Dear ESMO members,
For a professional society like ESMO, listening to its members is not a matter of choice: it is a fundamental principle of our organisation. In this spirit, I recently had the opportunity to speak with some of you and hear your responses during a series of working sessions dedicated to introducing the ESMO Vision 2025 to ESMO Officers. As expected from such a dialogue, a number of enlightening but also thought-provoking considerations emerged that I would like to share with you all, with a view to making ESMO a society with an enduring commitment to being an inclusive organisation.
On several past occasions I have stressed how important it is for our Society to be innovative – in the way it approaches issues, in the way it interacts with oncology stakeholders – if it is to remain relevant to our diverse community and guarantee equal opportunities to oncologists and their patients around the world.
As powerful as it may be, however, innovation on its own is not enough. Actions we take should be grounded in a common understanding of the purpose we serve and a shared commitment to reaching our goal: to continue securing the best possible outcomes for people with cancer. From ESMO’s leadership, through its Officers, members and staff, all the way to partners and suppliers, each of us must be fully attuned to the Society’s ideals. It takes everyone’s perspective, everyone’s involvement to ascertain that what we do has value for different realities.
Delving into the concepts and concrete implications of the Vision 2025 with ESMO Officers helped bring to light a number of areas where targeted efforts would be required in the near future. In particular, it will be important to invest more heavily in the ESMO Clinical Practice Guidelines to ensure that they remain valid and practicable in every region of the world. This could mean involving young oncologists and colleagues from low and middle-income countries (LMICs) in the development of recommendations to help patients with the best care available, in line with the findings of evidence-based medicine.
Unfortunately, we must recognise that the large disparities in cancer care that persist across the globe make it impossible for a single gold standard to be universally adapted. In this context, it becomes a moral and practical imperative for us to produce reference documents tailored to specific environments, such as the Pan-Asian Adapted ESMO Guidelines (PAGA), to make sure that cancer patients are consistently offered the best possible options they can get, no matter where they happen to live.
The same pragmatism will have to guide us in our efforts to improve the accessibility of anti-cancer therapies as well as of diagnostic tools. With the recently launched ESMO studies on the availability and accessibility of anti-cancer medicines and biomolecular technologies, the Society aims to take a snapshot of the global situation to inform future actions within the organisation but also in its external dealings with governments and regulators. The barriers patients face in accessing the treatments they need differ significantly between health systems – including within the European continent – therefore collaboration with regional and international partners will continue to be essential to our work.
This is where our well-established collaboration with the World Health Organization (WHO) becomes weighty: for example, the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) is acknowledged by the WHO as “a screening tool to identify cancer treatments that have potential therapeutic value that warrants full evaluation for the Essential Medicines List listing which the international organisation is happy to take in due consideration”. When participating in the June WHO Expert Committee on the Selection and Use of Essential Medicines, ESMO had the opportunity to highlight some of our key activities promoting increased access and availability to cancer medicines, including also a geographically adapted value-based reimbursement model, being developed with the London School of Economics, to tackle issues related to the reimbursement of expensive, innovative medicines. Importantly it’s not only about access: also affordability of cancer medicines is crucial to the daily practice of medical oncologists in order to offer the best possible care to their patients.
At the local level, we must ensure that the education ESMO offers – from the ESMO Summits to the Preceptorship courses – reflects this need for a sustainable approach to cancer care while always guaranteeing the reliability and timeliness of the information provided on important oncology topics. The solutions we develop must also remain viable for practising oncologists at the point of care: we must take into account possible hindrances such as having limited time for learning alongside their clinical obligations, which make their task as “generalists” all the more challenging in today’s hyper-specialised oncology arena. User-friendly tools such as the ESMO Checklists developed by the ESMO Practising Oncologists Working Group and the ESMO-MCBS are invaluable complements to ESMO Clinical Practice Guidelines in this respect. Going forward, more consistent involvement of fellow clinicians in the design of our educational programmes could help us better meet their specific information needs for the range of malignancies they treat in widely varying healthcare settings.
In looking outwards at how we can better serve oncologists and cancer patients everywhere, we should not forget to also think critically about ways to make the internal organisation of our Society more effective and impactful. We will need to encourage closer collaboration between our committees in order to make the most of potential synergies across different projects that play into the same bigger picture.
Understanding where our Society is heading to ensure that we are all pulling in the same direction: this responsibility is incumbent upon every ESMO member. The ESMO Congress 2021 will be an ideal occasion to restate and reflect on our Vision 2025 as we convene to discuss the latest advances in cancer treatment, prevention and care. Offering an enhanced virtual experience with opportunities for networking and live debates with colleagues from all around the world, the ESMO Congress will give us a chance to rebuild the sense of community that we have been missing of late. The virtual format will also close the gap between the need and the willingness to embrace the world while remaining relevant to the local communities, bringing the education and the information that they need exactly where they are. And we will be able to do all this around an outstanding scientific programme that will cover the breadth of the current oncology landscape and dive deep into the most controversial questions at the cutting edge of our field – from breakthroughs in understanding tumour biology, through novel strategies for tumour-agnostic treatment approaches all the way to the place of patient values and preferences in an increasingly complex care pathway.
I look forward to your engagement with the Congress content and hope to continue the conversation with you there.