More than 50% of cancer patients develop pain before death: 80% can be treated with drugs, but 20% show a low response or have serious adverse effects. Although non-pharmacological interventions such as neurosurgical procedures have been tested, these alternatives are not a preferred option to treat cancer pain due to their high cost, risk, invasiveness and not always proven efficacy. PAINLESS addresses a core component of pain relief, by using an innovative, evidence-based approach. The objective is to adapt and implement a novel, cost-effective, home-based intervention based on neuromodulation to reduce pain and improve quality of life of cancer patients with chronic pain. On the assumption that treatment of chronic pain can benefit from research on the brain mechanisms of pain, we will first attempt to improve our understanding of the role of central pain modulation. The project will be organized in 3 studies: 1) A cohort, longitudinal study (n=450) to explore whether the biomarkers of central pain modulation mechanisms can be predictive of the future occurrence of chronic pain in cancer patients; 2) A cross-sectional study to characterize and stratify cancer patients with vs. without chronic pain (750 patients with the proposed biomarkers and taking into account a number of moderator variables); 3) A pilot study (n=450) to assess the feasibility an efficacy of at-home delivery of transcranial low intensity electric stimulation (tES) for the palliative care of cancer patients suffering from pain PAINLESS will develop a customized web portal to share knowledge and to improve management of the patients; perform techno-economic analyses and Health Technology Assessment of the solution; analyze the possibilities of implementation in different European healthcare systems and results exploitation; and undertake an ambitious dissemination and communication strategy. We will also propose a wide range of measures to ensure compliance with the highest ethical standars.

Colorectal cancer (CRC) is one of the most common cancer types and its increased occurrence may be attributable to adverse health behaviors, especially in lower socioeconomic status populations. Stemming from the specific risk factors identified with CRC, ONCODIR integrates multidisciplinary research methods from health policy analytics; social and behavioural science; AI-powered multi-omics and retrospective data analytics as well as decision support theories to deliver evidence-based cancer prevention programmes and innovative AI-powered personalised prevention approaches. ONCODIR recognises that the evaluation of the ONCODIR prevention programmes needs to address cost effectiveness, affordability and cost benefit parameters. Thus it will also investigate cost balancing and demand generating financial schemes that will lead to enhanced CRC prevention programmes. The coherent technological ecosystem that ONCODIR is developing is based on robust AI trustworthiness and privacy preserving principles to deploy recommendation services that will be specified by citizens, health policy actors and SSH experts, during three design thinking workshops. SSH research will address aspects such as the life-status, nutritional and social habits in tandem with Economics, Sociology and Local/Regional Cultural identity and Ethics. ONCODIR’s results will be validated in three Laboratory Integration Tests (LITs) and three Large-scale Intervention Pilots (LIPs) in five EU member states, with the active involvement of medical scientists, health care providers, foundations and consortium experts. The ONCODIR consortium is composed of complementary partners, coming from multidisciplinary research, technological and SSH domains, with a proven track record of high-quality research capacity. The carefully structured workplan, embodies a holistic approach toward meeting the ONCODIR objectives and delivering feasible policy-supporting outcomes of significant exploitation potential. This action is part of the Cancer Mission cluster of projects on ‘Prevention and early detection.

With Colorectal Cancer (CRC) being accountable for 12.4% of all deaths due to cancer, and with only 14% of EU citizens participating in screening programmes, there is an urgent need for accurate, non-invasive, cost-effective screening tests based on novel technologies and an increased awareness on the disease and its detection. Furthermore, personalized approaches for screening are needed, to consider genetic and other socioeconomic variables and environmental stressors that lead to different onsets of the disease. ONCOSCREEN responds to these challenges by developing a risk-based, population-level stratification methodology for CRC, to account for genetic prevalence, socio-economic status, and other factors. It complements this methodology by a) developing a set of novel, practical, and low-cost screening technologies with high sensitivity and specificity, b) leveraging AI to improve existing methodologies for CRC screening, allowing for the early detection of polyps and provision of a personalized risk status stratification, and c) providing a mobile app for self-monitoring and CRC awareness raising. Furthermore, ONCOSCREEN develops an Intelligent Analytics dashboard for policy makers facilitating effective policy making at regional and national levels. Through a multi-level campaign, the above-mentioned solutions are tested and validated. For the clinical solutions specifically, a clinical validation study has been planned with the participation of 4100 enrolled patients/citizens. To ensure the adoption of the developed solutions by the healthcare systems, their cost-effectiveness and financial viability will be assessed. The 48-months duration project will be implemented by a multidisciplinary consortium comprising of 38 partners, including technical solutions providers, hospitals, Ministries of Health as policy makers, legal and ethics experts, Insurance companies, involving actively end-users/citizens in all phases of implementation through targeted workshops. This action is part of the Cancer Mission cluster of projects on ‘Prevention, including Screening.