ECCO 2019 European Cancer Summit

European Cancer Care: Across Borders

The ECCO 2019 European Cancer Summit on 12-14 September 2019 in Brussels, Belgium brought together worldwide leaders from cancer care, research, patient advocacy and public-private sectors in a unique multi-stakeholder forum. The theme of the second edition of the 2019 Summit is: “European Cancer Care: Across Borders”.

12 September 2019 12:00 - 18:00 13 September 2019 9:00 - 18:00 14 September 2019 9:00 - 17:00

Brussels Marriott Hotel
Rue Auguste Orts 3-7 1000 Brussels Belgium

Reaching the 70:35 Vision for cancer – 70% long term survival for all cancer patients across Europe by 2035 – requires breaking down the borders of cancer care: between countries, professions, sectors and stakeholders.

The ECCO 2019 European Cancer Summit:

- Debated leading-edge ideas in achieving improvement in cancer care

- Determined consensus resolutions for improving health care systems

- Decided on an action plan for the way forward to ensure ideas translate into policies that will impact daily clinical practice

Related Resources

  • Download the Summit Report
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  • View the Summit Webcasts
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  • 13:00 - 14:00

    Since we met last time

    Moderated by ECCO 2019 Summit Co-Chairs: Prof Philip Poortmans, President of the European CanCer Organisation (ECCO) and Dr Ian Banks, ECCO Board Member and Chair of the ECCO Patient Advisory Committee After a welcome and introduction, the opening session featured a report back on elements of progress made in respect to the themes and issues given attention at the ECCO 2018 European Cancer Summit. In respect to resolutions for action passed at the ECCO 2018 Summit: -Prof Mehmet Ungan, President of WONCA Europe, outlined ongoing activities to achieve greater integration of primary care contribution to improving cancer patient outcomes. -Simon Oberst, Chair of the Organisation of European Cancer Institutes (OECI) Accreditation & Designation Programme, spoke to OECI and ECCO activities to help continually move forward quality of cancer care in all European countries. -Prof Françoise Meunier, Vice President of the Federation of European Academies of Medicine (FEAM), updated on key legislative achievements in 2019 in respect to protecting cancer survivors from financial discrimination. Additionally: Kathy Oliver, Co-Director of the International Brain Tumour Alliance (IBTA) and Vice-Chair of the ECCO Patient Advisory Committee, shared recent work of the All.Can initiative, including a recent report of a survey of almost 4,000 people affected by different cancers across 10 countries. More information here. -Prof Yolande Lievens, Past President of the European SocieTy for Radiotherapy and Oncology (ESTRO), provided an update on how principles of value based healthcare can achieve greater application to non-systemic treatment areas. More information here.

  • 14:00 - 15:30

    ‘Putting a person on the moon’: How to deliver mission orientated cancer activity

    Moderated by Professor Mark Lawler, Queen’s University Belfast & Vice President of the European Cancer Concord, and Gilliosa Spurrier-Bernard, ECCO Patient Advisory Committee & Melanoma Patient Network Europe. The MEPs Against Cancer (MAC) group has recently stated that Beating Cancer is ‘Mission Possible’. https://bit.ly/2GpHoqV ECCO couldn’t agree more. But with a wealth of micro and macro missions stated on cancer, both nationally and internationally, what is the secret to implementation success in reaching ambitious goals? The session examined, variously, EU mission activity on cancer, sector and tumour specific targets for improvement, and the goal orientated approaches employed by ECCO member societies and patient associations. How can multi-sectoral and multi-disciplinary action be effectively harnessed and targeted towards obtainment of a shared goal in cancer? What have we learned so far, and what are the secrets of mission success? 3 scene-setting presentations opened up the principal discussion points: -Dr Jan-Willem van de Loo, Scientific and Policy Officer at the European Commission’s Directorate-General for Research and Innovation provided update on the background and current status of the EU Cancer Mission. -Prof Thierry Philip, President of the Organisation of European Cancer Institutes (OECI), which has been convening stakeholder organisations for consensus positioning on cancer mission related matters (see special edition of Tumori Journal, June 2019), will speak to the need for “A mission to fight inequalities in cancer all over Europe”. -Prof Mark Lawler of Queen’s University Belfast and the European Cancer Concord, spoke to the work of the Lancet Oncology Cancer Groundshot, highlighting the cost-effective, practical and proven measures for greatly improving outcomes in the fight against cancer that still remain to be fully taken up across Europe. Panel perspectives were thereafter be provided by: -Prof Gilles Vassal, Past President of the European Society of Paediatric Oncology (SIOP Europe) -Prof Véronique Trillet-Lenoir, MEP, Liste Renaissance, France
  • 16:00 - 18:00

    Resolution Session: Eliminating HPV related cancers

    Moderated by Prof Daniel Kelly (ECCO Board Member, Past President of EONS) The goal of eliminating HPV related cancers is a mercifully obtainable one, but requires a truly multi-stakeholder and multidisciplinary effort to achieve. How close are we to reaching this goal? What still stands in the way? Can a fresh consensus and coalition for action be expressed and formed via the Summit session? Co-led with the European Society of Gynaecological Oncology (ESGO), the session investigated such matters as gender neutral vaccination, the economic evidence for prevention actions, and relevant and recent EU and national experiences in respect to combatting limiting factors such as the spread of ‘fake news’ about vaccination. Part 1 of the session (“the Global Picture”) will illuminate the opportunities for HPV elimination through two scene-setting presentations: -Dr Maria Kyrgiou, Imperial College London, UK, outlined the epidemiology of HPV infection and the impact from HPV vaccination -Dr Murat Gultekin, Chair of the ESGO Prevention & Diagnostics Task Force and the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe), examined the opportunities for improving HPV screening and ESGO led collaborations at the international level. Part 2 of the session, “Eliminating HPV in Europe” brought event attendees towards a determining vote on a Summit resolution. -Peter Baker, HPV Action UK, described the successful campaign to achieve gender neutral HPV vaccination in the UK and progress towards establishing a similar campaign at the European level -Professor Daniel Kelly, ECCO and EONS, explained the development of the Summit resolution on HPV elimination and the accompanying action plan. The session closed with a live vote on a consensus resolution on the elimination of HPV related cancers and diseases, to be taken to the EU for implementation during the 2019-2024 mandate period.
  • 09:00 - 09:30

    Spotlight session: Clinical Trials Across Borders

    Moderated by Jan Geisler, CML Advocates Network and ECCO Patient Advisory Committee No significant EU legislative initiative has been taken to improve the access to clinical trials for patients living in another EU country. With this in mind, in a collaborative effort, a team comprised of researchers from the European Forum for Good Clinical Practice (EFGCP), the European Organisation for Research and Treatment of Cancer (EORTC), KU Leuven and Patvocates, with the support of the European Federation of Pharmaceutical Industries and Associations (EFPIA), engaged in an exploratory study on this topic. -Teodora Lalova, EORTC Research Fellow, provided Summit attendees with a first look at the preliminary results of the research. Panelist: -Dr Ingrid Klingman, European Forum for Good Clinical Practice (EFGCP)
  • 09:30 - 11:30

    Artificial Intelligence: Breaking down borders in cancer care in ways not yet known?

    Moderated by Prof Regina Beets-Tan, ECCO Board Member and 2nd Vice-President of the European Society of Radiology (ESR) and Sema Erdam, Europa Donna Artificial intelligence in cancer care is now well past the realm of science fiction. It is here already. Some examples include: -The use of AI to evaluate if an X-ray is normal, allowing radiologists to focus their time more effectively on the analysis of abnormal images; -Machine learning techniques to improve the identification of DNA mutations within cancers and even to forecast future genetic changes; and, -A surge of start-up companies focused on using AI and machine learning to accelerate new drug discovery and optimal use of technology in surgery and radiation oncology. The Summit session on AI, led by the European Society of Radiology (ESR), and moderated by Prof Regina Beets-Tan, ECCO Board Member and 2nd Vice-President of ESR, examined such matters as: -The ways in which AI is already impacting cancer care; -What can be expected in the future in respect to AI’s impact on cancer care; and, -How regulatory, commercial, governmental, healthcare professional and patient stakeholders are responding to AI trends in cancer care. Following a scene setting presentation from Prof Ivana Isgum of the Image Sciences Institute at UMC Utrecht, perspectives and insights were developed with speakers including: -Saila Rinne, Head of Policy Sector, DG CONNECT of the European Commission -Laura McDonald, Associate Director, Real-World Research, CORDS, Bristol-Myers Squibb (BMS) -Dr William Allum, Consultant Upper GI surgeon at the Royal Marsden NHS Foundation Trust, UK -Prof Vincenzo Valentini, Past President of the European SocieTy for Radiotherapy and Oncology (ESTRO) -Dr. Adrian Brady, Chair of the ESR Quality, Safety and Standards Committee
  • 11:45 - 12:30

    In conversation with… Dr Vytenis Andriukaitis, EU Commissioner for Health and Food Safety 2014-2019

    Dr Andriukaitis has been invited to provide his reflections on the achievements of the 2014-2019 European Commission mandate in respect to aiding countries in combating cancer and assisting patients to receive optimal care and treatment.
  • 13:30 - 15:30

    Accessing treatment across borders: don’t stop us now!

    Moderated by Prof Ruth Ladenstein, project coordinator of the European Reference Network (ERN) for paediatric cancer, ERN PaedCan and Anita Kienesberger, Childhood Cancer International (CCI). 8 years since EU Member States agreed to the text of an EU Cross border healthcare directive, how far on are we in respect to enabling cancer treatment across borders? Known barriers remain, including: -Difficulties in sharing patient data across borders and systems; -Ongoing reimbursement challenges, including financial toxicity for cancer patients when meeting out of pocket payments; and -A continuing challenge to raise healthcare professional and patient awareness of, and access to information about, their rights to cross border treatment. The session opened with an overview by Hélène le Borgne and Caroline Hager from the Directorate-General for Health and Food Safety of the European Commission. The presentation covered the background to the Directive on the application of patient rights in Cross-Border Healthcare and the European Reference Networks concept, progress in their implementation so far and the working challenges to their operations presently being overcome. Via panel and audience interchange further insights and views on the way forward were drawn out, including from: -Prof Béatrice Gulbis, ERN EuroBloodNet -Dr Annalisa Trama, ERN EURACAN -Lejla Kameric, Childhood Cancer International
  • 16:00 - 18:00

    How does access to innovative cancer medicines fit in high quality cancer care and well-functioning health system as a whole?

    Moderated by Teodora Kolarova, ECCO Patient Advisory Committee and International Neuroendocrine Cancer Alliance (INCA) and Maria Krini, The Cyprus Association of Cancer Patients and Friends ( PASYKAF). Led by the European Cancer Leagues (ECL), this session picked up on the recommendations and research of the ECL Access to Medicines Taskforce, which has brought attention to the disparities in availability of cancer treatments across Europe, some of the variety of factors underlying this, and potential mechanisms for European cooperation that may achieve improvement. After an opening presentation from Dr Kim Linton, Clinical Senior Lecturer in the Division of Molecular & Clinical Cancer Sciences at The University of Manchester, UK, the session took further insights on questions of access from, among others: -Dr Detlev Parow, Head of Patient Care Management at DAK-Gesundheit, Germany -Usman Khan, Executive Director of the European Patients’ Forum -Alexandre Lourenço, President of the Portuguese Association of Hospital Managers, Portugal Wrap up: Dr Wendy Yared, Director of the Association of European Cancer Leagues (ECL)
  • 09:00 - 11:00

    Clinical cancer research across Europe: Do we need to change tracks?

    Moderated by Dr Denis Lacombe, Director of the European Organisation for Research and Treatment of Cancer (EORTC) and Roger Wilson, sarcoma survivor and patient advocate. Precision oncology and new approaches to clinical trials are already changing the way practitioners in the research environment think about evidence gathering. Meanwhile, there is a growing policy understanding of the need to employ a fuller suite of clinical outcomes within research, treatment evaluation and reimbursement decisions. This means making use of a stronger range of quality of life indicators alongside patient survival. The content and focus invited summit delegates to reflect on the existing landscape of clinical cancer research across Europe, and the possibilities for improvement by paradigm shift, with the ultimate goal of better enabling rationale access to therapeutic strategies. Building on the EORTC ‘Manifesto for a new approach for better medicine in Europe’ and recently published proposals for reforming the model for late translational research, the session also reflected on the role of data in driving change and improvement in research, and the remaining obstacles to more meaningful exchange between systems in this area. Finally, the session also considered how models of clinical research in cancer in Europe can better involve the expertise and contributions of all healthcare professionals and the patient community. The range of issues addressed in the session opened via 3 presentations: -Dr Denis Lacombe, Director of the European Organisation for Research and Treatment of Cancer (EORTC) conveyed potential approaches for bringing new therapeutic strategies into being, including proposed reforms required to existing processes within the European regulatory environment. -Dr Magda Chlebus, Executive Director of Science Policy, the European Federation of Pharmaceutical Industries and Associations (EFPIA), spoke to her considerations of what is required to make treatment optimisation a reality. -Dr Ralf Herold, Scientific Officer, the European Medicines Agency (EMA), gave a picture of the EMA’s response to evolving debates on new endpoints and some of the continuing controversies and potential misunderstandings in this areas. Moderated exchange then took place between the audience on session speakers, including panelists: -Marcus Guardian, Chief Operating Officer, the European Network for Health Technology Assessment (EUNETHA) -Jo de Cock, Chief Executive Officer, the National Institute of Health and Disability Insurance, Belgium
  • 11:30 - 12:15

    In conversation with…Dr. Blase N. Polite, Member of the ASCO Board of Directors

    Dr Polite has been invited to share approaches by ASCO in the United States to issues and topic in focus at the European Cancer Summit, including in respect to improving quality of cancer care and ensuring better equity of access to treatment.
  • 13:15 - 14:45

    Specialisation in cancer care: It's a cross border issue

    Moderated by Emma Woodford, Chief Operating Officer of the European Oncology Nursing Society (EONS) and Anne-Marie Baird, ECCO Patient Advisory Committee and Lung Cancer Europe (LuCE). 250 years ago, economist Adam Smith set out how specialisation of workforces drives increased output and prosperity, helping to trigger a global industrial revolution. Does specialisation in the cancer workforce have similar impacts for improving outcomes for patients and health systems? Key matters to be addressed by the session will include: -The history of professional specialisation in cancer care, and benefits achieved -Factors driving oncology workforce specialisation in the present era, including scientific development, complexity of care, and new opportunities for professional development -Case studies of specialisation in cancer care -Challenges to achieving specialisation, including: o Fragmentation in approaches across countries o National and EU level regulatory barriers and difficulties -Opportunities to further achieving and embedding specialisation in cancer care -Recommendations and conclusions to be carried forward for the European Commission term 2019-2024 Dr Andreas Charalambous, President Elect of the European Oncology Nursing Society (EONS), will open the session by providing an overview on the history of specialisation in cancer care, its drivers and the challenges to be overcome and the cancer nursing case study. Thereafter, in combination with audience exchange, expert panellists provided perspectives and experiences from their domain of cancer care, including: -Prof Klaus Meier, ECCO Board Member, President of the European Society of Oncology Pharmacy (ESOP) and Chair of the ECCO Oncopolicy Committee -Prof Sergio Sandrucci, European Society of Surgical Oncology (ESSO)
  • 15:15 - 16:45

    Molecular tumour diagnostics in cancer care: should it be an essential requirement?

    Moderated by Prof Peter Schirmacher, European Society of Pathology (ESP) and Dr Matti Aapro, ECCO President-Elect and Board Member of the European School of Oncology (ESO). Co-led by ECCO member European Society of Pathology (ESP), this session delved into such questions as: -In what ways is molecular testing already being used in cancer care in Europe and elsewhere? -What can we expect in the future? -How is the patient community viewing these developments and what are their key asks in respect to achieving improvements? -How are regulatory and governmental stakeholders responding to the challenges of molecular testing in cancer care, including the growing evidence of hereditary components of cancer? -How are professions responding to molecular testing? -What caveats around molecular testing must all stakeholders in cancer care be aware of? 3 presentations will seek to provide answer to such questions: -Prof Peter Schirmacher, European Society of Pathology (ESP), unpacked the regulatory and practice challenges of molecular testing from the clinician perspective, including provision of information to patients -Jan Geissler, the CML Advocates Network and ECCO Patient Advisory Committee (PAC), provided thoughts on the provision of access to molecular testing across Europe -Prof Koen Norga, European Medicines Agency (EMA) outlined differing and converging regulatory approaches in the area of molecular testing and impacts in respect to existing and forthcoming regulation Dr Schirmacher and Dr Aapro was then assisted in opening up the subject for further examination by bringing in a variety of perspectives, including from: -Prof Sir John Burn, the European Hereditary Tumour Group (EHTG) -Prof Crispin Hiley, Radiation Oncology Consultant & Associate at the Francis Crick Institute, UK -Prof Fatima Carneiro, University of Porto
  • 16:45 - 17:00

    Summit Closing

    The closing session focused on the main highlights and Summit's conclusions. -Prof Philip Poortmans - President, European CanCer Organisation (ECCO) -Dr Matti Aapro - ECCO President-Elect, European School of Oncology (ESO) -Dr Ian Banks - ECCO Board of Directors, ECCO Patient Advisory Committee (ECCO PAC) -Mike Morrissey - ECCO Chief Executive

The ECCO 2019 European Cancer Summit is much more than a coming-together of leaders in the cancer policy field. By forming high level resolutions on the organisation of cancer care, the Summit represents an important ‘working together’ of diverse stakeholder interests, creating and expressing new consensus on the change required within European health systems to deliver the best care to cancer patients.

 

Resolution on HPV-Related Cancer Elimination - Passed 

Developed together with several te European Cancer Organisation's member societies and a large network of interested organisations and experts, and including a public consultation period, the resolution on HPV elimination reads:

'By 2030, effective strategies to eliminate cancers caused by HPV as a public health problem should be implemented in all European countries.'

The resolution was passed during the 2019 European Cancer Summit.

 

Proposed Actions and Measures to be Taken to Support Achievement of the Resolution

The following draft action plan was subject to public consultation during the summer of 2019 and will be further developed and published in light of the responses received.
 

Proposed Actions and Measures to Be Taken to Support Achievement of the Resolution on HPV Elimination

These Actions will be further described and articulated in a position paper to be developed between the European Society of Gynaecological Oncology (ESGO), European Network of Gynaecological Cancer Advocacy Groups (ENGAGe), the European CanCer Organisation (ECCO) and others following the ECCO 2019 European Cancer Summit.
 
Comments on the recommended actions are invited before the ECCO 2019 European Cancer Summit.
 

Actions on HPV Vaccination

  • By 2025, all European country cancer plans should include actions towards achieving population-based and gender-neutral HPV vaccination, if not already in place.
  • By 2030, gender-neutral vaccination programmes against the HPV infection should be in place in all European countries.
The target vaccination rate by 2030 in all European countries should be at least 90% of adolescents for both genders.
 
In support of vaccination goals, EU guidelines on integrated HPV vaccination and cervical cancer screening should be regularly updated. A third edition of evidence-based guidelines should be developed by 2022.
 
Supplementary to gender-neutral vaccination programmes, consideration should be given to the needs of high risk groups that may otherwise fall outside of the age parameters of the universal vaccination programme.
In support of vaccination goals, global cooperation should be fostered, through WHO or other agents, to resolve vaccine supply chain issues to ensure no country’s HPV vaccination programmes are impacted because of shortage.
 
To see also the position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation for Colposcopy (EFC) on Human papillomavirus vaccination, May 2019, for further information and recommendations in this area.
 

Actions on Screening & Early Diagnosis

  • By 2030, at least 70% of women in Europe should have been screened for cervical cancer with an appropriate high precision HPV test within the last 5 years. This coverage should be reached, at minimum, at 35 and 45 years of age, as part of an organised programme*. HPV screening programmes should take into consideration innovations such as self-sampling in respect to their potential for achieving higher rates of screening.
  • By 2025, all European country cancer plans should include actions towards achieving the 70% screening target, if not already achieved.
In support of screening goals, EU guidelines on integrated HPV vaccination and cervical cancer screening should be regularly updated. A third edition of evidence-based guidelines should be developed by 2022.
* For further information on these screening target rates, see the proposed WHO strategy for cervical cancer elimination
 

Actions on Treatment

  • By 2030, across all European countries, 90% of women with Grade 3 cervical intraepitheal neoplasia should be treated within 3 months; and 90% of all invasive cancer cases should have been detected and managed*.
  • By 2025, all European country cancer plans should include actions towards achieving these treatment goals if not already achieved
* For further information on these treatment target rates, see the proposed WHO strategy for cervical cancer elimination
 

Further Actions to Support the Achievement of the Summit HPV Resolution

 

HPV Awareness
  • By 2025 all European country cancer plans should include actions towards increasing public, patient and healthcare professional understanding and awareness about HPV. This awareness should include the range of related cancers and diseases, their symptoms and forms of prevention. Furthermore, this communication effort should elaborate to the public, patients and healthcare professionals the potential and need for HPV elimination, the strategies being pursued to achieve that goal, and the role of the public, patients and healthcare professionals to achieve the elimination goal. Awareness levels of the public, patients and healthcare professionals on HPV should be thereafter be monitored and reported on.

These awareness raising actions should encompass the dental workforce in respect to oropharyngeal cancer, and the schooling system.

Combating the impact of Fake News on Vaccination
  • By 2021, cancer societies, patient and healthcare professional associations, and other stakeholders, should publish a core list of consensus recommendations for European member states to implement in order to combat the impacts on HPV vaccination uptake posed by fake news.
  • By 2021, all major social media platforms operating in Europe should have developed and implemented strategies to reduce the spread of fake news on vaccination.
  • By the end of 2022, all national cancer plans in Europe should include actions to combat the deterrence effects of fake news upon HPV vaccination rates, as part of a broader campaign to reduce the negative impact of fake news on all vaccination programmes.

Improving data and monitoring
  • By 2025, all European countries should have population based registries in place to accountably track and report upon HPV vaccination, HPV screening and HPV related (and other) cancer incidence and mortality data.

EU Cancer Mission
  • By 2021 the EU Cancer Mission should have clear elements within its programme that are supportive to the WHO global strategy for the elimination of cervical cancer as a public health problem, and the ECCO 2019 European Cancer Summit resolutions on elimination of HPV.

This should include supporting research priorities such as new vaccine and screening technologies as well as care and treatment techniques.

Complementing the EU Cancer Mission with an EU Cancer Masterplan
EU Cancer Mission goals, such as on HPV, should be complemented by an EU Cancer Masterplan that supports achievement in respect to non research related matters. This might include facilitating greater use of EU Structural Funds to achieve EU and WHO wide HPV vaccination, cervical cancer screening, and treatment goals for HPV related cancers.
 
Monitoring of Member State Cancer Plans
As part of the coordination role that the EU should play in assisting member states to combat cancer by 2025 a public monitoring and reporting exercise should be established in respect to EU member state cancer plan items, similar to ‘the State of Health in the EU’ exercise. This should include monitoring of actions towards international goals on HPV related cancer elimination. 
 

A further set of actions accompanying the resolution will continue to be developed with stakeholders following the ECCO 2019 European Cancer Summit.

For further information about the resolution and action plan, and how you and/or your organisation can get involved in the campaign to follow, please contact summit@europeancancer.org.  

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