Taking place today is the training program for clinical monitors within FORZA, the spin-off of the Clinical Research and Drug Strategies Committee managed directly by ACC. This program is due to the collaboration between the National Institute of Health and Alliance against Cancer – the National Oncological Network established in 2002 by the Ministry of Health and AIFA.

The course, which will conclude at the beginning of April, is the first operational act for the grounding of FORZA, which, as confirmed by its coordinator Sandro Pignata of the IRCCS Pascale Foundation in Naples, associated with ACC, aims to create an operational infrastructure among 29 Scientific Research and Care Institutes of ACC to foster clinical and translational academic research.

«The intention – says Pignata – is to improve the quality of Italian academic experimentation to make our country more competitive». The training offer for clinical monitors – IRCCS professionals who will work in the same institutes to monitor the correct application of the rules of good clinical practice in clinical trials – is 40 hours overall.

The coordination group of ACC, which is entrusted with the management of FORZA, is composed of the coordinator, Franco Perrone (Fondazione IRCCS Pascale Napoli), Oriana Nanni (IRCCS Dino Amadori IRST Meldola), Paolo Zucali (IRCCS Humanitas Milano), Gennaro Daniele (IRCCS Fondazione Policlinico A. Gemelli Roma), Nicoletta Colombo (IRCCS IEO Milano), Fabio Ciceri (IRCCS San Raffaele Milano), Diana Giannarelli (IRCCS IRE Roma), Emanuela Marchesi (ISG), and Paolo Pronzato (IRCCS Ospedale Policlinico San Martino).

Massimo Boni | ACC Press Office

On March 1, the TRANSCAN-3 program started, with sustained collaboration of national and regional programs in cancer research, funded by the European Commission under Horizon 2020 (Grant Agreement no. 964264).

The consortium of participating organizations announced the first Joint Transnational Call for proposals (JCT 2021), which will fund ambitious collaborative research projects focused on the topic: Next generation cancer Immunotherapy: targeting the tumour microenvironment. ACC will participate with a budget of 300 thousand Euros to finance a maximum of two projects among those submitted by researchers belonging to one of the member institutes of ACC. The full call will be published on 6 April 2021. More information is available on the TRANSCAN website and the EU website.

By Pier Giuseppe Pelicci, Gioacchino Natoli, Ruggero De Maria

In this last year of pandemic management, we have become accustomed to seeing political leaders from all over the world communicating decisions alongside a scientist. Decisions that directly impact the lives and health of hundreds of millions of people and have transformative effects on behaviours and wealth evoke a great debate in the media and among people.

All of this cannot surprise us. During a pandemic, society expects scientists to develop and provide knowledge of practical value, politicians to make almost instantaneous decisions based on available scientific data, and that the population cooperate to minimize the spread of the infection even at the cost of critical economic sacrifices and individual freedom.

But this can only be done on one condition: scientists, politicians and citizens develop mutual trust. Sars-Cov-2 is a new virus. But only a year after its isolation, we have numerous vaccines whose administration advances rapidly in almost all the world. Although there is still a long way to go to improve its effectiveness, increase its number and reach the entire world population, the possibility that the pandemic will come to an end is, for the first time, a real possibility.

How has this been possible? The international scientific community has made an unprecedented effort of cooperation and productivity. Never before have governments and individuals have invested in synergizing financial resources and professional skills, resulting in an impressive single scientific project.

But we hope that the positive consequences of this extraordinary success go far beyond the current pandemic due to the consolidation of the relationship of trust between society, science and politics. The steadily growing acceptance of consensus of the population for vaccination against COVID-19 is the tangible manifestation of mutual trust between science and civil society, with politics playing a mediating role.

A combination that may seem obvious, but at least on this scale, has no precedent. Our history is indeed studded with a long series of examples of deep distrust in science by vast sectors of society and politics on issues as necessary to the fate of humanity, from climate change to genetically modified organisms and food.

A crisis of mutual trust in the population has created widespread mistrust towards both politicians and scientists. Distrust is often linked to the perception of low reliability of scientific information due to distortions caused by scientists’ political beliefs or personal interests.

Thanks to the COVID-19 pandemic, the relationship between science, politics and society is now at the centre of the debate worldwide, with some lights and some shadows. There is no doubt that the pandemic has forced us to make urgent political decisions based on the scientific evidence available.

The results are striking. If this approach becomes a stable method of political government, it alone could change the history of human civilization. But by its very nature, the available scientific evidence is constantly evolving and therefore incomplete, requiring that many decisions are taken in conditions of uncertainty, often generating disagreement and distrust and an undeserved impression of the unreliability of science.

The pandemic has created uncertainties in every aspect of our lives (from work to the care of our loved ones and the education of our children). Tensions that create instability and fear and inexorably open to distrust and the search for “alternative” certainties, often fueled by disinformation and imaginative conspiracy theories. The theory of Sars-Cov2 generated by a Chinese laboratory is not different from that of the German submarine as the origin of the flu pandemic virus of 1918, called “Spanish,” based on fake propaganda news. Science itself does not possess a magic wand that allows an immediate return to everyday life. Instead, it offers answers based on the knowledge available at each specific moment and is therefore, by the nature of the scientific process itself, provisional and incomplete. Science has this nature.

Science is based on building up observations and their interpretation. As accurate as the data are, their understanding reflects far from infallible mental processes. Science progresses in stages, each of which generates new knowledge and at the same time further uncertainty, the uncertainty that becomes the basis of subsequent scientific investigations.

In the context of some phenomena, and the pandemic is one of these, the scientist cannot provide absolute certainties but often statistical evaluations: we do not speak of confidence of healing or protection through vaccination but of statistical probability, which thus provides a direct measure of the level of confidence (or rather uncertainty) of knowledge.

The inevitable uncertainty of science, often perceived by the public as a failure of the scientific process, is the foundation of progress, motivating the deepening and refinement of knowledge.

Unfortunately, there is also the uncertainty fabricated for special interests, which has nothing to do with science. The most striking example is the fabrication in the minds of citizens of disputes that do not exist in the scientific community. In most significant issues (such as climate and vaccines), there is a broad consensus in the scientific community, based on reliable data accumulated over the years and subjected to rigorous analysis.

For personal interests or protagonistic attitudes, the few scientists who express disagreement do so more often in the media or social networks than in the appropriate scientific locations. This situation is often presented to the public as evidence of a debate between parties deserving equal representation. It’s an old trick. For decades, in the last century, the tobacco industries have promoted the perception of the absence of scientific consensus on the damage caused by smoking. These tricks strongly undermine the public’s confidence in science, much more than honest communication of scientific data in their context of uncertainty, which has clear positive effects on an educated people to understand the nature of scientific progress. In these complex relationships, the media plays a fundamental role, which precedes the rigorous information with the emotional one based on the insinuation of doubts, uncertainties and fear to keep the listeners loyal to the developments of the discussion. The information world should also understand the importance of intercepting the thought shared by most scientists based on the available data rather than handing it over uncritically to the individual public opinions of scientists often not provided with the necessary skills or authority.

From here, we must start to face the following challenges: the economic revival economy, the next inevitable pandemic, the defeat of still incurable diseases and finally, the environment, probably the largest of all. In all these cases, as in pandemic management, science and politics will have to work together. Just as it is true that a good policy should be based on sound scientific evidence, it is also true that scientific evidence is not sufficient to guarantee the soundness of a policy choice. And it is also true that no policy will succeed unless it is consistent with the vision of humanity and society that we want to choose. The scientists are ready to play their part.

*Pier Giuseppe Pelicci
IEO and University of Milan
Alliance against Cancer

Gioacchino Natoli
IEO Milan

Ruggero De Maria
Alliance Against Cancer
Catholic University and Policlinico Gemelli of Rome
Italian Institute for Genomic Medicine of Turin

On World Cancer Day, the scientific coordinator of Alleanza Contro il Cancro, Prof. Pier Giuseppe Pelicci, will be a guest on Radio on February 4 at 6:15 P.M., an Obiettivo Salute – Risveglio, the daily appointment with Nicoletta Carbone with strategy experts, Practical methods and tips for an excellent start to the day.

In recent days Pelicci, referring to the speed with which anti-Covid vaccines have been prepared, had explained that «society should learn a collective social and political determination can achieve incredible results» adding that «If there were such a mobilization also for the research against cancer, the tumours would have a short life, ten or fifteen years at most».

It will soon be distributed to the twenty-seven IRCCS members of Alleanza Contro il Cancro (the National Oncology Network founded by the Ministry of Health) and to the main stakeholders of Italian health, the volume containing the guidelines for the establishment of the Molecular Tumor Board (MTB).

Organisms designed to evaluate and interpret the outcome of complex molecular tests, aimed at identification, in patients’ tumours or in liquid biopsies, molecular alterations of various kinds that allow to predict vulnerability to molecular target therapies or immunotherapies.

An interpretation, that of MTB, aimed at recommending therapies outside the standards but already approved for other indications or clinical development, for patients who have exhausted the standard lines of therapy for their disease.

MTB are organisms designed to evaluate and interpret the outcome of complex molecular tests, aimed at identifying molecular alterations in patients’ tumours or liquid biopsies that predict vulnerability to molecular targeting or immunotherapies.

The need for coding of MTB is inscribed in the Consensus Document on the development and organization of Mutational Oncology in Italy presented at the recent Annual Meeting of the Network. Prepared together with AIOM and signed by Società Italiana di Anatomia Patologica e Citologia Diagnostica, Res – Fondazione Ricerca e Salute, Periplo, Cipomo, Cittadinanzattiva and Fondazione per la Medicina Personalizzata, the document describes the historical paradigm shift in the approach to cancer treatment by introducing a cultural change with significant effects on both the health of patients and the organization of the National Health Service.

«The MTB has the task of addressing the complexity of the profound changes that technological innovation is causing in the approach to oncology patients,»  explains Prof. Ruggero De Maria, president of ACC. Diagnostics and therapy for tumours – he still says – reached a degree of unimaginable complexity a few years ago. Just think, for example, that the interpretation of the omic analyses needs the support of molecular biologists and bioinformatics. These new figures will contribute, together with other medical specialists, the choice of therapies to be carried out in patients with advanced tumours in the usual meetings of interdisciplinary groups.»

According to Prof. Gennaro Ciliberto, Scientific Director of IRCCS Regina Elena of Rome (ACC meambers), coordinator of the working group that drafted the guidelines, «The expected impact on the survival and quality of life of cancer patients resulting from the use of advanced technologies for the characterization of molecular alterations of tumours and the availability of an increasing number of target therapies and immunotherapies, is enormous.

MTBs have a great responsibility to ensure rigorous, standardized decisions and the generation of reliable data. Alliance Against Cancer has taken up the challenge by generating these guidelines that define the many aspects that characterize the life of an MTB. The auspice – Ciliberto has concluded – is that the MTB of single qualified institutions can work in regional and national nets to generate data of real-world evidence assuring uniformly and without inequalities to the oncological patients on the national territory, high diagnostic and therapeutic standards».

Massimo Boni | Press Office ACC

The thoughtful problem – it is said – is that of  oncological screenings because Italy does not invest in prevention. We have ageing mammographs and long waiting lists.

In the first five months of COVID, 1.4 million fewer screening tests were carried out than in 2019. No more than 2,000 breast cancers have been diagnosed. Non-emergent surgeries have been delayed by 64%. A very high price if we think that postponing cancer care by one month leads to a higher risk of death than 13%. Not to mention the research, whose activities – added De Maria – have been reduced by 93%; the remaining 7% is dedicated to research on the COVID. But what can be done now? The top priority is to reactivate cancer screening. It is also necessary to strengthen telemedicine, monitor oncological patients at home and surgery activities of 20-30% to recover accumulated delays.

It is necessary to increase the places.

Sorry, this entry is only available in Italiano.

Sorry, this entry is only available in Italiano.