Denis Lacombe, John Bean and Mathilde Fenoulhet from the European Organisation for Research and Treatment of Cancer (EORTC) outline how clinical trials play an integral role in tackling cancer…
The European Organisation for Research and Treatment of Cancer (EORTC) is a European, academic, cancer clinical research organisation. A leader in promoting multidisciplinary cancer research, the EORTC is today one of Europe’s leading players in facilitating the passage of experimental discoveries into new treatments for patients with a view to prolong survival and improve quality of life.
Optimising multimodal cancer treatments
The EORTC has been able to improve the standard of cancer treatment by testing more effective therapeutic strategies based on combinations of drugs and/or surgery and/or radiotherapy that are already in use and also through the development of new drugs and other innovative approaches. Its trials not only improve treatment efficacy with the use of new and significantly more efficient drugs for treating cancer but are also important in identifying useful clinical and biological parameters to adapt treatment strategies.
Importance of international academic clinical trials
The work of the EORTC also fills an important niche in the clinical trial landscape; its international academic trials can address common and devastating malignancies where even a small improvement in survival would have a major impact on public health. They promote cross fertilisation, standardisation of reference treatments, and harmonisation of quality assurance across borders. These international trials play an important role in studies involving rare tumours. The low incidence of these makes international cooperation obligatory, and the EORTC’s broad network of clinical trial expertise makes conducting these studies practical. Indeed, the EORTC addresses a wide range of unmet clinical situations, specific populations, rare tumours, dose de-escalation, quality of life, etc., in fact, a whole host of studies which do not fall within the scope of the pharmaceutical industry.
Quality assurance is another hallmark of EORTC clinical trial research
The quality of radiotherapy can substantially impact overall therapeutic strategy. The integrated radiotherapy quality assurance platform takes into account everything needed to develop truly effective combined treatment modalities. Here, the EORTC harmonises radiotherapy treatment techniques between centres, standardises credentialing of modern radiotherapy techniques, and enhances compliance with the trial protocol and cost effectiveness, and increases public and regulatory acceptance of the drug effect. Surgery is an important discipline in cancer treatment, and the SURCARE quality assurance in surgery partnership between the EORTC and the European Society of Surgical Oncology provides opportunities to conduct prospective studies that will lead towards improvements in the quality of surgery in cancer clinical trials.
Quality Assurance in Medical Imaging is also important, because reliable, non-invasive staging of disease and response to therapy is crucial for patient management. The EORTC Imaging Platform ensures proper implementation of the different medical imaging modalities, protocol and imaging guideline compliance, quality control of scans, analysis of deviations, and process improvements for clinical trials.
Access to human biological materials, in sufficient quality and quantity and linked to high quality clinical data is essential to accelerate clinical and translational cancer research. In this respect, all EORTC studies and projects comply with all applicable ethical and legal requirements and quality assurance requirements regarding the collection of human biological materials. All human biological materials collections are stored in a validated storage facility and comply with the EORTC’s Human Biological Material Collection, Storage and Use policy.
An international leader in addressing quality of life issues
Quality of life results from clinical trials have had a positive impact on clinical practice in the treatment of numerous diseases such as brain, breast, melanoma, lung and ovarian cancer. The EORTC performs studies on Health related quality of life at the individual patient level and as a prognostic factor, and it has set global standards for translation, cross cultural adaptation, and computer-adaptive testing. The Quality of Life Core Questionnaire, the QLQ-C30, is one of the most widely used cancer specific health related quality of life questionnaires in the world. This questionnaire has been translated and linguistically validated into more than 90 languages and extended with over 40 validated modules for specific diseases.
Challenges ahead
The identification of molecular alterations in the cancer, and the possibility to specifically and selectively target them, has dramatically improved treatment efficacy in cancer patients. Cancer genetics has led to increasingly fragmented populations eligible for specific treatments. Precision medicine targets specific sets of molecular alterations, only useful for the relevant subsets of patients.
The EORTC has embraced this change with a strategy to first understand the biology and then propose a clinical trial and not the other way round. Through SPECTA – Screening Patients for Efficient Clinical Trial Access – oncologists can now allocate patients to clinical trials based on both their clinical characteristics as well as the molecular profiles of their tumours. Programs such as SPECTA will help advance treatments for diseases that were previously seen as a single entity. Moreover, such Pan-European research efforts involve partnerships with a variety of stakeholders including not just academic groups and learned Societies, but also patient organisations, cancer leagues, regulatory agencies and the pharmaceutical industry. Involvement in these endeavours enables the EORTC to pursue its mission and shape the future of cancer therapy.
Denis Lacombe
Director General
John Bean
Medical Science Writer
Mathilde Fenoulhet
Fundraising Manager
The European Organisation for Research and
Treatment of Cancer (EORTC)
Excellent that the EORTC are leading QOL research, and have helped guide others, with their impressive papers and impressive collaborations We would like to see more on this topic.