SPOTLIGHT

ESMO and the EACR working in partnership at ESMO 2019:

Building bridges between oncologists and basic scientists

Encouraging closer collaboration between clinical, basic and translational research, the ESMO 2019 Congress will take place in partnership with the European Association for Cancer Research (EACR) in Barcelona, Spain. With the tagline, ‘Translating science into better cancer patient care,’ the congress will provide a global platform for the exchange of ideas and knowledge relating to latest advances in cancer science, some of which may be practice changing. In keeping with this edition’s theme of collaboration, we asked a clinical researcher, a clinician/translational researcher and a basic scientist about the importance to future cancer management of building bridges between oncologists and scientists.

Alexander Stein

Clinical Researcher, University Cancer Center Hamburg, Hamburg; contributor to ESMO Consensus Conference Guidelines and ESMO Open Reviewer


What aspects of cancer management do you think can be positively influenced by good collaboration between basic scientists, translational researchers and clinicians?

All aspects of systemic cancer treatment begin with basic science in the laboratory. Once an experimental agent enters clinical trials, it usually becomes obvious that not all patients benefit; this is where translational science comes to the fore in identifying specific subgroups of patients who are more likely to respond. The clinical subgroup data are often further researched in the laboratory to determine whether they can guide the development of additional agents for the treatment of patient subtypes, and a cycle of development is set in motion. In order to efficiently conduct clinical trials in oncology today, it is essential to have a dedicated translational research team. One of the challenges we currently encounter when conducting cancer clinical trials is determining whether a response is due to the novel agent under study or to standard backbone combination treatment. Translational science is extremely important in detecting early changes in the specific targets of a new therapy that help us to decide whether a treatment is likely to be beneficial.

What is your experience of this? Can you provide any specific illustrative examples?

At ASCO this year, we presented data from a phase 2 exploratory study in first-line metastatic colorectal cancer (AVETUX trial) in which a novel agent (PD-L1 inhibitor) was added to standard chemotherapy plus an EGFR antibody. Through a focused translational research programme, we were able to detect early signs of immune-related changes that correlated with response, leading us to conclude that the high response rate observed in these patients was likely to be triggered by the addition of immunotherapy to standard treatment, rather than being due to the standard treatment alone.

How can partnership between professional bodies such as the EACR and ESMO help scientists and oncologists to build, sustain and strengthen these bridges?

Strong links between scientists and clinicians are needed in order to bring new experimental anticancer agents to the clinic, and, as previously outlined, translational researchers are essential to clinical trial programmes. Early discussions need to take place between all parties in order to ensure research is appropriately targeted at areas of greatest unmet clinical need, and clinicians need to be aware at an early stage of the novel compounds coming through from the laboratory so they can plan relevant trials in advance. Partnership between professional bodies representing scientists and practising medical oncologists can encourage this dialogue, for example during specifically-designed congress sessions. At the ESMO Congress, for example, the scientific programme includes tracks on tumour biology and pathology, translational research, basic science, biomarkers and developmental therapeutics that provide an interface between basic and clinical science.

Are there any other ways in which these relationships can be sustained and further developed in the future to ensure the best possible care for cancer patients?

Our university hospital organises a yearly ‘retreat’ that brings together clinical scientists, translational scientists and basic scientists in an environment remote from the hospital where everyone has an opportunity to present their latest research and learn from the work of others. This event is viewed positively by participants and I think works well in terms of building and sustaining these professional relationships. However, the challenge is always to ensure the programme caters for the interests and needs of all parties. It is not easy, but if done well it is extremely worthwhile.


I think the Translational Research Unit Visits offered by ESMO, in which clinicians are invited to gain hands-on experience in a laboratory setting, or scientists are able to spend time in a clinical trial unit, are probably even more useful. This offering could potentially be expanded to include overseas visits to gain insights into, for example, new laboratory techniques or alternative approaches to clinical research that may be usefully applied at home.

Teresa Troiani

Clinician/Translational Researcher, Università degli Studi di Napoli Federico II, Naples, Italy; Young Oncologist attendee at ESMO Leaders Generation Programme 2016


What aspects of cancer management do you think can be positively influenced by good collaboration between basic scientists, translational researchers and clinicians?

As a clinician, it is extremely important to work as part of a multidisciplinary team in order to offer patients with cancer the best possible outcomes. Improved patient survival has been demonstrated in several studies when a collaborative approach to treatment has been followed. As I also work as a translational researcher, I have personal experience of how translational research can positively influence treatment decisions and patient care.

What is your experience of this? Can you provide any specific illustrative examples?

My colleagues and I have been involved in various studies to explore the mechanisms underlying resistance to treatment for colorectal cancer. Using genome sequencing of samples from non-responding patients, we were able to identify a gene involved in the development of resistance. After blocking this gene, we demonstrated responses in previously non-responding patients. This is very exciting and will lead to tangible benefits for patients. As a translational researcher, I am also able to help guide treatment decisions, for example when the results of follow-up scans are equivocal. Patients with colorectal cancer may present with very small nodules on a CT scan that may or may not be metastases. By analysing samples from the nodules I can determine their composition and recommend an optimal treatment path.

How can partnership between professional bodies such as the EACR and ESMO help scientists and oncologists to build, sustain and strengthen these bridges?

The programmes and courses run by ESMO, such as the Oncology Fellowship Programme and Translational Research Unit Visits, not only offer young oncologists a fantastic opportunity to better understand the science of medical oncology, but also provide an important link between oncologists and scientists. The ESMO Translational Research and Precision Medicine Working Group also helps to support a career in translational research and personalised medicine, and minimises barriers to enable the incorporation of translational components within clinical research projects. In this respect, ESMO truly is a medical society for everyone who wants to provide the best possible care for patients with cancer.

Are there any other ways in which these relationships can be sustained and further developed in the future to ensure the best possible care for cancer patients?

Communication is key, and facilitation of meetings among small groups of clinicians and scientists seems to be an effective approach to foster relationships between these individuals. For example, ESMO currently holds events in countries such as Africa and Asia focusing on specific topics relevant to local cancer treatment. It would be good to see these programmes expanded to include additional countries where limited resources prevent healthcare professionals from attending key congresses. Meetings that bring together small groups of clinicians and scientists from local areas would enable valuable exchange of knowledge to improve patient care. It is only through communication and sharing best practices that we can open minds to new possibilities and different ways of working for the benefit of our patients.

Eli Pikarsky

Researcher/Basic Scientist, Institute for Medical Research Israel-Canada, Jerusalem, Member of the EACR25 Organising and Scientific Programme Committee and Speaker


What aspects of cancer management do you think can be positively influenced by good collaboration between basic scientists, translational researchers and clinicians?

There is a real need for more effective two-way information exchange between scientists and clinicians. The situation is gradually changing; we are seeing more collaboration between scientists and clinicians in, for example, clinical trial design and publication development, than we did 20 years ago. There is evidence of earlier collaboration too, with involvement of both ‘sides’ from the outset of a project, and this has a hugely positive influence on patient care. Basic scientists typically have a good understanding of treatment and resistance pathways in cancer, and, in my experience, clinicians can learn from scientists when considering targeted treatment choices. Likewise, basic scientists can benefit from discussions with clinicians to gain a better understanding of the critical unmet needs in the clinic and where more effective interventions should be specifically targeted.

What is your experience of this? Can you provide any specific illustrative examples?

Several years ago, a multidisciplinary molecular oncology forum was founded at our institution involving a wide range of disciplines from both the medical school and hospital. The forum meets every two weeks to discuss specific, difficult-to-treat patient cases and to make informed decisions relating to the management of advanced cancer. Basic scientists participate in the discussions and provide valuable insights that help to guide these important therapeutic decisions. Through their participation, the scientists also learn about the daily needs and challenges faced by oncologists and their patients. I believe this opportunity for the exchange of ideas and knowledge between scientists and clinicians is particularly beneficial to all involved.

How can partnership between professional bodies such as the EACR and ESMO help scientists and oncologists to build, sustain and strengthen these bridges?

The partnership between ESMO and the EACR provides a wonderful learning opportunity for both scientists and oncologists, provided the content is of interest to both parties. These organisations can also make a huge difference to their future collaboration by providing networking opportunities, especially for young scientists and oncologists. By facilitating discussion between these young professionals at conferences, ESMO and the EACR can help them to build good working relationships. In my experience, these networking sessions work fantastically well and I would definitely encourage more of them.

Are there any other ways in which these relationships can be sustained and further developed in the future to ensure the best possible care for cancer patients?

Organisations such as ESMO and the EACR could possibly help to influence policy makers to generate more grant opportunities for future collaboration between scientists and clinicians, both at a national and European level.



ESMO 2017: our past Congress in partnership with EACR

Anton Berns, the EACR Past President, explains that the EACR and ESMO partnership in this congress is welcome as research and clinical practice need each other. His selection of studies from promising young investigators shows the interest of what they are doing in the field.