Cancer Research - Europa

groups and management structures. These subnets and platforms
will then be integrated in the European Leukaemia
Network which will conduct the integrated research programme
detailed below. The network will be managed by the Network
Coordinator (NC), the Scientifi c Network Manager (SNM) and
the Steering Committee (SC) consisting of the coordinators
(=Lead participants) of the work packages (WP). The University
of Heidelberg will provide the expertise for fi nancial, legal and
contractual management.
2. Set-up of European networks for each leukaemia and
related syndrome.
These networks will comprise the national trial groups for
each leukaemia and represent the fi rst stage of networking
and European integration.
3. Set-up of European platforms for each interdisciplinary
specialty.
These platforms are sub-networks of excellence of diagnostic,
therapeutic and biometric research groups on their own
and constitute interdisciplinary partners enabling the clinical
trial groups to achieve the high quality patient care and
research required for European leadership.
4. Performance of clinical trials (all leukaemias).
Employing uniform common data sets the trial groups will
continue their current trials funded by alternative sources and
will start new trials using diagnostic standards established by
the diagnostic platforms (WPs 10-13). Criteria for accreditation
of trials will be set up.
Lung infection and infl ammation is a growing problem within
all states of the EU, and the infections are routinely treated
with antibiotics. The pharmaceutical industry is interested in
the development of protein therapeutics, which can be used as
alternatives to antibiotics. There is a relatively fragile protective
barrier, the alveolar lining layer, which controls the interaction
between the atmosphere and the lung. The fi lm, known as lung
surfactant, plays two important roles, prevention of lung collapse
during respiration and provision of a fi rst line of defence
against the extremely varied range of particles, allergens and
microbes that are present in the environment. The lung surfactant
is a surfaceactive mixture of phospholipids and four
main surfactant proteins – SP-A, SP-B, SP-C and SP-D. The SP-
B and SP-C proteins are small, highly hydrophobic, polypeptides,
which are strongly associated with the phospholipid portion of
the surfactant, whereas SP-A and SP-D are large (approximately
600kDa) and complex, disulphide-bonded, proteins of
a more hydrophilic nature. They can bind, via their lectin
domains, to arrays of carbohydrate structures on the surfaces
of pathogenic microbes and to glycosylated allergens, thus
initiating defence against a range of viral, fungal and bacterial
lung infections and modulating allergic reactions. There is
TREATMENT
evidence of lowered levels of SP-A, and SP-D, in the lung
surfactant of a growing number of types of infection- or
allergy-mediated lung infl ammation, which strengthens the
case for testing the use of recombinant forms of these proteins
as therapeutic alternatives to antibiotics.
5. European Registry (all leukaemias).
A European registry will allow to determine incidence and
disease patterns across Europe including gender, age and
ethnic diff erences, investigate familiar aggregations, overlap
syndromes or precursor conditions, explore risk factors associations
and diff erences in gene environment interaction,
using data from cytogenetic analyses (WP 11) and genomic
profi ling (WP 13), perform quality of life assessments, recognize
sub-entities on the basis of cytogenetic or gene profi ling
information, follow-up patients for the development of prognostic
scores for old and new therapies and determine
proportions of patients in individual countries treated on specifi
c protocols or with specifi c therapies e.g. SCT (WP 14).
The registry will be run by the expert group Biometry for
Registry, Epidemiology, Metaanalyses and Prognosis (WP 17).
This group has gained a long-standing broad experience in
collecting data, performing meta-analyses and establishing
prognostic scores. The database established by the network
will have far-reaching implications for research and public
health planning far beyond the period of EC funding.
6. Standardisation.
Standardised and quality controlled diagnostic procedures
and therapies constitute the basis for improvements of clinical
outcomes. This concerns all diagnostic approaches such as
morphological diagnosis of blood and marrow cells (WP 10),
cytogenetics (WP 11), detection of minimal residual disease
(WP 12) and gene expression profi ling (WP 13) as well as therapies
such as transplantation, anti-infection prophylaxis and
treatment and the testing of new drugs in phase I/II trials
(WP 14 and 15). The establishment of standards for a wide
spectrum of diagnostic and therapeutic applications will raise
the quality of research and patient care beyond the period of
EC funding and will predictively have a profound impact on
outcome as measured by prolongation of life and cure rates
across Europe.
7. Meta-analysis and guidelines.
Whenever randomised trials are available for analysis (mostly
CML and AML), meta-analysis will be performed and published
(WP 17). On the basis of meta-analysis, evidence-based guidelines
will be worked out and used for the improvement of
patient management and for educational purposes (training
programmes, workshops in associated countries, exchange of
researchers and physicians for training purposes). Meta-analysis
will be also performed on combined data sets with rare
subtypes of leukaemias (WP6).
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