Summary

While childhood cancer survival rates are increasing in Europe, they remain low in Lithuania – partially due to a lack of innovative research in the country.1 2 To combat this, the Twinning in Research and Education to improve survival in Childhood Solid Tumours in Lithuania (TREL) project was initiated by the European Commission.3 The project partnered the Vilnius University Hospital Santaros Klinikos (VULSK) with research-intensive organisations from across Europe, which provided education, training and management support to researchers at VULSK.4 The project has resulted in the initiation of novel research, VULSK involvement in a number of clinical trials, the establishment of a long-term follow-up clinic, and the implementation of the European Survivorship Passport.5 The TREL project demonstrates the positive effect that twinning has on research capabilities and capacity and childhood cancer survivorship.

Challenge

Childhood cancer five-year survival rates are increasing in Europe, with the most developed countries experiencing an average rate of over 80%.1 However, there are persistent inequalities in survival rates across the continent, with Eastern European countries experiencing lower survival rates.

Lithuania has 10–20% lower childhood cancer survival rates than the European average.6 While this is partially attributed to low per-capita health expenditure, a lack of cancer research and innovation is also cited.2 Innovation in cancer research is directly linked to cancer survival rates.7 8 For example, in the UK, huge investment in breast cancer research and innovation has doubled the five-year survival rate to 85%.4

Lithuania’s low research capacity and limited resources to participate in multinational clinical trials are thought to be key reasons for the country’s low childhood cancer survival rates.5

Solution

The Twinning in Research and Education to improve survival in Childhood Solid Tumours in Lithuania (TREL) project was initiated in 2020 as part of the European Commission’s Horizon 2020 programme. The aim of the project was to enhance Lithuania’s research profile and increase scientific excellence in paediatric solid tumours in order to improve childhood cancer survival rates.3 5

The project twinned the Vilnius University Hospital Santaros Klinikos (VULSK) in Lithuania with eight leading research-intensive organisations in Austria, Belgium, Denmark, France, Italy and the Netherlands.3 Twinning is an institution-building tool that helps bridge gaps in research and innovation by providing networking, coordination, training and management support.9

The primary objectives of the TREL project were to:5

  • increase understanding of translational research to assess the drivers of childhood cancers
  • improve researcher knowledge and skills to handle innovative therapies in early-phase clinical trials
  • foster collaboration in clinical research and improve preparedness to conduct prospective clinical trials
  • scale up research on childhood cancer survivorship quality of life, including fertility research
  • integrate VULSK into pan-European research activities
  • train early-stage researchers (e.g. medical students and PhD candidates) to allow them to collaborate in large-scale research projects and initiate their own
  • disseminate the impact of twinning activities
  • strengthen research capacity at VULSK.

What has been achieved?

The TREL project ran from 2021 to the end of 2023.3 An evaluation of the programme found that it achieved the following:5 10

  • Nine cross-centre educational events
  • The initiation of research on fertility preservation in children with cancer
  • Ten VULSK researchers joining international research groups
  • Six signed agreements for VULSK to participate in international academic clinical trials
  • Training in, and implementation of, liquid biopsy techniques to allow for neuroblastomas to be analysed at VULSK
  • The establishment of a long-term follow-up clinic to ensure continuity of care
  • The publication of five journal articles – four of which had VULSK early-stage researchers as lead authors
  • The implementation of the European Survivorship Passport
  • This tool aims to provide all European childhood cancer survivors with optimal long-term care by making medical records instantly available in any European hospital. This allows follow-up care to be sympathetic to previous treatments or potential risks.11

The project also had a direct impact on patient wellbeing and experience, with:5 10

  • 32 patients receiving personalised treatment recommendations based on multidisciplinary discussions from experts in partner organisations
  • 25 rare genetic variants of childhood cancers being classified by twinning VULSK researchers with bioinformation teams at partner organisations.

The TREL project was considered to have met all its objectives, and a direct effect has already been felt by those who received multidisciplinary care recommendations.10 Results from the project were presented at a number of conferences, demonstrating the positive effect that twinning has on research capabilities and capacity in order to provide high-quality care and improve childhood cancer survivorship.3

Next steps

VULSK researchers are continuing to improve the provision of childhood cancer care and research based on the expertise they gained during the TREL project. Their knowledge of tumour biology will be used to enhance diagnoses and risk stratification in children with central nervous system cancers and neuroblastomas.5 10

With the skills taught by partner organisations, they hope to implement whole genome sequencing to enhance VULSK’s diagnostic capabilities, and expand liquid biopsy capabilities into other cancers.10

VULSK is now participating in a number of clinical trials on childhood cancers, with more on the horizon.5

References:

  1. Botta L, Gatta G, Capocaccia R, et al. 2022. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study. The Lancet Oncology 23(12): 1525-36 [accessed: October 2024]
  2. Pritchard-Jones K, Lewison G, Camporesi S, et al. 2011. The state of research into children with cancer across Europe: new policies for a new decade. Ecancermedicalscience 5: 210 [accessed: October 2024]
  3. European Commission. 2024. Twinning in Research and Education to improve survival in Childhood Solid Tumours in Lithuania. Available here: https://cordis.europa.eu/project/id/952438 [accessed: August 2024]
  4. National Institute for Health and Care Research. Research brings advances and innovation in breast cancer treatment. Available here: https://bepartofresearch.nihr.ac.uk/articles/breast-cancer/ [accessed: October 2024]
  5. Rascon J, Blackute R, Cerkauskiene A, et al. 2024. Twinning to reduce research and innovation inequalities in paediatric solid tumours across Europe. EJC Paediatric Oncology 3: 100153 [accessed: October 2024]
  6. Gatta G, Botta L, Rossi S, et al. 2014. Childhood cancer survival in Europe 1999–2007: results of EUROCARE-5—a population-based study. The Lancet Oncology 15(1): 35-47 [accessed: October 2024]
  7. Lichtenberg FR. 2017. The Impact of Pharmaceutical Innovation on Premature Mortality, Hospital Separations, and Cancer Survival in Australia. Economic Record 93(302): 353-78 [accessed: October 2024]
  8. Lichtenberg FR. 2019. The long-run impact of new medical ideas on cancer survival and mortality. Economics of Innovation and New Technology 28(7): 722-40 [accessed: October 2024]
  9. European Commission. Twinning. Available here: https://international-partnerships.ec.europa.eu/funding-and-technical-assistance/technical-assistance/twinning_en [accessed: August 2024]
  10. European Commission. 2023. Cross-border skills exchange helps children in Lithuania get the cancer treatment they deserve. Available here: https://projects.research-and-innovation.ec.europa.eu/en/projects/success-stories/all/cross-border-skills-exchange-helps-children-lithuania-get-cancer-treatment-they-deserve [accessed: October 2024]
  11. The European Society for Paediatric Oncology (SIOPE). Survivorship Passport. Available here: https://siope.eu/activities/joint-projects/survivorship-passport/ [accessed: October 2024]