Speed up progress toward a cure appeal
An appeal for international action to speed up progress towards curing cancer
Progress towards developing cancer treatments that are effective and affordable is being seriously undermined by reliance on unsuitable business models, which reward low-risk, high-cost, incremental benefit approaches to drug discovery and development, and discourage true innovation and collaboration.
We participants in the World Oncology Forum 2014 call on governments, policy makers and international agencies to effect a change in the ecosystem of discovery and development of new cancer therapies, to incentivise innovative research aimed at cure or long-term control of cancer with a good quality of life and discourage wasting resources on 'me-too' therapies and on therapeutic strategies that fail to address the ability of cancers to evolve and develop resistance.
This will require:
1. A package of measures to promote sustainable new models of public–private partnership, to be developed in consultation with all stakeholders, including insurance agencies and research charities/foundations, that:
- Invest substantial public funds in the public/not-for-profit sector to carry out drug discovery and early development work
- Incentivise industry to partner with public/not-for-profit research entities from an early stage, e.g. through tax incentives and profit sharing, including the sort of multilateral partnerships that will be needed to develop and test novel combination therapies
- Require clinical trials to satisfy public interest criteria to avoid recruiting patients to, and wasting resources on, trials that:
- are unlikely to show significant benefit to patients or health services in relation to expected risks or costs, and/or
- fail to address important clinical questions that could not otherwise be answered, eg about the benefit/risk of use in different rational combinations, different durations of administration, and different stages of disease.
- Move to a system of setting prices through negotiation, at national, regional (eg EU-wide) or even international level (eg following the GAVI model for vaccinations) designed to:
- reflect the magnitude of benefit to patients and health systems, defined according to indication
- take into account the contribution to discovery and development costs made by public funding as well as the manufacturer
- allow for flexibility in pricing as evidence on value builds, and
- in the case of essential therapies, take account of ability to pay.
- Make access to such differential pricing systems conditional on governments adopting transparent and verifiable systems to ensure they are used as intended in the populations for which they were intended.
2. Improving the way new cancer therapies are evaluated for their clinical benefit/risk and their overall value to patients and health services, through
- Investing in data gathering of clinical and patient-reported outcomes in general populations and clinical settings (through public-private partnerships where appropriate)
- Adopting adaptive/staggered procedures that allow decisions on access to the market and adoption into clinical practice to be re-evaluated as the evidence base develops
- Investing in regulatory science to improve regulatory/HTA tools and procedures used.
3. Changing the way academic research is rewarded to incentivise:
- Collaboration and team building above individual status and gain
- Scientific innovation rather than 'safe' research in familiar territory
- Basic/translational/clinical research geared towards making an impact on the way
Matti Aapro, Dean of the Multidisciplinary Oncology Institute, Genolier, Switzerland, and Executive Board member of the International Society for Geriatric Oncology (SIOG) and of the Multinational Association of Supportive Care in Cancer (MASCC)
Christopher Booth, Canada Research Chair in Population Cancer Care, Department of Oncology, Queen’s University, Canada
Franco Cavalli, Chair of the Scientific Committee of the European School of Oncology, Italy and Switzerland, Medical Director of IOSI, the Oncology Institute of Southern Switzerland
Eduardo Cazap, Founder and first President of the Latin-American & Caribbean Society of Medical Oncology (SLACOM), executive board member of the National Cancer Institute of Argentina
Thomas Cerny, President of Oncosuisse and Director of the Oncology Center, St Gallen, Switzerland
Alberto Costa, Scientific Director of the European School of Oncology, Italy and Switzerland
Alexander M.M. Eggermont, General Director of the Gustave Roussy Cancer Centre, France
Mary Gospodarowicz, Immediate past President of the Union for International Cancer Control (UICC) and Director of the Princess Margaret Cancer Centre, Canada,
Augustin Lage, Director of the Center of Molecular Immunology (CIM), Cuba
Jonathan Licht, Chief of Oncology/Haematology, Northwestern University, USA
Ian Magrath, Director of the International Network for Cancer Treatment and Research, Belgium
Alex Matter, CEO of the Experimental Therapeutic Centre & D3, A*STAR, Singapore
René Medema, Scientific Director, Netherlands Cancer Institute (NKI), The Netherlands
Hitoshi Nakagama, Director of the National Cancer Center Research Institute, Japan
Jakob Passweg, Chair Swiss Cancer League and head of Haematology, University Hospital Basel, Switzerland
Pier Giuseppe Pelicci, Scientific Co-Director and Chairman of Experimental Oncology Department at the European Institute of Oncology, Italy
Martine Piccart, President of ECCO (European Cancer Congress) and Medical Director of the Institute Jules Bordet, Belgium
Bob Pinedo, Professor Emeritus VU Medical Center, The Netherlands, and chair of Fundashon Prevenshon, Curacao
Luiz Antonio Santini, Director General of the Brazilian National Cancer Institute (INCA) Brazil
Richard Schilsky, Chief Medical Officer and past President of the American Society of Clinical Oncology (ASCO), USA
Paul Workman, Director, Institute of Cancer Research, UK
The Treat the Treatable appeal is available as a pdf in: