A team of experts from the University of Glasgow will lead a new international effort to improve cancer control and reduce global health inequalities.

Spearheading the new Lancet Oncology Commission focused on cancer genomics and precision oncology, University of Glasgow researchers will lead an international team of experts over the next two years to create a blueprint for overcoming barriers and improving global access to the most innovative diagnostic tests and personalised cancer care.

The newly formed commission will start by examining some of the biggest challenges faced by healthcare systems and cancer clinicians worldwide for the widespread adoption of molecular testing in routine clinical care. The team of international experts will offer practical solutions to ensure sustainable and equitable access and advancement for cancer diagnosis and treatment.

The commission will analyse the challenges that impede accumulation of health and genomic data that can be shared in an appropriate way to refine current best practise and inform ongoing therapeutic development.

A rapidly increasing proportion of contemporary cancer care relies on a precision oncology strategy – the process of using molecular testing to understand a patient’s tumour and how to successfully target the cancer cells within it. Oncologists can use the results of these tests to select the best available treatment options for each patient, ultimately improving survival and quality of life. Molecular testing can also help identify hereditary cancer syndromes providing the opportunity to reduce cancer mortality through personalized prevention.

However, the majority of patients with cancer around the world, particularly those living in lower- and middle-income countries, cannot access molecular testing due to a range of issues including regulatory, financial, logistical, educational and clinical barriers. It is envisaged that this international consortium of experts will define solutions to these key problems, and ultimately help improve cancer care for patients around the world.

The Lancet Oncology Commission will be coordinated by the International Cancer Genome Consortium: Accelerating Research in Genomic Oncology (ICGC-ARGO) initiative. ICGC ARGO is a new phase of the International Cancer Genome Consortium focused on analysing specimens from 100,000 cancer patients with high quality clinical data to address outstanding questions in a bid to defeat cancer.

The Commission brings together international stakeholders with relevant expertise across a range of priorities that collectively define how precision cancer medicine can be implemented in a feasible and affordable way; how cancer omics data can be retained in a more sustainable and accessible manner; be shared more widely; and be better used for the benefit of people affected by cancer.

The organisations involved include the European Society for Medical Oncology (ESMO), the International Agency for Research on Cancer (IARC/WHO), Latin American Cooperative Oncology Group (LACOG), African Organisation for Research and Training in Cancer (AORTIC), the Asian Oncology Society (AOS), the Global Alliance for Genomic and Health (GA4GH), the International Quality Network for Pathology (IQN Path), the U.S. Food and Drug Administration (FDA), and many others.

Director of ICGC ARGO Professor Andrew Biankin, Regius Chair of Surgery at the University of Glasgow, said: “We have made great progress in defining the genomic aberrations that cause and drive cancer, are developing more and more treatments that directly target these cancer-causing molecular abnormalities. Yet these great advances are only reaching a small proportion of people even in developed countries.

“The time has come to incorporate broad genomic testing in routine cancer care. This will improve outcomes by using current treatments better through predicting who they will work for and for whom they won’t before giving a treatment. This will avoid the use of ineffective treatments, minimising side-effects and costs and providing better access for patients to new treatments and clinical trials.”

Dr Raffaella Casolino, a pancreatic cancer expert from the University of Glasgow’s School of Cancer Sciences and chair of the Commission, said: “This Commission has the ambitious goal of improving the lives of people affected by cancer and their families driving the evolution of precision oncology over the next decades. Collaboration between stakeholders from different disciplines and countries, including engagement with the public, patients, and their families, together with attention to the policy of diversity, equity and inclusion, represent the fundament of this Commission and will be critical to achieve the intended goals. Cancer burden is doubling by 2040 and health disparities are major drivers of inequalities in outcomes both within and between countries. It is only through a global approach that we can reduce the burden of cancer. And this represents the strength of our initiative through which we really hope to impact at a scale.”

Professor Biankin and has team are world-leading experts on cancer genomics and testing, and have established a number of cancer initiatives including The Glasgow Precision Oncology Laboratory (GPOL) and Precision Panc – pancreatic cancer trials focused on a precision medicine approach, delivered through the NHS and funded through Cancer Research UK and the Scottish Government Chief Scientist Office.