The case for connecting de-escalation research across borders
We need more large-scale de-escalation studies to determine what exactly the optimal treatment for cancer patients is to minimise side effects. Networks such as EUnetCCC can help bring researchers across Europe together, says Solène Trévidic at the French National Cancer Institute (INCa).
De-escalation in cancer care means treating patients with less: lower doses, shorter treatment duration, fewer therapies.
“This [is] to minimise side effects and improve quality of life for patients, without compromising survival rates,” said Solène Trévidic. She works as an EU affairs manager and is part of the EUnetCCC coordination team.
The idea itself is not new — plenty of de-escalation studies are already under way. The problem is scale, Solène explained in a video interview on the sidelines of the EUnetCCC symposium on de-escalation studies, which took place in Amsterdam on 5-6 March 2026.
Smaller studies often fail to change clinical practice
Individually, these studies are “extremely important, but many of them remain small, national or single-centre initiatives. As a result, they sometimes lack the statistical power and the visibility to effectively change clinical practice,” Solène said.
That doesn’t mean the answer is to abandon local research — quite the opposite.
“We should also recognise that many of the most promising ideas actually tend to start locally, within individual centres or national research initiatives,” she said.
“This local innovation is highly valuable, because it is often where new approaches are first tested and new hypotheses emerge.”
De-escalation research, she noted, typically begins exactly this way: with a locally initiated study exploring a new hypothesis, or testing a new approach in a specific patient population.
The challenge, then, “is not to replace those local initiatives, but to try to better connect them with larger research infrastructures,” she said.
Bringing researchers together
This is exactly where networks like EUnetCCC come in — bringing together cancer centres across Europe that combine research, clinical care and advanced data infrastructures, Solène explained.
“These networks can really facilitate… multicentre studies that involve many more patients and share expertise. In that way, promising ideas that start locally can be tested and validated at a larger scale,” she said.
Solène added that it remains “very important to preserve the ability of individual centres to innovate.”
To succeed, bridges must be built between local innovation and European collaboration, she argued, “so that the most promising ideas that are initiated locally can grow into robust evidence that truly benefits patients.”
As she put it, de-escalation research ultimately comes down to one thing: “delivering the right treatment to the right patients at the right intensity. Local innovation should be the starting point — but collaboration between different hospitals, and across national borders, is what allows innovation to truly change practice.”