SAGITTARIUS aim to optimize the clinical management of locoregional stage II high-risk/stage III colon cancer (LRCC). Approximately half of all LRCC patients relapse within two years from time of curative surgery because of imaging-undetectable micro-metastatic residual disease (MMRD). Given the lack of reliable predictors of individual risk, LRCC patients are treated with a one-fits-all adjuvant chemotherapy. This gunshot approach results in either over- or under-treatment. Measuring circulating tumor DNA (ctDNA) in the patients’ bloodstream can diagnose MMRD. Retrospective studies show that ctDNA detection after surgery predicts cancer recurrence with high sensitivity and specificity. SAGITTARIUS will deploy a ctDNA assay to detect the absence, presence, or persistence of MMRD in individual patients. The diagnosis of MMRD will guide and personalize therapeutic interventions. SAGITTARIUS is a pragmatic trial whereby real-world patients are treated in two parallel trials based on their MMRD status and the genomic landscape of their tumors. ctDNA positive patients are randomized to conventional or personalized targeted therapy. ctDNA negative patients are randomized to a physician-driven therapy or a Wait&See strategy. The efficacy and effectiveness of this potentially ground-breaking new strategy of care will be measured via multiple outcomes, including safety and time to events variables, patient-reported outcome measures, and health-economics evaluation. Since colon cancer deaths are usually associated with metastases rather than local disease, MMRD will also reclassify how this disease is perceived by clinicians. This new prism will allow for treatment to be better matched against the tumor biology, also allowing for better monitoring – via ctDNA – to assess disease evolution in each patient, minimizing harm and maximizing the odds of cure. This action is part of the Cancer Mission cluster of projects on ‘Diagnosis and treatment.

The public-private partnership, READI, seeks to help clinical studies (CS) to finally serve the complete general population, and therefore more patients. To date CS have struggled to recruit and retain participants from diverse backgrounds and communities, such as marginalized or disadvantaged groups (e.g., sexual, gender, age, cultural, and socioeconomic cohorts). The resulting knowledge gaps entrench or increase health disparities. The READI consortium strives to tackle these challenges by fostering a more cohesive and integrated CS ecosystem for underserved (US) and underrepresented (UR) communities. It will actively connect all key stakeholders who can facilitate access to a wide range of patient populations. It will provide these stakeholders with the necessary tools, training programs, and approaches essential for the recruitment and retention of US/UR patients in CS. In addition, it will design, build and implement a digital platform which is patient-centred, sustainable, open and innovative. This will foster improved access to CS information and READI tools, while also supporting patient connections with the created communities. Finally, at least 4 CS will be used for testing the effectiveness of the developed tools and approaches. READI has a three-fold objective: to help US/UR communities overcome CS participation barriers (e.g., lack of information/awareness, mistrust, poor communication, geographic limitations, prejudice), which in turn will improve research of many diseases and conditions, preventative care and treatment effectiveness in different demographic groups, and better serve society. READI’s success will draw from its interdisciplinary, multi-stakeholder, consortium composition of 73 organizations from 18 countries, with key expertise in drug development and CS (design and operations), engagement strategies for US/UR populations, digital platform development, training and capability building initiatives, effective communication and dissemination, long-term sustainability, ethics and regulatory affairs.

This proposal for a European Cancer Patient Digital Centre (ECPDC) Information Portal, EU-CIP, addresses the information needs of cancer patients, survivors, relatives, and caregivers. EU-CIP aims to create a patient-centric cancer information portal that improves health literacy, empowers patients, and reduces inequalities in access to cancer care information across Europe. The EU-CIP primary goal is to improve quality of life and enhance cancer patient care by improving access to general and personalized knowledge, delivering comprehensive information on cancer prevention, early detection, diagnosis, and treatment options including risks, side effects and late effects as well as information on rehabilitation and management of recurrence and palliative care. EU-CIP will prioritise high-incidence cancers, those with poor prognosis, and paediatric cancers. A Common Library of Contents available to all Member States will be created and EU-CIP nodes will be deployed in 10 Member States. The Library of Contents will use information from evidence-based sources such as the Knowledge Centre on Cancer and the European Cancer Information Service, existing Cancer Information Portals, and European guidelines. A governance framework for scalable content creation and review processes supported by AI tooling will be established. The consortium partners, including several patient organisations, will ensure that the patients’ view is reflected in the content review and technology usability aspects. The EU-CIP Central and local nodes will be built in a modular fashion to allow integration with existing electronic health infrastructures. To align with the EU Cancer Mission goal to improve lives through prevention, EU-CIP will raise awareness about the Mission and Europe’s Beating Cancer Plan. Alignment with the Mission’s overall plans will be realized through collaboration with the EU funded projects of the related 01-01/01-02 calls.

Most cases of gastric cancer (GC) are detected at a late stage, when patients have a median life expectancy of about a year. Diagnosing people at risk of developing GC at the pre-symptomatic stage, typically chronic gastric inflammation, could significantly improve the outlook. Artificial intelligence (AI) can help clinicians make sense of their own data by automating much of the treatment and analysis, which require manual work and years of experience. But it can do more: it can bring together available data from various sources into a vast data lake and cross-correlate the data to derive a ‘risk score’ for gastric cancer and shed light on the mechanisms of its evolution. Aida aims to do just that. It helps researchers understand the mechanisms that trigger gastric oncogenesis, helps clinicians diagnose precancerous inflammation at the earliest possible stage, suggests personalised therapeutic strategies for treatment and follow-up, and makes personalised recommendations for monitoring patient health status, thus contributing to gastric cancer prevention. This places Aida squarely on Europe’s agenda of ‘Staying healthy in a rapidly changing society’. Aida unites some of Europe’s leading authorities in the field of gastric inflammation, gastric cancer, leading AI and machine learning experts, experts on data governance and privacy, representatives of the public administration and patient advocates. Aida also has strong ties with the industry. After the project, the results will live on in an association that acts as a transnational focal point for chronic gastric inflammation — and GC in general. We hope that the solid, inclusive design principles of Aida, its societal relevance and its durability will spawn a vigorous ecosystem around chronic gastric inflammation, its understanding and its treatment. And we hope that it will inspire other data collaboratives in health — for other chronic inflammations, other forms of cancer or other ailments altogether.

The overall goal of DISCERN is to understand the causes of three poorly understood cancers in Europe; renal, pancreatic and colorectal cancer, and help to explain their geographical distribution, including their high incidence in central and eastern Europe. This will be achieved by combining large-scale European biorepositories comprising population-based cohorts and tumour case-series with state-of-the-art molecular profiling techniques and machine learning approaches. In particular, DISCERN will identify potential new causal risk factors for the three cancers using novel exposomics and proteomics scans, as well detailed geospatial and environmental exposure information from 16 large-scale epidemiological cohorts including almost 900,000 individuals. It will also explore biological mechanisms on how these risk factors are potentially causing these cancer types with a focus on promoting factors in normal tissues using deep sequencing, single cell multi-omics and spatial proteomics. The causal effects of identified cancer risk factors and the cellular signalling responses they trigger will be further evaluated using a panel of stem cells and colon, renal and pancreatic 3D organoids. The results from DISCERN will be disseminated to citizens, patients and policy makers through collaborating patient and participant organizations. DISCERN will provide the critical evidence base required to develop new prevention strategies to tackle the growing burden of renal, pancreatic and colorectal cancer in Europe. This action is part of the Cancer Mission cluster of projects on "Understanding".