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ESMO 2020 VISION esmo.org

CARING FOR PEOPLE WITH CANCER Cancer patients and their needs are at the centre of all that we do: our profession is driven by our determination, individually and collectively, to offer better care to people with cancer.

As our knowledge of the disease increases and our methods of treatment advance, our profession and Society evolve to integrate every new development into the effective delivery of our mission. This process of continuous improvement is reflected in all ESMO s initiatives and activities, and also in the periodic assessments through which the Society evaluates the future direction of oncology and the changing needs of its members. In 2015, the ESMO 2020 Vision identified three major trends for short and mid term developments in oncology: 1 INTEGRATED CANCER CARE Bridging cancer prevention, research, early-diagnosis, and treatment to improve patient outcomes 2 SPECIALISED EDUCATION Supporting oncologists in a fast-changing professional environment 3 SUSTAINABLE CANCER CARE Advocating for equal access to quality treatment and for cancer prevention

This edition of the ESMO 2020 Vision gives an update of what has been achieved in the first two years and outlines the tangible ESMO actions that will be implemented in the years to come, up to 2020. NOT A CHANGE IN FOCUS BUT A SHARPENING AND CLARIFYING OF THE SOCIETY S VISION FOR ITS MEMBERS IN A FAST CHANGING ENVIRONMENT.

PILLAR 1 INTEGRATED CANCER CARE Bridging cancer prevention, research, early-diagnosis, and treatment to improve patient outcomes PRINCIPLES Molecular tumour analysis is increasingly fundamental in choosing the most appropriate anti-cancer therapies for patients, laying the groundwork for the development of precision medicine. Oncologists will increasingly be working in close teamwork with colleagues in pathology, molecular biology, bioinformatics and other related disciplines, integrating data and expertise from the work of professionals involved in prevention, early-diagnosis, basic, and translational cancer research, as well as organ specialists. CHALLENGES Despite this trend, Europe has not yet achieved full integration of cancer care, from prevention to early diagnosis to treatment and palliative care. With the exception of large centres, there is a need for more oncologists with solid backgrounds in primary and secondary prevention, early diagnosis, basic, translational and clinical research who can truly understand and translate the principles of precision medicine to individual treatments while using resources available in the most sustainable way. ESMO ACTIONS ACHIEVED since 2015 Annual congress platform Collaboration with oncology organisations CAREFOR platform with the EACR and EORTC Joint Clinical Practice Guidelines and Consensus conferences with EANO, ECPC, EONS, ESGO, ESSO, ESTRO, MASCC Membership Opened to all professionals working in cancer research, diagnosis, treatment, care and advocacy ESMO Faculty: integration of basic researchers and pathologists Joining about 500 multidisciplinary oncology experts in different tumour types EXPANDING Monitoring availability of molecular diagnostic tools ESMO endorses and participates in the annual European Consensus Conference for External Quality Assessment in Molecular Pathology, organised by AIOM together with ESP, and SIAPEC-IAP, to promote accurate diagnostic testing for anticancer drug selection

ONGOING NEW Cross-Cutting Themes in Oncology series Publications on transversal themes in oncology First title to be released: Genomics and Genetics of Cancer Integration of ESMO Clinical Practice Guidelines With adaptations to special populations and ethnicities, starting from adaptation for Asia TAT Congress is now an ESMO Congress From 2018, ESMO will be leading the international congress on Targeted Anticancer Therapies (TAT) a platform to share data on new cancer therapeutics and drug targets in early development Position paper on the role of Translational Researchers within multidisciplinary teams Creation of a network of scientists with ESMO Translational Research Fellows Collaboration between ESMO Quality Task Force and ESOP Assessing quality and safety in cancer care (in progress) AIOM, Associazione Italiana di Oncologia Medica; EACR, the European Association for Cancer Research; EANO, European Association of Neuro-Oncology; ECPC, European Cancer Patient Coalition; EONS, European Oncology Nursing Society; EORTC, European Organisation for Research and Treatment of Cancer; ESP, European Society of Pathology; ESSO, European Society of Surgical Oncology; ESTRO, European Society for Radiotherapy and Oncology; ESGO, European Society for Gynaecological Oncology; IAP, International Academy of Pathology; MAASC, Multinational Association of Supportive Care in Cancer; SIAPEC, Società Italiana di Anatomia Patologica

PILLAR 2 SPECIALISED EDUCATION Supporting oncologists in a fast-changing professional environment PRINCIPLES Increased integration of cancer care brings with it increased demand for highly specialised expertise. Complex, informationintensive molecular biology underlies many promising new treatment opportunities; this naturally accelerates oncology s evolution into a profession of specialists. Multi-professional teams, organised into organ-specific tumour boards with the presence of qualified translational researchers, could optimally become the standard for delivering quality cancer care. CHALLENGES In this increasingly specialised environment, oncologists need to adapt to rapid changes in standards of practice and further sharpen their expertise, gaining in-depth, disease-specific knowledge and learning how to collaborate effectively with other specialists in an integrated, multi-professional setting. On one hand, sub-specialising allows professionals to achieve the highest possible standards over a selected range of diseases. On the other, in such a confining framework, there is a need for professionals who can connect all aspects of basic, clinical research and cancer care and serve to enhance collaboration: these are translational research experts. ESMO ACTIONS ACHIEVED since 2015 ESMO/ASCO Recommendations for a Global Curriculum in Medical Oncology 3rd edition published in 2016 with its related Log-book Fully integrated oncology education Comprehensive educational offer for medical students, trainees and young oncologists, specialised and senior oncologists ESMO Leaders Generation Programme Developing the oncology leaders of tomorrow EXPANDING Multi-professional & specialised scientific and educational events Educational Courses: providing training to young oncologists and updating experienced oncologists Symposia: highly specialised meetings on particular topics with selected audiences Congresses: multidisciplinary, disease- or therapeutics-focused, providing state-of-the-art education and abstract-related latest research results Expansion of ESMO Fellowship programme New: European Integration and Welcome Home Fellowships

ONGOING NEW ESMO Preceptorship Courses Tumour specific courses primarily designed to educate young oncologists about the current standards of care across a range of malignancies Advanced Courses and Updates for experienced oncologists Mentoring Programme Mentoring sessions during the ESMO Congress and a mentoring programme identifying and matching high-profile mentors with young oncologists ESMO-SIOPE Adolescents & Young Adults (AYA) Working Group Educational and awareness initiatives addressing the needs of adolescent and young adult cancer patients Summits in Africa, Latin America, Middle-East ESMO Examination Offered in English and German Educational Resources for Patient Advocates Dedicated Congress tracks; annual workshops; guides for patients; e- learning modules ASCO, American Society of Clinical Oncology; ESO, European School of Oncology; SIOPE, European Society for Paediatric Oncology

PILLAR 3 SUSTAINABLE CANCER CARE Advocating for equal access to quality treatment and for cancer prevention PRINCIPLES As our understanding of the complex molecular biology underlying different cancers advances, the potential for personalised therapies continues to grow but so do the costs of each patient s cancer treatment. Government authorities must seek a balance between treatment costs and clinical benefit when assessing reimbursement policies. Added to this is the lack of resources in disadvantaged countries or financial restrictions due to limited budgets of certain healthcare systems. It is essential to ensure the sustainability of and equal access to optimal cancer care for all patients, wherever they live. CHALLENGES To sustain the costs of cancer care while offering the most appropriate treatment to cancer patients, oncologists and other decision-makers need to be supported with the highest standards of guidance. Sustainability is also integral to cancer prevention and to increasing awareness amongst the wider public on issues such as screening programmes and healthy lifestyle choices. ESMO ACTIONS ACHIEVED since 2015 European and International ESMO Consortium studies on Availability and Accessibility of Anti- Neoplastic Medicines In collaboration with the WHO, to provide health authorities with data to best address and resolve the issues identified Advocacy campaigns supporting the EU Clinical Trials and the EU General Data Protection Regulations Aiming to facilitate clinical cancer research in Europe and reduce burdens EXPANDING RCE Rare Cancers Europe Multi-stakeholder partnership addressing the specific challenges posed by rare cancers Official Relations status with the WHO: providing direct input about cancer issues into critical worldwide public health issues Collaboration on the implementation of the 2017 Cancer Resolution at the national level Contribution to a WHO Global Cancer Report to be published in 2019 ESMO collaboration with the UICC On global policy issues at the WHO and United Nations levels

ONGOING NEW ESMO Magnitude of Clinical Benefit Scale A scale that provides a relative ranking of the magnitude of clinically meaningful benefit that can be expected from a new anti cancer treatment Integration in the ESMO Clinical Practice Guidelines ESMO-MCBS version 1.1 (2017) Standing collaboration with the EMA On issues related to cancer medicine approvals Cancer Medicines Working Group Addressing topics related to expensive and inexpensive medicines Launch of a set of recommendations on shortages of inexpensive cancer medicines, in collaboration with the Economist Intelligence Unit - EIU (2017) ESMO position paper on Biosimilars (2017 update) Describing the issues revolving around biosimilars that are relevant in the oncology field, especially the prescribers In partnership with the EMA Making Big Data manageable Through the ESMO Taskforce on Big Data, to investigate how big data can benefit patients Continued collaboration with EUnetHTA On issues related to the harmonization of cancer medicine reimbursement EMA, European Medicines Agency; EUnetHTA, European Network for Health Technology Assessment; UICC, Union for International Cancer Control; WHO, World Health Organization

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