'Investigar, educar, dialogar. Las lecciones que aprendimos de José Mariano Gago (1948-2015)'. Con este título celebramos los días 1 y 2 de junio de 2016 en la Fundación Ramón Areces un simposio para homenajear la trayectoria de quien fue ministro de Ciencia y Tecnología (1995-2002) y ministro de Ciencia, Tecnología y Educación Superior (2005-2011) de Portugal. Gago desempeñó una labor crucial en el diseño de los planes de desarrollo de la ciencia, la tecnología y la innovación, no solo en su país sino en toda Europa.

1. Shaping EU Cancer Research Policy:
Towards a Virtual European Cancer
Institute
Julio E. Celis
European Academy of Cancer Sciences,
EurocanPlatform, and Danish Cancer
Society Research Centre
Madrid, June 1st, 2016

2. Overview
 Cancer: A growing problem.
 Building a concerted approach to cancer
research in Europe: A chronological account
of the steps leading to the creation of Cancer
Core Europe.
 Cancer Core Europe, a first step towards a
virtual European Cancer Institute.
 Next steps and Conclusions.

3. Cancer: A Growing Problem
Cancer is one of the major health
issues affecting our societies.
And the situation is set to worsen
globally as the population ages!
The number of new cancer patients in Europe alone will
increase from 3.6 to 4.3 million in the next two decades!

4. Today’s Cancer Research Paradox
– Significant progress in research and
better understanding of biological
processes underlying disease
pathogenesis.
– Yet, slow translation of research
discoveries into concrete benefits for
patients.

5. The pathways through which discoveries
translate into applications for the
benefit of patients are complex and
difficult to manage, and there is lack of
coordination at the European, national
and regional level that is detrimental to
the progress of scientific knowledge and
quality of care.
A Simple Explanation for this Paradox

6. Translational Cancer Research Continuum
Basic research/
cancer biology
Preclinical
research
Clinical
research Late
translational
research
Adoption in
the health
care systems
Gap1 Gap 2
BASIC/PRECLINICAL RESEARCH
-molecular cell biology, genetics, etiologic
epidemiology
- target discovery & biological validation,
- new anticancer agents,
- biomarker discovery,
- animal models,
- preclinical validation
CLINICAL RESEARCH
- early clinical trials,
- stratification of patients,
- omics technologies,
- imaging,
- bioinformatics,
- pharmacology,
-biostatistics,
-clinical /prevention research
LATE TRANSLATIONAL RESEARCH
-clinical validation – assessment of
clinical effectiveness,
- health economics

7. Barriers to Translational Cancer Research
 The complexity and heterogeneity of cancer which comprises many
different diseases.
 Inadequate research coordination at national, regional, and EU level.
 Short-term research funding.
 Regulatory, educational, workforce, and sustainability issues.
 Inadequate collaboration with the industry.
 Modest support for high-end technology platforms.
 Lack of venture capital.
 Lack of models to reward team efforts.
 Insufficient collaboration between DG SANTE and DG Research and
Innovation (including national research and health ministries).
As a result of these barriers, the translational process is slow, inefficient, and
expensive.

8. There is an urgent need to structure
translational research in order to
harness the potential that continues to
emerge from increasing knowledge,
and develop effective new tailored
treatments that meet the needs of
the patients, and are affordable for
the healthcare systems

9. Building a Concerted Approach to Cancer
Research in Europe: A Chronological Account
of the Steps Leading to the Creation of
Cancer Core Europe

10. 2002
Conference ”Towards
Greater Coherence in
European Cancer
Research”
2002
P. Busquin created
the European
Cancer Research
Area (ECRA)
FP6 started
2004
EC Working Group on
the ”Coordination of
Cancer Research in
Europe”
2005
Funding of the
Eurocan+Plus Project
in FP6 (2006-2007)
c
2008
Eurocan+Plus
report
c
Key Early Events (1)

11. Private Sector
ECRA
Member StatesEuropean
Parliament
Cancer community
Universities/Hospitals/Centres
Ethical/Legal
Bodies
European Commission
Funding
Agencies
Patient
Organisations
Regulatory Bodies
P. Busquin: “ECRA will be what you make of it”
ECRA Stakeholders

12. ?
FP7
had already
started
2002
Conference ”Towards
Greater Coherence in
European Cancer
Research”
2002
P. Busquin created
The European
Cancer Research
Area (ECRA)
FP6 started
2004
EC Working Group on
the ”Coordination of
Cancer Research in
Europe”
2005
Funding of the
Eurocan+Plus Project
in FP6 (2006-2007)
c
2008
Eurocan+Plus
report
c
 One of the main recommendations of the Eurocan+Plus
project was the creation of a platform for translational
cancer research composed of interlinked cancer centres
with shared infrastructures and collaborative projects, to
facilitate rapid advances in knowledge and their translation
into better cancer care.
 A European Cancer Institute was discussed and agreed
upon, provided it would be a virtual structure.
 The role of the Comprehensive Cancer Centres (CCCs)
was considered critical as they integrate research and
health care.
Key Early Events (2)

13. The Stockholm Declaration: Pledge
from Cancer Centres Leaders
Encouraged by the outcome of the Eurocan+Plus project, the directors of
16 leading European cancer centres met in Stockholm in September 2008
to define the platform for translational cancer research concept and to
discuss steps towards its implementation.
To mark their commitment to work towards its realization, they published
a manifesto “the Stockholm Declaration”, clearly stating their
intention to join forces and share resources.
At a meeting at the UNESCO headquarters in Paris in 2008 sponsored by
the Danish Cancer Society, the ISE, and UNESCO, the first steps towards
moving the “Stockholm Declaration” into reality were discussed with
various stakeholders.
At this point, it became necessary to engage cancer organizations and
policy advisers to accelerate the process

14.  Oncopolicy Committee (scientists and
political advisors) and Patient
Advisory Committee (Patient
Advocates)
 European Academy of Cancer
Sciences (EACS) (evidence-based
advice)
 Annual Oncopolicy Forum/ECCO
Congress (common insight to fight
cancer)
ECCO’s Policy Committee Advisors:
 Philippe Busquin, former Member of the
European Commission with responsibility
for research.
 José Mariano Gago, former Portuguese
Minister of Science, Technology and Higher
Education.
 Frank Gannon, Former Director of EMBO
 Peter Lange, Former Director General of
Health and Life Sciences, German Federal
Ministry of Education and Research.
 Federico Mayor-Zaragoza, Former Director-
General of UNESCO

15. The EurocanPlatform Network of
Excellence (2011-2015)
As a result of the Eurocan+Plus project recommendations and support
from the cancer community, the EurocanPlatform Network of
Excellence was funded by the European Commission in 2011.
The mission of the Consortium was to create a translational cancer
research platform aimed at promoting innovation in prevention,
early detection, therapeutics and outcome research, with a focus
on personalised cancer medicine.
A long-term goal of the Platform was the creation of a virtual
European Cancer Institute, having the critical mass of expertise,
resources, infrastructures, and number of patients that is needed to
innovate and perform in all areas of cancer research.

16. Participants (1)
 CNIO, Madrid
 NKI, Amsterdam
 Norwegian
Radiumhospital..
 Cambridge Research Inst…
 Danish Cancer Society
 Inst Jules Bordet
 Erasmus… Rotterdam
 Manchester Cancer Re
 EIO, Milan
 Istituto Nazionale… Milan
 Institute Curie, Paris
 IGR, Villejuif
 DKFZ, Heidelberg
 NIO, Budapest
 Oxford University
 IARC, Lyon
 EMBL, Heidelberg
 Karolinska Inst, Stockholm

17. Participants (2)
 ICR, Royal Marsden
 Leiden Univ Med
center
 FIVO, Valencia
 Istituto tumori, Bari
 Vall d’Hebron,
Barcelona
 eCancer.eu
 ECCO
 OECI
 ECPC
 EORTC
A main outcome of the EurocanPlatform was the establishment of Cancer
Core Europe, a consortium of six elite cancer centres with a particular
focus on the development of therapeutics.

18. Cancer Core Europe, a First Step
Towards a Virtual European Cancer
Institute

19. Cancer Core Europe
Gustave Roussy Cancer Campus Grand Paris
Cambridge Cancer Centre
Karolinska Institutet
Netherlands Cancer Institute
Vall d’Hebron Institute of Oncology
German Cancer Research Centre with its comprehensive
cancer centre: the National Centre for Tumour Diseases
The creation of Cancer Core Europe was spearheaded by A. Eggermont
and O. Wiestler.
http://www.cancercoreeurope.eu/index.php

20. Objectives
 Carry out joint translational and clinical
research.
 Conduct next-generation clinical trials.
 Drive the development of new treatments
and early diagnoses for patients, and
more efficient cancer prevention for
Europe’s citizens.
 Create a virtual European-wide Cancer
Institute.
From A. Eggermont

21. Critical Mass of Patients
 They see 60.000 newly diagnosed
cancer patients.
 Provide 3,000.000 cancer treatments.
 Perform about 1.000.000 outpatient
visits.
 Conduct more than 1,500 clinical trials
among the six centres.
From A. Eggermont
Yearly:
Create a virtual E-Hospital

22. Cancer Core Europe Highlights
 Scientific, societal, and political relevance.
 Integration of national research programmes.
 A critical mass of expertise, patients and highly developed
research infrastructures.
 Task forces on data sharing, molecular diagnostics,
immuno-oncology, imaging, clinical trials and training &
education.
 Annual Conference.
 Attractive to the pharmaceutical industry.
 Legal entity.
 Exclusive at the start, to become inclusive in the long-term.

23. CCC
Industry
The EurocanPlatform in
collaboration with the
EACS developed quality
criteria and methodologies
for the designation of
CCCs of excellence to
further quality assure
cancer research centres.
CCE:Therapeutics
Participation of Additional Centres
C1
C1
C2
C3
C4
C5
C6
C7
C8 CCC
CCC
CCC
CRI
CRI
CCC
CRI
CCE

24. Integrating Other Geometries
Therapeutics
Outcomes
research
Prevention Early detection
The methodology used for CCE could pave the way
towards structuring other geometries. However, there
is no ‘one-size-fits-all’ solution to coordinating
research in all areas.

25. Next Steps and Conclusions

26. Sustainability: A Work in Progress
 The success of the Cancer Core Europe will very much
depend on achieving sustainability. The first step has
already been taken by allocating their own resources
to kick start the process.
 The next step is to identify “Champions” among the
corresponding Member States, and to work with them
and the Commission (Article 185 of the Treaty) to define
a methodology that would ensure sustainability in the
long-run.

27. A new Path for Europen Research
and Innovation Policy
In 2015, Commissioner Carlos Moedas established three
strategic priorities to invigorate ERA: Open Innovation,
Open Science, and Open to the World, and appointed
a group of scientists (RISE HLG) that advice him.
The RISE-HLG on Open Science has chosen funding
mechanisms as one of three thematic priorities, and a
policy paper on ”Translational Oncology” (case study)
is currently under preparation.

28. Conclusions
 The establishment of the Cancer Core Europe - more than twelve
years since the strategic developments triggered by the EC, the EP,
and the cancer community – is a very significant milestone in the
quest towards expediting the implementation of new discoveries
and technologies into clinical practice.
 The eventual creation of a virtual ECI in the long-run may pave the
way towards the establishment of a European Institute(s) for
Health Research, similar to the NIH in the USA.
Research communities, policymakers, and other stakeholders must work
hand by hand to provide patients with the treatments and diagnostics that they
rightly demand.

29. I would like to finish the presentation by acknowledging
the guidance, vision, leadership, and encouragement
provided by José Mariano Gago during the various
phases of the process I described.
Mariano, strongly believed in the power of building
communities to deal with major societal challenges!
José Mariano Gago (1948-2015)

30. Together we can make a difference!
Thank you for your attention!