Precision oncology in the framework of personalized medicine: policies,networks, and multi-stakeholder initiatives in the european context

This doctoral thesis examines the governance, implementation, and translation of precision oncology in Europe, situating it at the intersection of science, regulation, and policy. It is guided by three core research questions: (i) how European platforms and partnerships shape strategic agendas in precision oncology; (ii) how EU-funded projects operationalise precision oncology in translational and clinical settings; and (iii) which systemic factors enable or hinder the integration of precision oncology into routine care.The study adopts a four-step methodology: (1) a structured evaluation of six European platforms (ERA PerMed, EU Cancer Mission, EFPIA Oncology Platform, All.Can, European Cancer Organisation, and EP PerMed); (2) semistructured interviews with stakeholders from clinical, regulatory, industrial, and patient domains; (3) a comparative assessment of six emblematic EU projects (IMPACT-AML, MEET-AML, SYNtherapy, 3DLeuko-TAD, SWEATPATCH, and PREDICO) through a multidimensional matrix; and (4) synthesis of results into cross-cutting analyses and policy recommendations. The analysis indicates notable advancements in strategic coordination and innovation capacity within precision oncology, although important challenges and disparities remain. Platforms have advanced coherent agendas, governance mechanisms, and funding structures, while projects have generated notable scientific and technological outputs. Yet persistent barriers remain: fragmented infrastructures, regulatory heterogeneity, misaligned reimbursement models, and insufficient integration of ethical, legal, and equity dimensions. Patient access to precision oncology continues to be uneven across Member States.The thesis concludes that consolidating Europe’s precision oncology ecosystem requires: (a) strengthening multi-level governance and infrastructure interoperability; (b) embedding equity, ethics, and patient engagement throughout research and implementation; (c) aligning regulatory and reimbursement frameworks across jurisdictions; and (d) ensuring long-term sustainability through durable partnerships beyond project-based funding. These steps are essential for realising the ambitions of the Europe’s Beating Cancer Plan and the Cancer Mission, and for delivering precision oncology as an accessible, equitable, and sustainable model of care.