Cancer affects 35,000 children, adolescents and young adults (CAYAC) in Europe each year. Current 5-year survival rates are 80%, but the intensive oncological treatments leave CAYAC Survivors (CAYACS) at increased risk of cancer or treatment-induced late health effects, excess morbidity and mortality, and reduced quality of life (QoL). Follow-up care of survivors includes monitoring of cancers, managing all types of late effects, and maintaining overall health. It should also involve considering the needs of families whose functioning has been disrupted by cancer. There are several challenges providing follow-up care for CAYACS and their families: i) it is resource-demanding in an overburdened healthcare system, ii) psychosocial and supportive care needs are often unmet, and iii) access is inequal between European countries. The overall goal of e-QuoL is to use e-health tools to promote Equity in Quality of Life for CAYACS and their families. It will adapt an existing interoperable personalised e-Health tool that can be used alone or as an add-on module to existing tools such as digital survivorship care plans already used in several European countries. Through participatory research, involving CAYACS, families, associations, networks, health institutes, social sciences and humanities researchers and industrial partners from 15 different countries and backgrounds, we will i) identify the unmet needs of CAYAC families and survivors’ (including vulnerable groups: young age and cognitive impairments) and ii) adapt accessible and affordable tools to address these needs. These tools will provide a person-centred approach from medical follow-up, preventive behaviours (e.g. physical activity, nutrition), psychological and social support (e.g. education, employment) to related health information (e.g. on reproductive issues). Ultimately, e-QuoL will improve CAYACS’ QoL by enabling them to actively engage in their care and better self-manage their health and well-being. This action is part of the Cancer Mission cluster of projects on “Quality of Life.

The ARTEMIs project aims to consolidate existing computational mechanistic and machine-learning models at different scales to deliver ‘virtual twins’ embedded in a clinical decision support system (CDSS). The CDSS will provide clinically meaningful information to clinicians, for a more personalised management of the whole spectrum of Metabolic Associated Fatty Liver Disease (MAFLD). MAFLD, with an estimated prevalence of about 25%, goes from an undetected sleeping disease, to inflammation (hepatitis), to fibrosis development (cirrhosis) and/or hepatocellular carcinoma (HCC), decompensated cirrhosis and HCC being the final stages of the disease. However, many MAFLD patients do not die from the liver disease itself, but from cardiovascular comorbidities or complications. The ARTEMIs will contribute to the earlier management of MAFLD patients, by prognosing the development of more advanced forms of the disease and cardiovascular comorbidities, promoting active surveillance of patients at risk. The system will predict the impact of novel drug treatments or procedures, or simply better life habits. The system will therefore not only serve as a clinical decision aid tool, but also as an educational tool for patients, to promote better nutritional and lifestyle behaviors. In more advanced forms of the disease, therapeutic interventions include TIPPS to manage portal hypertension, partial hepatectomy, partial or complete liver transplant. ARTEMIs will contribute to predict per- or post-intervention heart failure, building on existing microcirculation hemodynamics models. The model developers will benefit from a large distributed patient cohort and data exploration environment to identify patterns in data, draw new theories on the liver-heart metabolic axis and validate the performance of their models. The project includes a proof-of-concept feasibility study assessing the utility of the integrated virtual twins and CDSS in the clinical context.