This article is sponsored by Daiichi Sankyo and AstraZeneca.

Healthcare is a team sport: Tackling cancer inequalities in Europe

Throughout history, great scientific advancements have been made through collaboration. While the narrative of the ‘lone genius’ is prevalent in our society, the truth is that science is a team sport.

Without contributions from multiple people around a shared challenge, significant advances may have never been made. One thinks of the huge collaborative effort of the international Human Genome Project, spearheaded by Dr Francis Collins, MD, PhD, but only achieved by a truly vast collaboration across the world; or the crucial correspondence between Georges Lemaître and Albert Einstein, which led to what we now call “The Big Bang” model of the universe. These are two examples among a litany of advances for which collaboration was central to success.

Nowhere is this more true than for those of us who work in healthcare. Intricately connected to a multitude of factors, including societal demographics and economics, addressing the challenges of population health requires input and effort from across the healthcare ecosystem. This includes the field of oncology, where social deprivation, obesity, ageing, and healthcare expenditure, among other factors, play a major role in determining population-level cancer outcomes.

The scientific and clinical community, including the pharmaceutical industry, plays a major role in creating new opportunities for progress in healthcare. Looking specifically at oncology, we have seen astronomical advances in our understanding of the biology of cancer, leading to the advent of personalised and immune therapies – achieved through collaboration across the public and private sectors. This was clearly evident at this year’s ASCO Congress, which was brimming with the fruits of collaboration in oncology research.

Pictured: Markus Kosch (left), head of oncology Europe and Canada at Daiichi Sankyo, and Greg Rossi (right), senior vice president, oncology, Europe and Canada at AstraZeneca.

Daiichi Sankyo and AstraZeneca entered into a major partnership in 2019 with the goal of combining their collective expertise to push the boundaries of what is possible in cancer care, based on a shared commitment to address high unmet patient needs. Speaking about the importance of collaboration to achieve advances in oncology, Markus Kosch, head of oncology Europe and Canada at Daiichi Sankyo, said:

“While our goal of preventing cancer as a cause of death is ambitious, we believe that the power of collaboration to create significant advances in science and technology will one day make this a reality for patients. We have already come so far – our increased understanding of the biology of cancer has led to a ‘golden age’ of biomarker-led precision medicine, unlocking innovative treatment strategies that can optimise response rates, overcome therapy resistance, and improve adverse event profiles. By combining our expertise and resources, we can accelerate and go even further.”

However, despite significant advances in care, deaths caused by cancer continue to increase and it remains the leading cause of death in people aged under 65 in the European Union. Cancer touches all of us, with every second person estimated to develop cancer throughout their lives. Greg Rossi, head of oncology for Europe and Canada at AstraZeneca, explained:

“We are an increasingly elderly population, and there are growing challenges around obesity, which we know is a key driver of the incidence of cancer. We also have the challenge of significant cancer inequalities both between and within countries, including between those who live in a rural versus urban setting. This is an urgent challenge that the European community and individual countries are looking at, but we need increased urgency and to act together if we are to make tangible progress for patients.”

Europe’s Beating Cancer Plan provides an important framework for the region to leverage significant opportunities to improve cancer outcomes. Launched by the European Commission in 2021, it outlines current factors limiting cancer care improvement across Europe, focusing on four key areas: prevention, early detection, diagnosis and treatment, and quality of life of cancer patients and survivors. Addressing inequity is a major theme throughout – there is a significant difference in the five-year cancer survival rate across Europe, ranging from the lowest at 74%-77% in Estonia and Lithuania through to 89% in Sweden and Finland, and there are several influential factors associated with this.

“There should be no first and second-class cancer patients in the EU.”

Europe’s Beating Cancer Plan

Early diagnosis is fundamental to improving cancer survival

Screening and other strategies that support the earlier diagnosis of cancer are critical to avoid later diagnoses when the disease has spread and treatment with curative intent is less likely. In breast cancer, for example, screening has had a significant impact on outcomes in Europe, estimated to have prevented nearly 21,700 deaths from breast cancer per year in the period 2015-2020.

According to Europe’s Beating Cancer Plan, 25 EU Member States have included population-based screening programmes in their National Cancer Control Plans; however, many programmes have not yet been fully implemented, and inequalities in access to screening persist both within and between countries. For example, coverage of the target population for breast cancer screening ranges from 6% to 90% across Europe. Rossi says there are many factors at play:

“Age, gender, mobility, and socioeconomic status are just a few of the demographics impacting the uptake of cancer screening. The COVID-19 pandemic also caused significant continuity challenges. Partnership working with multidisciplinary healthcare teams and patient advocates to ensure screening is available, equitable, and taken up by all communities must be an urgent focus.”

New EU cancer screening recommendations published in December 2022 reaffirm the goal to ensure that 90% of the EU population who qualify for breast, cervical, and colorectal screenings have access to a screening programme by 2025, and recommend screenings are extended to include other forms of cancer in a stepwise approach. It is critical that this goal is met to ensure patients have an equal opportunity to detect their cancer early.

Biomarker testing is the key to unlocking targeted therapy

Significant progress has been made in the identification of biomarkers and matched therapies in oncology, with around 55% of all oncology clinical trials in 2018 involving the use of biomarkers, compared with around 15% in 2000. However, in clinical practice across Europe, there are significant variations in access to – and the quality of – biomarker testing.

In order to address these issues, Kosch says:

“We must improve testing infrastructure, update guidelines, and educate patients and healthcare professionals about the importance of testing at diagnosis. Crucially, we must implement a parallel regulatory and reimbursement approval process for biomarkers alongside precision medicines, so that access to testing does not hold a patient back from accessing a therapy that could potentially make a meaningful difference to them.”

New technology is going to play an important role in the future, says Rossi.

“We see the potential that machine learning and artificial intelligence (AI) derived systems have and believe that, among other areas, they will transform diagnostics services in the near future. For example, together with Daiichi Sankyo, we are collaborating with Ibex Medical Analytics, a leader in AI-powered cancer diagnostics. Optimised breast cancer diagnosis for pathologists using AI and improved identification of patients for targeted therapies is the ultimate aim of this collaboration.”

Timely access to new innovative treatments

If and when a patient accesses a new medicine can make a significant difference to their experience and treatment outcomes. However, disparities in the time it takes for patients in different EU Member States to access new medicines following EMA regulatory approval are increasing. The duration ranges from almost immediate reimbursed access in Germany, to more than 899 days for patients in Romania. For patients with cancer, particularly those at an advanced tumour stage, every day counts.

Rossi adds:

“As pharmaceutical companies, our main part to play is the development and implementation of treatments to advance cancer care for patients. However, this is a team sport – we cannot achieve this goal by ourselves. We must support each other to ensure country reimbursement frameworks keep up with advances in science and enable patient access to new innovative therapies in a timely manner.”

Together we can meet the needs of people with cancer in Europe

Improving cancer care and addressing inequalities is clearly a complex and intricate challenge that cannot be solved by a single person, health authority, or company. Recent events have shown us that a cross-sector approach, united around a shared goal and pursuing that with urgency, can overcome even the most major and complex global healthcare challenges. If we apply the same approach here, we can improve cancer care for all patients in Europe, no matter who they are or where they live.

Kosch concludes:

“While we are still far away from a world without cancer deaths, we aim to better the lives of all people living with cancer and turn the disease into a chronic or cured condition for as many patients as possible. Our alliance with AstraZeneca is an important partnership that helps us both accelerate towards this goal.”

Daiichi Sankyo Logo

With more than 100 years of scientific expertise Daiichi Sankyo (DS) is dedicated to creating new modalities and innovative medicines by leveraging our world-class science and technology. DS is primarily focused on developing novel therapies for people with cancer, as well as other diseases with high unmet medical needs. With a presence in more than 20 countries, DS and its 16,000 employees around the world draw upon a rich legacy of innovation to realise the 2030 Vision to become an “Innovative Global Healthcare Company Contributing to the Sustainable Development of Society.” For more information, please visit www.daiichi-sankyo.eu.

AstraZeneca logo

AstraZeneca (AZ) is a global, science-led biopharmaceutical company that focuses on the discovery, development, and commercialisation of prescription medicines in oncology, rare diseases, and biopharmaceuticals. In oncology, the company’s ambition is to provide cures for cancer in every form, by following the science to understand cancer and all its complexities to develop and deliver life-changing medicines to patients. AZ operates in over 100 countries and its medicines are used by millions of patients worldwide. For more information, please visit www.astrazeneca.com.

Markus Kosch

Markus Kosch is the head of oncology Europe and Canada at Daiichi Sankyo. In his role, he leads the medical affairs, market access, and commercial organisation across Europe and Canada.

Kosch obtained his medical degree at the University of Münster, Germany. He has always been passionate about improving cancer care, driven by his personal experience of losing his father to colon cancer when he was 21 years old. Kosch has over 15 years of experience in the pharmaceutical industry and is a founding member of the “Vision Zero” cancer prevention initiative and think tank.

Greg Rossi

Greg Rossi is senior vice president, oncology, Europe and Canada at AstraZeneca. Through his role, he is responsible for leading the medical affairs, market access, and commercial teams for oncology across Europe and Canada.

Rossi received his doctorate in Biochemical Engineering from University College London and has since built a career in the biotechnology and pharmaceutical industry. Over the last 25 years, Rossi has worked in national (US and UK), regional and global roles for Amgen, Genentech, Roche, and finally AstraZeneca.

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