British cancer patients could be left “significantly disadvantaged” by the UK’s departure from the EU, leading oncologists have said, as collaboration with European scientists has been vital to making breakthroughs in the field.
In an editorial published on Friday in the ecancermedicalscience journal, six doctors, representing cancer physicians, patient advocacy groups and genomics researchers, said the UK government must be prepared to fill in the gaps in law, regulation and resource allocation that would open up after Brexit.
“It’s important that the UK’s cancer researchers and cancer care providers watch the ‘Brexit space’ very closely,” they wrote. “We need to take every opportunity to remind the UK government that cancer patients and cancer research could be significantly disadvantaged, unless great care is deployed in the negotiations of the legal and economic frameworks which will govern the UK’s relationship with the EU beyond Brexit.”
The authors are the Nobel prize winner Sir Paul Nurse, CEO of the Francis Crick Institute; Peter Selby, the president of the Association of Cancer Physicians UK; Mark Lawler, the chair of transnational cancer genomics at Queens University Belfast’s Centre for Cancer Research and Cell Biology; Richard Baird, academic consultant in breast cancer therapeutics at the Cambridge University hospitals; Ian Banks, vice-president for patient advocacy at the European Cancer Concord; and Patrick Johnston, vice-chancellor of Queens University Belfast.
Lawler said: “It is vital that UK researchers continue to perform high-quality science that leads to new diagnostic tests and therapies for cancer patients. Research is no longer an ivory tower silo-type pursuit – collaboration is the key.
“UK scientists contribute greatly to the European research effort while having scientists from different countries working within our research institutions and hospitals contributes greatly to our battle against cancer.”
The authors, who in May argued the case for voting remain, said the consequences of the Brexit vote were unclear but expressed a lack of confidence current regulatory structures would be replaced by the UK government.
“There are widely held concerns among the cancer community,” they wrote. “Brexit would mean that the EU directive no longer applied in the UK, which is of concern to the manufacturers of devices and tests unless the EU and the UK share regulatory frameworks in future to allow ready import and export of devices/tests.”
Another complication is the fact that the headquarters of the European Medicines Agency (EMA) is in London. “It is also possible that the EMA would not feel it appropriate to have its headquarters in a country not fully part of the EU,” Lawler said.
“If the EMA [were] to move to another jurisdiction, then the Medicines and Healthcare products Regulatory Agency (MHRA) would have to step up to take over certain regulatory activities and conduct cooperations with other global regulators.”
The uncertainty about funding, Lawler said, could discourage senior researchers from relocating to the UK, particularly if they felt that prestigious funding such as European council grants were no longer available to them.
“Anecdotally, a number of UK institutions have already indicated that pre-Brexit recruits have turned down positions due to uncertainties related to continued EU funding,” he said.
Genetic analysis of tumour samples can help decide what course of treatment is best for individual patients and help researchers fully understand the mutations behind many cancers. One recently announced international project, Harmony, seeks to centralise and make better use of genetic data from blood cancer patients across Europe. But how sensitive patient data is handled is crucial.
“There would be considerable uncertainty about the movement of personal research data between the EU and the UK,” Lawler said. “Data protection regulations would influence UK companies wishing to trade in services to individuals within the EU. All of this is likely to be the subject of complex negotiations.
“We need to break down data silos, not build them up. It is vital for cancer research and most importantly for our patients that we share information that can help to identify new targets for cancer therapy.”
After Brexit, the group wrote, the UK will have to establish its regulations for clinical trials with a view to achieving the minimum necessary bureaucracy, as well as compatibility with other European countries for multinational trials.
They noted that some assurances have been offered: it has been agreed that current EU funding held by UK individuals and institutions will be honoured, and the government is talking about increasing the total spend available for research, within which cancer might figure significantly.
“But will they continue to fund researchers who compete successfully for European grants? That is the key question that needs to be answered,” Lawler said.
A spokesperson for the Department of Health said: “Ensuring patients have timely access to safe, effective medicines is and always will be a priority – in fact, Brexit brings opportunities in this area and we will be focused on whether we can secure even faster access to the latest innovations for British patients, as well as making sure the UK retains its position as one of the best places in the world to invest in life sciences.”
