and at the societal level, very close to citizens. But only by understanding people’s needs and involving them in research and the immediate implementation of research results can we achieve better results than before.

We need to work together to generate and maintain a new mindset regarding cancer research, as well as the way prevention, screening, diagnosis, and treatment services are delivered to citizens and patients. Research should no longer be viewed as a luxury but as a critical part of cancer control in the 21st century.

The national hub structures must take into account the specificities of each country (or even the local or regional specificities), and cultural and social factors. Still, there will always be a common thread connecting them all, ensuring coordination, multi-directional dissemination of good practices, and continuous feedback mechanisms aimed at continuously improving quality.

We have the opportunity to generate unique, disruptive, and adaptive impact models, as they have never existed before, based on mapping, activating, and involving traditional and non-traditional stakeholders, in an approach to cancer as a societal problem.

An essential role will be played by specialists from non-traditional areas as well: social sciences and humanities, science communication, social innovators, digital media analysts, and so on.

In the complex picture of cancer, oncology research, and European and national initiatives (dozens of research projects approved by the EU in less than 2 years), we need a new type of leadership (distributed leadership; leadership as a process) to respond effectively.

Trust is a key word when considering new possible leadership models and when thinking about effective models for involving citizens in #CancerMission. It is essential to understand the mechanisms by which people’s trust is formed (in doctors, healthcare systems, decision-makers, or trust at the societal level), as well as their attitudes and perceptions of cancer, in order to create new, personalized models of communication, education, and engagement.

Cancer represents a global health challenge. It affects everyone regardless of gender, or even social status and is a tremendous burden for patients, families, friends, and societies. According to the European Cancer Information System, the incidence of cancer in Europe by 2040 is expected to increase by 20.96% and mortality by 31.76%. This means that if no further actions are taken, around 3.24 million people will be diagnosed, and 1.66 million people will die in Europe. In Romania, the mortality will increase by 13.6%.

Driving the Horizon Europe Mission on Cancer initiative is the ambitious goal to improve “the lives of more than 3 million people by 2030 through prevention, cure and for those affected by cancer including their families, to live longer and better”. This is also the driving force behind the project ECHoS, Establishing of Cancer Mission Hubs: Networks and Synergies.

ECHoS, a new, three-year European consortium supported by Mission on Cancer, will play a vital role in supporting the bold and inspirational goals defined by this European initiative. Bringing together the expertise of 58 leading organizations, from governmental, healthcare, research, academic, and non-profit sectors, this key consortium will ultimately provide member states and associated countries (MS/AC) with the capacity to create National Cancer Mission Hubs (NCMHs) gradually. These NCMHs, operating at national, regional, and local levels, will have a vital role in involving all relevant stakeholders, including citizens, in cancer-related policy dialogues.

“The fight against cancer can no longer be an isolated endeavor. Currently, research, innovation, and healthcare initiatives are largely siloed within specific communities and the engagement of citizens is either poor or non-existent,” said Dr. Anabela Isidro, member of the AICIB (Agency for Clinical Research and Biomedical Innovation in Portugal) board. “Supported by the European Beating Cancer Plan and the EU Mission on Cancer, cancer occupies a central place within the European political agenda. At the conclusion of the Conference on the Future of Europe, political leaders championed pan-European cooperation towards a Health in All Policies approach, and a data-informed, citizen-focused, research-driven agenda. The time to act is now.” She concluded.

Romania is represented by the Centre for Innovation in Medicine, which will collaborate closely with the consortium coordinators (AICIB) and leading experts across Europe, to establish a NCMH in our country. This combined effort will coordinate R&I and Healthcare actions on cancer with policy-making processes toward people-centric healthcare and research systems in ways that cannot be achieved through individual efforts and fragmented initiatives.

“The creation of national hubs of the Cancer Mission and their interconnection is a fundamental step for the Europe’s Beating Cancer Plan and the Mission’s action plan. The ECHoS project will generate in the next 3 years both models of governance and impact, as well as models of interaction with traditional and non-traditional stakeholders, but especially with citizens. Cancer Mission hubs must have real citizens at the center, start from their needs, and involve them in research, innovation, and implementation from the beginning and continuously. For this reason, the Cancer Mission is more than a mission that promotes cancer research, just as ECHoS is more than a European project – it is the beginning of a movement that involves 58 organizations from 28 countries, including the Centre for Innovation in Medicine”, said Dr. Marius Geanta, President of the Centre for Innovation in Medicine, and national coordinator of the ECHoS project. “Creating a National Cancer Mission Hub in Romania represents a key step towards strengthening the voice of national stakeholders in cancer policies in Europe.”

The recent COVID-19 emergency exposed the fragilities in health systems, halting research, arresting clinical trials, and forcing limited resource allocation to tackle these emerging needs. Still, it highlighted countries’ capacity to create functional synergies in health, policy, and research, successfully impacting the health scenario. With the Kick-Off Meeting occurring today, ECHoS will set the foundations for a strong and cohesive network of NCMHs among MS/AC aligned with the Mission on Cancer. ECHoS will break new frontiers, beyond established research and health systems, reaching from individual citizens to European Institutions, Civil Society, Social Sector, Academia, and Public and Private Sectors, improving the current landscape and setting a brighter future in cancer.

The Centre for Innovation in Medicine (INOMED) is an Associated Partner of the Project.

“We have many medicines at our disposal, but unfortunately, we still know too little about the categories of patients who can truly benefit from them. Personalized medicine has the potential to breathe new life into existing drugs that are not being used to their full potential, for the benefit of both patients and healthcare systems. We are honored to be part of the PRIME-ROSE project because it gives us the opportunity to learn from the best about personalized medicine in oncological practice, while at the same time preparing for the implementation of these approaches in the Balkan states to reduce East-West inequalities through innovation.”

Dr. Marius Geantă, President of INOMED

Sustainable and affordable precision cancer medicine across Europe

The PRIME-ROSE vision is access to affordable Precision Cancer Medicine (PCM) that prolongs life at the best quality possible for all cancer patients. PCM is an approach that depends on access to adequate molecular diagnostics and drugs to have an impact and move towards implementation in the national healthcare systems. Today there is inequality in access to PCM between and within EU countries, and while the promise of PCM is clear, implementation remains a challenge. This, in particular, affects cancer patients with the poorest prognosis who have exhausted all lines of standard-of-care treatment, those with tumors carrying rare mutations, and patients with carcinoma of unknown primary.

The PRIME-ROSE project builds on a bottom-up, clinician-initiated family of PCM clinical trials which have been particularly successful in bringing up inclusion rates to offer additional lines of treatment and in providing patient benefit. These trials share the pragmatic clinical trial design of the original Dutch DRUP trial, with broad inclusion criteria and a limited set of endpoints. However, the trials are still anchored into a national context and are funded independently. The result is a distributed DRUP-like clinical trial network that addresses local priorities while collaborating internationally for scale and impact.

Work to be done in PRIME-ROSE moving PCM forward in Europe

The consortium will use these existing adaptive and pragmatic clinical trial platforms to answer key questions regarding clinical effectiveness, provide health-economic evaluations, and contribute to scientific progress across cancers. In particular, the cross-country collaboration provided by PRIME-ROSE will build capacity as well as enable cross-trial data aggregation and analysis, initiate shared cohorts across borders, and provide health-economic evaluations. To ensure successful implementation, the consortium will work together with regulators, policymakers, payers, healthcare providers, and patient advocacy groups to implement evidence-based PCM in routine practice and address inequalities in access.

Altogether, this Europe-wide precision cancer medicine deployment will address key scientific and methodological questions to accelerate broad and equitable access to new and effective cancer treatments. The ongoing effort is already leading to harmonization, standardization, and pragmatic consensus.

Pan-European precision cancer medicine community: PRIME-ROSE project is led by Professor Kjetil Taskén, Head of the Institute for Cancer Research at Oslo University Hospital Comprehensive Cancer Centre in Norway.

PRIME-ROSE Consortium Partners:

1. Oslo University Hospital, Oslo, Norway
2. Leiden University Medical Center, Leiden, The Netherlands
3. Stockholm School of Economics, Stockholm, Sweden
4. Capital Region, Copenhagen, Denmark
5. Helsinki University Hospital, Helsinki, Finland
6. Centre Leon Berard, Lyon, France
7. IPOPORTO, Porto, Portugal
8. Region Uppsala, Uppsala, Sweden
9. The Swedish Institute for Health Economics, Lund, Sweden
10. Karolinska Institutet, Stockholm, Sweden
11. Region Skåne, Sweden
12. Heidelberg University Hospital, Heidelberg, Germany
13. Maria Sklodowska-Curie Institute of Oncology, Warsaw, Poland
14. University Hospital of Split (KBC Split), Split, Croatia
15. Tartu University Hospital, Tartu, Estonia
16. National Institute of Oncology, Budapest, Hungary
17. Vall D’Hebron Institute of Oncology, Barcelona, Spain
18. Center for Personalized Cancer Treatment (CPCT, DRUP trial consortium), hosted by Radboud University Medical Center, Nijmegen, The Netherlands
19. National Cancer Institute, Vilnius, Lithuania
20. Cancer Research UK, London, UK
21. University of Manchester, Manchester, UK
22. Trinity College Dublin, Dublin, Ireland
23. Masaryk Memorial Cancer Institute (MOU), Brno, Czech Republic
24. Center for Innovation in Medicine (CIM), Bucharest, Romania

Read the full report from the event, here.

The first session:

• Martine Ingvorsen, Policy Officer, Directorate-General for Health and Food Safety (SANTE), Public
  Health and Health Security Department
• Afonso Moreira, Public Health Expert, Portuguese National Health Institute
• Svetlana Nicolaescu, Ministry of Health State Secretary, Republic of Moldova
• Patrick Swain, Coordinator of the Coalition for Life-course immunization
• Laurent Louette, Director Public Affairs & Country Liaison, Vaccines Europe

The second session – Panel discussion with the representatives of the countries from EEVAX:

• Amina Kozaric, Professor, International Burch University, Faculty of Engineering and Natural
  Sciences, Department of Genetics and Bioengineering, Bosnia and Herzegovina
• Viktor Dombradi, Senior lecturer, Semmelweis University Health Services Management Training
  Centre, Hungary
• Viktor Semenov, Family Medicine Medical Doctor and Teaching assistant at the department of
  Social Medicine and Public Health, Dnipro State Medical University, Ukraine

Europe, June 2022. This is the third year of the Covid-19 pandemic, one of the turning points of humanity that impacted every level of our ”normal lives”. It can be seen as a barrier against what we thought was normal, as well as an opportunity to ReThink our Health and Build Forward Better.

In early March 2020, WHO declared the global pandemic Covid-19, and in late December 2020, the first Covid-19 vaccine became available in the European Union. Vaccination started at the same time, with enough doses, in every Member State. It was unprecedented. One year and a half since the Covid-19 vaccination campaigns started, the East-West divide is very large. Vaccine hesitancy is higher in CEE compared to Western Member States not just for Covid-19 vaccination, but also for other vaccine types (e.g., HPV). CEE countries have experienced one of the highest mortality and fatality rates from Covid-19, an indicator of vulnerable health systems inadequately prepared to respond to the pandemic crisis (highlighted for many years in the European Semester).

We are witnessing an „iron curtain of vaccination” in Europe, rooted in a common historical background of CEE countries. Studies suggest that Covid-19 vaccination hesitancy is related to low trust in governments and political establishments as a consequence of common cultural factors. The Berlin Wall, which has divided Europe for decades, fell in 1989. In terms of vaccination, the ”Iron Curtain” still persists, after decades in which Eastern European countries have either become EU members or are on their way to EU membership. Unfortunately, the ”iron curtain of vaccination” is not unique to Covid-19, although it came to the public’s attention as an emergency to be resolved during this pandemic. The same inequalities can be observed in other types of vaccination, with HPV vaccination being one of the most notable.