European CanCer Organisation

BackgroundThe health-related quality of life (HRQoL) of patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) is impacted by both disease- and treatment-related factors. Treatments that preserve and maximize HRQoL in this setting represent a substantial unmet need.MethodsKEYNOTE-412 (NCT03040999) was a randomized, double-blind, placebo-controlled phase 3 study of pembrolizumab plus chemoradiotherapy (CRT) versus placebo plus CRT for maintenance therapy in participants with treatment-naïve LA HNSCC. Patient-reported outcomes (PROs) assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EORTC QLQ Head and Neck 35 (H&N35) were pre-specified secondary endpoints and administered at baseline and throughout the study. Least squares mean (LSM) change from baseline was assessed using a constrained longitudinal data analysis model. No formal statistical significance testing was performed.ResultsThe PRO analysis population included 395 participants randomized to receive pembrolizumab plus CRT and 397 to receive placebo plus CRT. Completion rates for all assessed PROs were >95% at baseline and >66% at week 45. LSM change from baseline to week 45 was similar between groups across EORTC QLQ-C30 and QLQ-H&N35 subscale scores. There were no notable differences in empirical mean change or the proportion of participants with improvement, stability, or deterioration from baseline to week 45 between treatment groups.ConclusionThe addition of pembrolizumab to CRT did not meaningfully impact HRQoL in participants with LA HNSCC.

BackgroundIn 2022, nearly 20 million new cancer cases and 9.7 million deaths occurred globally. Europe, comprising under 10% of the world’s population, accounted for over 22% of cases and 20% of deaths, reflecting an aging population, lifestyle risk factors, and extensive screening. With 40% of cancers preventable through modifiable risk factor interventions, effective prevention is essential. The European Code Against Cancer provides evidence-based guidelines that drive health initiatives across Europe. Supported by Europe’s Beating Cancer Plan and the EU4Health program, the EU Mobile App for Cancer Prevention was developed to disseminate these recommendations. However, its effectiveness depends on usability across populations with varying digital and health literacy; this study evaluates the app’s usability among diverse European populations.ObjectiveThis study aimed to identify enablers, barriers, and user requirements for the use and maintenance of the English version of the EU Mobile App for Cancer Prevention, focusing on how usability varied across individuals with different levels of digital health literacy and diverse sociodemographic backgrounds. In addition, user feedback on mock wireframes—visual representations of the app’s interface and functionality—was gathered to evaluate usability and ease of use, providing insights for tailoring the app design to a broader population.MethodsWe conducted a mixed methods study in 7 European countries with 76 adults aged 19‐84 years recruited via purposive quota sampling. Participants completed quantitative usability testing using mock wireframes to perform 10 predefined tasks simulating core app functionalities (eg, profile setup and health goal tracking). We recorded task completion time, success rates, self-reported confidence, and perceived difficulty. Digital health literacy was assessed using the eHealth Literacy Scale (eHEALS) scale. Qualitative data were collected through focus group discussions guided by a semistructured interview guide, and transcripts were analyzed via thematic content analysis. Statistical analyses included descriptive statistics and 1-way ANOVA to explore group differences.ResultsOverall task completion rates ranged from 75% to 98%, with a median of 86%, indicating general usability. However, usability varied by age, education, and digital health literacy: younger participants and those with higher education and literacy levels reported greater confidence and lower difficulty, whereas older adults and lower-literacy users experienced more challenges. Qualitative analysis identified key themes affecting usability: the need for accessibility (multilingual support and simple language), user-centric design (age-friendly interfaces and intuitive navigation), ethical concerns (data privacy and security), and motivational features (gamification and personalized health goals).ConclusionThe app is generally usable across diverse populations but requires streamlined interfaces and design adaptations to accommodate varying digital health literacy. Ensuring robust data privacy practices is essential for fostering user trust, and integrating motivational elements may enhance sustained engagement. Future work will involve piloting the finalized app to evaluate its real-world uptake and impact on cancer prevention behaviors.

The European Commission (EC) proposal for New Genomic Techniques (NGTs) of July 2023 specifies that Category 1 NGT (NGT1) plants, which are considered equivalent to conventional plants, that is those obtainable by conventional plant breeding or mutagenesis, may differ from the recipient or parental plant by no more than 20 insertions, which cannot be longer than 20 bp; deletions can be no more than 20 but of any size. Here, we examine the proposed 20/20 NGT1 limit against the background of the theoretical considerations and older data used to frame it and in light of recent data from highly contiguous long-read assemblies for reference genomes and pangenomes. We find that current genomic data indicate that natural variation in germplasm used by breeders is much greater than earlier understood and that both conventional breeding and mutagenesis can introduce genomic changes that are both more extensive in size and more frequent than the NGT Category 1 '20 insertions of maximum 20 bp' limit would allow. Furthermore, natural variation also scales with genome size and complexity, a factor not considered in the EC proposal. We conclude that the proposed cut-offs under which an NGT plant is considered equivalent to conventional plants do not align with what is observed in nature, conventional breeding and mutagenesis. Updating the 20/20 rule to broader limits would facilitate breeding for climate resilience, farming sustainability and nutritional security, while ensuring that NGT1 plants are equivalent to conventional ones.

Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal RETUD registry. All analyses are descriptive in nature; therefore, P values are not reported. A total of 1438 patients with a median age of 68.7 years (range: 34-94 years) were included between 1 January 2019 and 31 December 2022. 79.7% of patients had an Eastern Cooperative Oncology Group performance status of 0-1. 54.9% of resectable patients received adjuvant chemotherapy after upfront surgery, with a median overall survival (mOS) of 33.3 months (range: 26.1 months-not reached) for those treated with Folfirinox. 79.5% of metastatic patients received first-line chemotherapy, primarily gemcitabine and nab-paclitaxel (62.6%), with a mOS of 8.7 months (range: 7.1-9.6 months). Overall, 1- and 3-year net survival rates were 46% and 9%, respectively, with a clear increase for resectable/borderline stages. KRAS, microsatellite instability (MSI), and germline BRCA1/2 were determined in 16.4% (81.8% mutated), 21.2% (1.6% MSI-high), and 9.2% (12.8% mutated) of patients, respectively. Our study provides a real-world perspective on PC patients in Spain, revealing very poor survival similar to those reported in population-based and epidemiological studies. Notably, resectable PC patients receiving adjuvant chemotherapy had lower survival compared with those in clinical trials, a trend not observed in more advanced stages. Adherence to international guidelines varied, and clinical trial participation was low. Additionally, access to molecular testing was limited, remaining a significant challenge.

Pancreatic cancer (PC) remains one of the most challenging malignancies to treat. Current therapeutic options are unsatisfactory, and there is an urgent need for more effective and less toxic drugs to improve the dismal prognosis of PC. In recent years, drug repurposing (DR) has emerged as an attractive strategy to identify novel treatments for PC by leveraging existing drugs approved for other indications. Through the use of electronic medical records, Artificial Intelligence, study of metabolic pathways, signalling pathways, and many other approaches, it has become much easier in recent years to identify potential novel uses for old drugs. Although policy, funding and research attention in this area are steadily growing, major challenges to efficient and effective patient-centric DR in PC need to be addressed. These include but are not limited to regulatory, financial and funding barriers and the lack of coordination and collaboration among several sectors and stakeholders. To explore the opportunities and challenges associated with DR in PC, a one-day multi-stakeholder meeting was held on 14th of November 2023 in Brussels, Belgium as part of the REMEDi4ALL project. This meeting provided a platform for researchers, clinicians, industry representatives, funders, regulatory experts, and patient advocates to discuss and propose actions to optimize and accelerate DR in PC. Insights from this meeting support the potential of DR to enhance PC treatment options while highlighting the importance of systemic and supportive changes in the regulatory, policy and funding landscapes, interdisciplinary collaboration, data sharing, and patient involvement in driving therapeutic innovation. This summary highlights key outcomes and recommendations from the meeting in informing future efforts to advance DR initiatives in the context of PC.

The Jordán-Chicamocha River, born in the Runta district south of Tunja, has undergone significant changes due to human development, which has led to eutrophication, loss of vegetation cover, and increased frequency of flooding. The ecological quality and ecosystem services (ES) were evaluated in three sections of the river through in situ sampling of physicochemical variables and analysis of benthic macroinvertebrates, identifying 13 families, with a predominance of Tubificidae and Glossiphoniidae. These findings are related to high levels of hardness, phosphates, nitrates and electrical conductivity, in addition to evidence of physical degradation in the riverbed and riverbank. According to the Andean Biological Index (ABI), the ecological quality is classified as moderate, very poor, and poor. A total of 100 surveys indicated that, despite the provision of wildlife habitats and water availability, these benefits diminish with increased urbanization and lower ecological quality. Anthropogenic activities exert pressure on the ecosystem, altering the composition and distribution of the evaluated community and affecting the ecological quality, functions and services of the aquatic ecosystem.