In the evolving battle against cancer, a powerful synergy between laboratory research and clinical practice is transforming how we develop new treatments.
The landscape for cancer research is profoundly different today from that of only one decade ago. Basic science is moving rapidly, and biotechnological revolutions in molecular targeting and immunology have completely modified the opportunities and concepts for cancer treatment. We have now entered the age of molecular therapeutics—drugs rationally designed to target strategic checkpoints that underlie the malignant phenotype, moving beyond the era of cytotoxic molecules screened with toxicity as their primary endpoint.
At the heart of this transformation lies translational research, the critical bridge between laboratory discoveries and patient care. The European Organization for Research and Treatment of Cancer (EORTC) has recognized this shift and has pioneered the integration of translational research directly into its clinical trial cooperative group mechanisms, creating a continuous feedback loop that accelerates progress and refines treatment strategies for cancer patients across Europe and beyond 1 .
Molecular targeting and immunology have transformed cancer treatment approaches.
Connecting laboratory discoveries directly to patient care through integrated research.
Translational research analyzes biological materials—blood, tissue, and other samples—collected during clinical trials to deepen our understanding of each tumour, knowledge that can be directly applied to improve cancer treatment 9 .
This approach represents a fundamental shift from traditional methods. Where researchers once screened cytotoxic molecules in the laboratory before testing them in clinical studies with toxicity as the primary endpoint, they now focus on "proof of principle with mechanistic analysis" 1 . This strategy allows optimization of therapy from the beginning and provides crucial feedback to pre-clinical drug developers.
Screen cytotoxic molecules → Clinical trials with toxicity as primary endpoint
Proof of principle with mechanistic analysis → Optimize therapy from beginning
Translational research plays distinct but equally important roles at different stages of drug development:
It enables radically different trial designs and validates new biological endpoints, ensuring the full potential of these new agents is realized 1 .
It helps define different patient populations that may benefit to differing degrees from new treatments, refining clinical practice toward a more patient-tailored approach 1 .
Recognizing translational research as essential to modern cancer drug development, the EORTC has established a comprehensive infrastructure to support its integration throughout the clinical research pathway 1 .
Reviews proposals for new drug development and ensures a coherent scientific strategy regarding both drug development and translational research 1 .
Provides expert scientific and practical advice on translational research projects, prioritizes projects, and oversees quality assurance for the research conducted 1 .
The EORTC's Translational Research Unit works alongside its Laboratory Research Division, which includes specialized groups focusing on screening and pharmacology, molecular mechanisms, biomarkers, functional imaging, and pathology 1 . This structure ensures that the necessary expertise is embedded throughout the research process.
Screening & Pharmacology
Molecular Mechanisms
Biomarkers
Functional Imaging
Pathology
Data Management
The EORTC 1333/PEACE-3 study exemplifies how translational research principles are applied in a modern clinical trial setting. This randomized, open-label, multicentre phase III trial investigated treatments for metastatic castration-resistant prostate cancer (mCRPC) in collaboration with international groups including Clinical Trial Ireland and the Canadian Urological Oncology Group 2 .
The trial enrolled 446 asymptomatic or mildly symptomatic patients with mCRPC and at least two bone metastases. Participants were randomized to receive either:
160 mg daily
Androgen receptor inhibitor targeting hormone signaling pathways in prostate cancer cells.
Six intravenous injections of 55 kBq/kg every four weeks
Combination approach: enzalutamide as androgen receptor inhibitor and radium-223 as targeted alpha therapy binding to bone metastases.
The PEACE-3 trial demonstrated significant benefits for the combination therapy approach:
| Endpoint | Enzalutamide Alone | Enzalutamide + Radium-223 | Hazard Ratio | P-value |
|---|---|---|---|---|
| Radiological Progression-Free Survival | 16.4 months | 19.4 months | 0.69 | 0.0009 |
| Overall Survival | To be presented | To be presented | Significant improvement confirmed | Final analysis 2025 |
The primary analysis, published in Annals of Oncology, showed that adding radium-223 to enzalutamide significantly improved radiological progression-free survival from 16.4 to 19.4 months 2 . An interim analysis suggested an overall survival advantage, and the final overall survival analysis completed in September 2025 confirmed this significant benefit 2 .
months with combination
months with single agent
The PEACE-3 trial represents a model of translational research in practice by:
Translational research requires sophisticated infrastructure and specialized tools. The EORTC has developed comprehensive resources to support this work across its network.
| Tool/Platform | Primary Function | Application in Translational Research |
|---|---|---|
| SPECTA Platform | Molecular screening across tumour types | Aids patient selection for clinical trials through quality-controlled molecular analysis 9 |
| Tissue Banking Systems | Collection, storage, and management of biological samples | Enables large-scale biomarker studies and retrospective analyses 1 |
| Validated Assays | Reproducible measurement of biological endpoints | Ensures reliable data on molecular targets and treatment effects 1 |
| Functional Imaging | Visualizing and quantifying biological processes | Provides non-invasive methods to monitor treatment response 1 |
| Quality Control Systems | Standardizing methodologies across multiple centres | Ensures consistency and reliability of translational data in multicentre trials 1 |
Implementing translational research as a key component of drug development presents several unique challenges that the EORTC's infrastructure specifically addresses:
Balancing researcher preferences for tissue samples with patient comfort and ethical considerations 1
Ensuring assays are specific, reproducible, and sufficiently sensitive to detect relevant "molecular signatures" 1
Standardizing procedures across different institutions and countries to ensure data consistency 1
Fostering effective teamwork among clinicians, basic researchers, imaging specialists, pathologists, and statisticians 1
Comprehensive guidelines for sample collection, storage, and analysis
Rigorous validation processes for all assays and methodologies
Ensuring consistency across multiple research centers
Facilitating communication and collaboration across disciplines
The EORTC continues to evolve its translational research capabilities under new leadership. Professor Benjamin Besse was recently announced as President-Elect, bringing his expertise in thoracic cancers and personalised treatment through molecular profiling 6 . Similarly, newly appointed Co-Chairs of the Scientific Chairs Council, Professors Anne-Marie Dingemans and Jean-Pascal Machiels, bring specialized expertise in lung cancer and head/neck cancers respectively, reinforcing EORTC's commitment to translational research excellence 6 .
President-Elect
Co-Chair, Scientific Chairs Council
Co-Chair, Scientific Chairs Council
The organization's participation in conferences like the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics further demonstrates its ongoing commitment to advancing the field through global collaboration and knowledge sharing 3 .
"The future of cancer research lies in deepening connections between bench and bedside. The EORTC's comprehensive framework provides a robust model for building collaborative, multidisciplinary networks necessary to realize the full potential of translational research for patients worldwide."
The integration of translational research into clinical trial cooperative group mechanisms represents a paradigm shift in cancer drug development. By creating systematic pathways for biological insights to inform clinical practice and for clinical observations to guide basic research, organizations like the EORTC are accelerating progress against cancer.
This approach has moved us beyond the one-size-fits-all model of cancer treatment toward a more personalized, patient-tailored approach that considers the unique molecular characteristics of each patient's disease. As the PEACE-3 trial demonstrates, this integration leads to tangible improvements in patient outcomes—prolonging survival and enhancing quality of life.
Bridging laboratory discoveries with clinical applications to deliver personalized cancer care
References will be listed here in the final publication.