The European Society for Medical Oncology (ESMO) is launching the International Cancer Foundation (ICF), which has taken upon itself a mission to support activities that enhance cancer prevention, diagnosis, treatment, and follow-up in every country where they are needed. The ultimate goal of the new organization is to help save lives by ensuring that the best treatment is available to every cancer patient worldwide.

“Immunotherapy is being shown to work across many diseases and new drugs are on the horizon in the precision oncology field, but as an international organization, we at ESMO have to be realistic about how accessible these breakthroughs are from a global perspective,” said Professor Solange Peters, MD, Ph.D, the current 2020 – 2021 President of the European Society for Medical Oncology (ESMO) and a member of the ESMO Faculty for Lung and Other Thoracic Cancers.

“Even if we constantly offered education to our members to be at the forefront of cancer research and treatment, we would still be leaving some patients at the side of the road,” she added.

Peters said that the new foundation is expected to provide practical support for the training of oncologists as well as offer financial backing for fellowships, country-specific research projects, patient resources, prevention campaigns and public education about cancer in under-resourced regions across Africa, Asia, and Latin America.

The announcement comes just days before the official opening of the 2021 ESMO Congress which starts on September 16, 2021, and is already counting more than 19,000 participants from all around the world.

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The theme of this year is “Connecting and engaging those who care about cancer,” which is considered a fitting tagline for this second consecutive virtual edition of the highly anticipated annual event, an appointment not to be missed for the entire oncology community – and the second to be held against the backdrop of the COVID-19 pandemic.

Landmark studies
With a wealth of landmark studies in Breast, Cervical, Melanoma, Prostate, Colorectal, Oesophagus, Endocrine, and Lung cancer, the ESMO Congress 2021 is a clear demonstration that oncology research has once again gathered momentum after being temporarily stopped in its tracks by the outbreak of the virus.

“The pandemic generated remarkable consequences on people and healthcare systems, but also on cancer research,” said Antonio Passaro, MD, Ph.D a medical oncologist at the Division of Thoracic Oncology of the European Institute of Oncology in Milan, Italy.

“This year, however, we have seen a resurrection of oncology research reflected by an increase in the number of abstracts and practice-changing data submitted, and ultimately translating to more than 2,000 studies, with nearly 70 late-breaking abstracts being presented at this ESMO Congress,” Passaro added.

“In addition to research, the pandemic has also disrupted the treatment strategies in place for our patients. In this area, too, new data shows that the oncology community has worked and continues to work in the right direction to protect cancer patients during the health crisis,” he further noted.

Enhanced interactivity
This year the 2021 ESMO Congress will be presented in a virtual format with an enhanced virtual experience, focusing on offering more interactivity across the breadth of its program. In contrast to the 2020 edition of the virtual event, this year there will be more opportunities to engage with key opinion leaders, possibilities to contribute to customizing the content of certain sessions, chances to debate with investigators, and much more.

Long-term side-effects of COVID-19
One study to be presented at the upcoming 2021 ESMO Congress explored the prevalence of long-term side-effects from COVID-19 among cancer patients having survived an infection with the virus, as well as the impact on pathways to resuming treatment following recovery.

The study is based on data collected from about 2,795 patients at 35 European institutions between February 2020 and February 2021 through the OnCOVID registry. A total of 1,557 patients who underwent a clinical reassessment after recovering from COVID-19 were included in the analysis.

The results showed that 234 (15%) of the patients who survived the infection with SarS-CoV-2 reported symptomatic sequelae from the disease, including respiratory symptoms such as shortness of breath or a chronic cough (49.6%), chronic fatigue (41%) and cognitive/psychological dysfunction (4.3%). Persisting COVID-19 sequelae were significantly more likely found in males (p=0.0407) aged ≥65 years (p=0.0489) with ≥2 comorbidities (p=0.0006) and positive smoking history (p=0.0004). Sequelae were associated with a history of prior hospitalization (p<0.0001), complicated disease (p<0.0001), and COVID-19 therapy (p=0.0002).[1]

The investigators reported that with a median post-COVID-19 follow up of 128 days (95%CI 113-148), multivariable analysis of survival revealed COVID-19 sequelae to be associated with an increased risk of death (HR 1.76, 95%CI 1.16-2.66) after adjusting for sex, age, comorbidities, tumor characteristics, anticancer therapy, and COVID-19 severity.[1]

“The fact that the cancer patients who most frequently suffered sequelae were those who survived severe forms of the disease leads us to imagine the beneficial effects that COVID-19 vaccination campaigns will have on these aspects,” said study author Dr. Alessio Cortellini, MD, a consultant medical oncologist and a clinical scientist with a special interest on immunotherapy of cancer at Hammersmith Hospital and Imperial College London, UK.

Cortellini added that prevention, early recognition, and treatment of COVID-19 sequelae would be an important step to prevent disruptions in the continuity of patients’ cancer care in the future.

“This data confirms the need to continue to prioritize cancer patients, which is one of the top goals that ESMO has set since the start of the outbreak,” Passaro emphasized.

Investing in Healthcare
“Amid the efforts invested by healthcare systems in the fight against the pandemic, it is of the utmost importance that we do not neglect to study and understand the curves of cancer incidence and mortality in order to plan appropriate health policies for the future,” Passaro noted.

Results from a second study to be presented, by Tadeusz Dyba, Ph.D, at the upcoming 2021 ESMO Congress during the Proffered Paper Session ‘Public policy’ on Monday 20 September 2021 describe the latest estimates of the cancer burden in the European Union and EFTA countries (Iceland, Liechtenstein, Norway, and Switzerland). along with the most recent projected population figures released by Eurostat for the coming decades to predict long-term cancer incidence and mortality across Europe by age, sex, country, and cancer site.

Because long-term projections of cancer burden are an important input to health-policy planning. Major cancer risk factors – such as genetics, lifestyle, environmental exposure to carcinogens, in combination with the associated population structures – impact on the observed number of cancer incidence and mortality cases.

The results of the study show that by 2040, the number of new cancer cases could increase by more than a fifth (21%) to 3.4 million, with deaths from cancer reaching 1.7 million the same year, up from 1.3 million in 2020. [2]

The investigator look at how these numbers would change up to the year 2040 under different population structures, assuming the estimated 2020 cancer incidence and mortality crude rates remain the same.[2]

“We evaluated how demographic variations in terms of fertility, mortality, and migration levels would impact the population age pyramid over time and how that, in turn, would affect the number of future cancer cases in 2040,” said study author Manola Bettio Ph.D, a scientific researcher at the EU Commission’s Joined Research Centre (JRC) in Ispra, Lombardy, Italy.

“The results we obtained allow international comparisons, highlighting differences and identifying possible actions to mitigate inequalities between and within countries. The first and easiest way to reduce the future cancer burden across Europe is prevention, because the good news is that almost 40% of cancers can be prevented by reducing people’s exposure to environmental and lifestyle risks, which are also linked to social and economic development,” Bettio said.

For those who do have to face a diagnosis of cancer, today or in the future, ESMO2021 Scientific Co-Chair Professor Pasi Jänne saw hope in the results to be unveiled over the five days of the ESMO Congress, which are evidence that cancer research works.

“Many of the studies presented this year will change or influence our current clinical practice,” he said, highlighting great strides made in precision medicine.

“Giving the right treatment at the right time, to the right patient, is an important strategy that we as an oncology community are implementing worldwide to continue making progress in cancer therapies and thus improve outcomes for patients,” Jänne concluded.

[1] Abstract 1560O_PR ‘Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-COV-2 infection’ will be presented by Alessio Cortellini during the Proffered Paper Session ‘SARS-CoV-2 and cancer’ on Tuesday 21 September 2021, 13:30 to 14:50 (CEST) on Channel 5. Annals of Oncology, Volume 32, 2021 Supplement 5
[2] Abstract 1501O_PR ‘Long-term estimates of cancer incidence and mortality for the EU and EFTA countries according to different demographic scenarios’ will be presented by Tadeusz Dyba during the Proffered Paper Session ‘Public policy’ on Monday 20 September 2021, 13:30 to 14:50 (CEST) on Channel 5. Annals of Oncology, Volume 32, 2021 Supplement 5

Featured image: Before Covid-19, ESMO Prticipants meeting in persion. ESMO 2019 Opening, September 27, 2019, Barcelona, Spain. Photo courtesey: © 2019 European Society for Medical Oncology (ESMO). Used with permission.

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