The vast clinical research network coordinated by the EORTC (European Organisation for Research and Treatment of Cancer) constitutes one of the main spearheads of European cancerology. This independent body has been receiving considerable support from the European Commission for a number of years.
Medicine is currently able to cure one
cancer in two. While significant victories have been won in the
fight against this scourge, they still remain insufficient in the
face of the million and a half new cases recorded in Europe every
year. Advances in the knowledge of molecular biology are opening
up new therapeutical possibilities and enormous efforts are being
made in the area of research and development in university and industrial
Before these discoveries can actually result in new treatments to be applied in the not too distant future, they must first undergo the indispensable process of clinical research, which is the meticulous analysis of the real effects of innovatory therapies on selected groups of patients. These clinical studies, which need to be carried out with the greatest scientific rigour and on an extensive scale, require the international participation of medical researchers in a number of specialisations, notably surgery, chemotherapy, radiotherapy, immunology, pathology, etc.
The research network
The vast network set up by the European Organisation for Research and Treatment of Cancer (EORTC) in 1962 now includes 360 clinical institutions, from which some 2000 physicians are taking part in about thirty multidisciplinary study groups. The results of the clinical analyses carried out by this network are compiled in a centralised data bank - the EORTC Data Center - which contains the observations gathered during trials carried out on more than 100000 patients in thirty different countries.
The cooperation promoted by the EORTC has taken root in Europe and is also being extended to involve other bodies outside the continent. In fact, 16% of the 6500 patients studied in 1996 as part of these group studies were treated by cancer specialists from Central and Eastern Europe, Israel, Russia, Canada, Saudi Arabia and Turkey.
The organisation has also instituted close and constant exchanges with its American counterpart, the National Cancer Institute. The latter body, which also makes a financial contribution to the network's budget, has even set up its European liaison office next door to the EORTC office in Brussels.
A global and multidisciplinary approach
"The clinical approach being developed and applied on a vast international scale by the EORTC has two major facets," explains Professor Françoise Meunier, the Director of the organisation. "We carry out all the preliminary studies on the effectiveness and potential toxicity of new medicinal products before they are approved and put on the market. The second aspect of our work goes far beyond these tests on the effects of new molecules: it is an attempt to strategically evaluate the association of the various forms of treatment and their optimal combination. The value of such research, for instance, is to highlight any improvements, even minimal ones, in the recovery rates. Given the scale of the most common types of cancer, such results can in fact signify the survival of a relatively large number of patients."
The huge scope of this undertaking requires the cooperation of numerous medical partners belonging to various disciplines, pharmaceutical industry specialists who are likely to manufacture new medicinal products and, finally, the health authorities responsible for product approval and for the reimbursement of medical treatments. The validity and reliability of the clinical research projects launched under the auspices of the EORTC also depend on the highly rigorous monitoring of quality in the execution of the protocols drawn up by the investigating teams. This is an area where the structures of the organisation also play a key part in supervision and monitoring.
Dissemination and training
The dissemination of the therapeutic progress highlighted by the clinical research is, of course, essential. "We estimate that the recovery rate from cancer could increase by about 10% if all patients had access to the latest discoveries regarding treatment," says Françoise Meunier. Another highly important facet of the EORTC's activities is thus its continuous updating of clinicians' knowledge.
A number of training programmes aimed at researchers, physicians, nurses and healthcare specialists are organised within the framework of the network. What is more, any cancer specialist or general practitioner may obtain the latest information on optimal therapeutic strategies and research protocols in progress from the EORTC at any time.
The human and economic dimensions of cancer
As it has become one of the spearheads of European cancerology in the course of time, the EORTC has also been led to focus its concerns on the general problems posed by combating this disease in both human and socioeconomic terms. This expansion of its role has been made possible in the last ten years mainly thanks to support from the European Action Plan "Europe against cancer" and through financing projects in the context of the RTD programme "Biomedicine and health".
"Improving the quality of life of patients is an essential part of clinical research. This is a priority objective in several of the research projects being carried out within the network," stresses Françoise Meunier. "In addition, any clinical trial must respect very rigorous protocols approved by ethics committees. A relationship based on openness and trust between the clinician, paramedical staff and patients is indispensable, and more active participation by patients in important decisions concerning their illness has proved its worth."
Where research into the socioeconomic aspects of the illness are concerned, notably in terms of the cost-effectiveness of treatments, these are of particular interest to social security bodies. With the aid of the Biomed Programme, the EORTC has created units for the meta-analysis and economic assessment of healthcare to study this topic.