1. EU RTD + FP6 - 1 - Cancer Treatment: A priority for patients in Europe 7 th European Health Forum Bad Gastein 7 October, 2004 Cornelius Schmaltz MD European Commission DG Research F-2 (Cancer Sector) cornelius.schmaltz@cec.eu.int

2. EU RTD + FP6 - 2 - Cancer Treatment in Europe Role of the EU l Organisation and delivery of health services and medical care is responsibility of member states l EC Treaty Article 152: “Community action, which shall complement national policies, shall be directed towards improving public health, preventing human illness […] Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and prevention.”

3. EU RTD + FP6 - 3 - Cancer Research in the 6 th Framework Programme (FP6) Aims (Workprogramme) Patient-oriented strategies: from prevention to diagnosis and treatment (ca. 310 Mill. €) –establishing facilities for the exploitation of research on cancer in Europe; development of evidence-based guidelines for good clinical practice and improved public health strategies –supporting translational research aimed at bringing basic knowledge through to applications in clinical practice and public health –supporting clinical research (clinical trials) –other issues related to cancer such as ageing and cancer, regional differences, psycho-social aspects, palliative care and guidance to support groups + cancer-related topics in "Fundamental Genomics" and "Biotechnology for Health“! (ca. 140 Mill. €)

4. EU RTD + FP6 - 4 - “Combating Cancer” in FP6 Basic, Translational and Clinical research l Basic research as “knowledge producer” and the basis for innovation l Translation of basic science discoveries into clinical studies: Translational research l Clinical Research involving patients: key step to validate effectiveness of new treatment/diagnostic/prevention l Translation of clinical studies into medical practice and health decision making in systems of care: Outcomes research, health systems research

5. EU RTD + FP6 - 5 - “Combating Cancer” in FP6 Basic/Translational Research (Example) l Molecular targets for innovative cancer treatment: 7 “integrated projects” funded for ca. 52,6 Mill. € addressing major pathways for cancer development –Protein p53 (altered in ~ 50% of human cancers) as target for improved treatment –Targeting angiogenesis (tumour vessels supporting tumour growth) –Lack of oxygen (hypoxia), responsible for resistance to chemotherapy → targeting oxygen-sensing molecules

6. EU RTD + FP6 - 6 - “Combating Cancer” in FP6 Clinical research: TRANSBIG (example) Problem: for early-stage (“node-negative”) breast cancer patients 70% are long-term survivors 30% die from the disease Adjuvant therapy reduces BC mortality …but WHO NEEDS TREATMENT ? Today’s medicine leads to overtreatment ! “Translating molecular knowledge into early breast cancer manage- ment: building on the BIG network for improved treatment tailoring” EU contribution: 7 Mill. € for 5 years “Network of Excellence” with 49 partners from 21 countries

7. EU RTD + FP6 - 7 - CLINIC INDIVIDUAL PATIENT INDIVIDUAL TUMOR Gene expression analysis Protein expression analysis “Combating Cancer” in FP6: TRANSBIG LABORATORY TRANSLATIONAL RESEARCH Who needs treatment ? Who needs treatment ? Which treatment works best ? Which treatment works best ?

8. EU RTD + FP6 - 8 - BENEFITS: Only women who NEED chemotherapy RECEIVE it! Reduce toxicity & side effects Reduce toxicity & side effects Reduce cancer care costs Reduce cancer care costs Reduce burden on health care systems Reduce burden on health care systems croarray for ode Negative isease may void hemo herapy GENOMICS IS BETTER AT TELLING US WHICH BREAST CANCERS WILL COME BACK “Combating Cancer” in FP6: TRANSBIG First main workpackage = MINDACT Clinical Trial:

9. EU RTD + FP6 - 9 - “Combating Cancer” in FP6 Through collective European research projects towards better cancer treatment for patients in Europe!!!