PRESENTATION "COMMON SENSE ONCOLOGY" IN EUROPE. BARCELONA VHIO

 

On September 13, 2024, within the framework of the European Society for Medical Oncology (ESMO) Congress, the "Common Sense Oncology" Symposium took place in the auditorium of the CELLEX Biomedical Research Center at the Vall D'Hebron Hospital in Barcelona. Doctors Bishal Gyawali, Winette van der Graaf, Dario Trapani, Rodrigo Lastra, and Joan Brunet discussed the concept of Common Sense Oncology and its application in clinical practice and research.

The event was presented and chaired by Dr. Joan Brunet, the current director of the Catalan Institute of Oncology (ICO).

Canadian oncologist Bishal Gyawali’s presentation, titled "Common Sense Oncology: Why We Exist?", highlighted the reasons behind the Common Sense Oncology (CSO) movement. Gyawali noted that many oncology drugs do not meet expectations due to failures in clinical trial design, yet they are encouraged by media influence and biased education. He proposes a recalibration of priorities in oncology research, emphasizing that clinical trials should focus on outcomes that truly matter to patients. Additionally, the CSO movement advocates for improving the interpretation and communication of evidence, ensuring that oncology treatments provide significant benefits and are accessible to patients.

Dutch professor and oncologist Winette van der Graaf, president of the EORTC (European Organisation for Research and Treatment of Cancer), spoke about the need to reform oncology clinical trials, highlighting the importance of focusing on outcomes that truly matter to patients, such as overall survival (OS) and health-related quality of life (HRQoL). She criticized the excessive use of progression-free survival (PFS) as a primary endpoint, as it does not always reflect real benefits. She also emphasized the need to objectively evaluate and report long-term side effects, and to design trials that generate meaningful evidence, particularly for rare cancers. Finally, she advocated for greater patient inclusion and the collection of data that helps improve long-term healthcare.

Italian oncologist Dario Trapani, from Milan, addressed the need to apply the principles of Common Sense Oncology in the European context. He highlighted disparities in access to high-value oncology treatments across different European Union countries and the importance of developing more efficient and equitable drug evaluation systems. Trapani stressed that patient-relevant outcomes, such as overall survival (OS) and health-related quality of life (HRQoL), should be the focus of every clinical trial and regulatory decision. He also called for harmonizing health technology assessment processes and ensuring that oncology treatments offer significant improvements for patients.

Spanish oncologist Rodrigo Lastra's presentation, titled "An Oncology with Common Sense: Challenges and Opportunities in Spain", addressed the need for a more humanistic and equitable oncology approach. Lastra emphasized that while oncology has made significant advances in terms of technology and pharmacology, it is crucial to keep the patient at the center of care. He highlighted the importance of social determinants of health, such as employment and education, in cancer incidence and mortality, noting, for example, how "postal code and credit card can impact more than genetic code and health card when it comes to inequalities in oncology." He also criticized the excessive focus on expensive treatments with very limited benefits, especially in terminal patients, advocating for more investment in non-pharmacological areas such as supportive care, cancer prevention, social determinants, and screening.

To conclude, there was nearly an hour of intense and enriching dialogue among the hundred attendees who filled the auditorium of the CELLEX Biomedical Research Center at Vall D'Hebron Hospital in Barcelona. Lastly, we extend our gratitude to the hospital for opening its doors to this much-needed initiative in contemporary oncology.