“Prioritise prospective studies and real-world data”

13 June 2017 By Loek Keizer

The EAU Research Foundation is uniquely placed to conduct and coordinate important prospective trials in the coming years, its new chairman has told European Urology Today.

Prof. Anders Bjartell (Malmö, SE) took over chairmanship of the EAU Research Foundation at EAU17 in London. Prof. Peter Mulders (Nijmegen, NL) chaired the Research Foundation for two four-year terms before him. Prof. Bjartell is an esteemed and experienced researcher and urologist, having previously worked with the EAU in different positions. (see insert)

On this occasion, we spoke to Bjartell about his views on the Foundation’s work, his ambitions and the field of clinical trials in general.

Strengths of the EAU RF

“Of course I’ve been familiar with the EAU RF for quite some time now,” Prof. Bjartell begins. “I’ve been following their work, and the Foundation has become more and more active in recent years, but I believe there’s a lot more to do.”

“Things have changed a lot in the last decade. On the whole, we’ve generated a lot of retrospective studies. Now what we need is to examine real-world data. How do drugs, biomarkers, and new genetic tests work? We also need to initiate prospective studies because these will be increasingly important in the near future. To focus on prospective studies and real-world data, that should be our focus as researchers and for the EAU RF.”

The EAU RF has some unique qualities that give it an advantage when establishing new trials, most of that is due to the position and reputation of the EAU itself.

Bjartell: “I think the EAU is a strong and established name in the world of urology. We not only have such a large membership to rely on, but also a Scientific Committee and a world-class Guidelines Office, with all of its panels. These different parts of the EAU are vital partners for the future work of the Research Foundation. As a research foundation, we can lean on all of this expertise when we set up new studies.”

“The EAU is also a strong partner in relation to other bodies. We have a good relationship with the EORTC, which we absolutely need to get close to and collaborate with in new studies, as well as with Cancer Research UK, and beyond Europe with the AUA. Patient organisations should also be considered very important stakeholders. In designing new trials and studies, I think it’s important to discuss with patient organisations what is relevant, to get their opinion about how the studies are designed and what we can achieve by initiating new studies.”

“On its own, the EAU RF already has a great team. As part of the EAU, we have a chance to bring together highly-skilled and experienced people. As part of an international body, this gives us the opportunity to initiate multicentre studies.”

Ambitions

The EAU RF faces some important challenges in the coming years. Prof. Bjartell points to the emerging of new biomarkers and improving cooperation as major challenges for the Foundation.

“New biomarkers are emerging, we need to identify even more. Crucially, it’s important to see how they work in real life. We need to critically evaluate biomarkers and new methods, treatments, and imaging modalities. There is so much still to be evaluated in prospective studies. It’s also important to collaborate with drug companies and other parties by providing new tests, biomarker tests and also imaging modalities. Together we can design the studies we really need to perform and take another step forward in helping patients.”

When asked if this marks a break from the previous policies of the Research Foundation, Bjartell praised his predecessor: “Prof. Mulders has done a wonderful job in initiating a number of new studies and mobilising many experts in different fields and we now have a solid platform for research. But because things are changing, sometimes very quickly, we need to identify which studies are most urgent today. Those will probably not be the same as we could identify only five years ago.”

“This will be a challenge, but personally I think the most urgent studies will have to look prospectively. Involving patient organisations in future studies is also essential. These will be my priorities in the coming years.”

Suggestions and submissions for new trials will be most welcome and always be considered at the EAU RF. “There are so many topics within urology that deserve our attention. All initiatives are welcome but of course we have to be selective and we cannot accept every proposal. It is also important for us to give feedback to those who propose the studies, and not just decline. We need to discuss the relevance of the study, the impact on patients, and its scientific soundness. Maybe the proposal only needs some modification before it goes ahead.”

Trends in research

Looking at the landscape of urological research in general, Prof. Bjartell sees some trends that will become more prevalent in coming years. Big data will determine the course of registries and trials more and more.

“As the number of registries increases, we need to know how to handle big data like genetic information and biomarkers in new tools and next generation sequencing. How should we manage this data, and how should we diagnose, monitor and treat patients in the future?”

Beyond diagnostics and treatment, patient monitoring can be improved as well: “be it through active monitoring, surveillance, and different options for post-treatment monitoring. There are so many steps between diagnosis and the final end-stage of the disease, and we need to take this into consideration when we devise new studies.”

Fellowships and investigator-led research

The EAU RF collaborates with the European Urology Scholarship Programme to offer researchers the opportunity to visit centres across Europe. These scholarships go beyond urology, also designed to involve basic scientists. Prof. Bjartell has personally divided his time between a career as a urologist involved with patients and a basic scientist involved with drug evaluations and clinical studies.

Bjartell: “It’s important for us to focus on new genetic tests, new ways to improve diagnostics, and the experts on these topics are basic researchers. We need to get close to them from the clinical side, and the basic and translational researchers also need clinicians to implement their findings in practice. The Research Foundation can create a bridge between basic and translational research on the one hand and clinics and clinical researchers on the other.”

On the role of industry in initiating trials, as opposed to those initiated by independent researchers: “Both are important. For instance, if a medical company recently performed a multicentre study, as there are many, then they will have a unique database. There’s so much more to be gained by further examining that database, allowing you to generate new studies from that.”

“If we initiate our own studies from the Research Foundation, we may also choose to get the industry involved, for a variety of reasons. That will of course be a win-win for both of us.”

 

Prof. Anders Bjartell: A career in research

Anders Bjartell has worked with or within the EAU for several years. He was Associate Editor for European Urology from 2005 to 2012, and he is a former chairman and board member of the EAU Section of Urological Research (ESUR). Bjartell is currently Senior Consultant in Urology at Skåne University Hospital (1998-) and Professor in Urology (2006-) and assistant Dean (2012‐2017) at the Medical Faculty of Lund University.

Bjartell is also a national principal investigator for several trials of new drugs in castration-resistant prostate cancer and Head of the clinical trial unit at the Urology Department at Skåne University Hospital. He leads a research group in translational prostate cancer research with long-term experience in prostate cancer biomarkers. His research also encompasses clinical projects on robotic surgery, imaging, and drug development. He has participated in several EU-sponsored prostate cancer projects, and he has published more than 235 peer-reviewed original articles.

Reflecting on his new position, Prof. Bjartell stated: “I’m extremely grateful to get this big opportunity to chair the Research Foundation. With my background in all different kind of research, and experience, I hope I can contribute and do something worthwhile in the coming years.”