Lung cancer: “From research a new life expectancy for patients”
Early diagnosis, appropriate taking charge of patients, access to molecular tests, innovative therapies at the forefront and quick times for the approval of the new drugs. These are some of the topics addressed during the conference ‘Innovation and sustainability in pulmonary cancer comparison between experts’, organized by a health engine’, thanks to the unconditional contribution of MSD and which saw the participation of the institutions, clinicians and patient associations.
Pulmonary cancer is located among the main big killers in the world
“Pulmonary cancer is positioned among the main big killers in the world, by incidence and mortality. Fortunately, pharmaceutical research does not stop and in recent years has allowed the personalization of the treatment strategy with molecular target drugs with high therapeutic response, guaranteeing the patient a good quality of life.
It is essential that the research continues to develop increasingly effective innovative therapies and at the same time are approved in increasingly faster times, so as to guarantee people affected by one of the most serious pathologies worldwide the greatest support and future possible. The use of innovative and effective drugs, already from the first line of treatment, in patients with lung cancer, brings a benefit not only in clinical but also cheap terms.
Fund for innovative drugs
The priority of the NHS must be to guarantee citizens the opportunity to benefit from sustainable access to the best therapies which, over the years, the progress of the research will offer. A contribution has arrived in recent years from the fund for innovative drugs that has played a fundamental role to guarantee access to new therapies. However, I believe that the most effective weapon remains prevention.
It is necessary to follow correctness of appropriateness, adherence to therapies, targeted interventions, “said Giuseppe Simeone, president of VII Healthcare Commission, social policies, social and health integration, welfare, Lazio Region.
The Non Squamoso NSCLC is the most frequent form of cancer
The non -scaly NSCLC is the most frequent form of lung cancer and represents 83% of the total lung carcinomas. In Italy, lung cancer is among the most frequently diagnosed neoplasms (with 42.500 new diagnoses estimated in 2019 by Airtum data) and the main cause of oncological death (with 33.838 deaths recorded in 2016).
There is an urgent need for increasingly effective and innovative treatments that can improve and prolong the life of these patients and recent data have shown that therapeutic innovation, more and more often, goes in the direction of combination treatments that see the most association drugs between them. This is the case of the recent Keynote 189 studio that has shown how immunotherapy with pembrolizumab in association with chemotherapy in the front line doubles the survival of patients with non -small cell cancer (NSCLC) non -scaming metastatic, with a reduction in the risk of death of 44% compared to chemotherapy alone.
Identify specific alterations
“Progress in profiling of the characteristics of the genome of cancer cells has allowed us to identify specific alterations that make these cells sensitive to molecular target drugs, capable of improving the response possibilities for many patients suffering from neoplastic diseases that arise in different organs. The current immunotherapy is based on drugs that have their target not on the tumor, but on the cells of our immune system.
These drugs improve the ability to recognize sick cells (which survive precisely because they are able to hide) or prevent the tumor from turning off the action of our normal defense cells, after these have recognized the sick cells. In the near future, our patients will have immunotherapy drugs capable of acting even on new and different targets. However, we must not forget that the tumor we have to fight is not in a test tube or on the pathologist’s table.
The oncologist must take into account when he chooses a therapy
It is located in the interior of a patient, with his individual fragility, with his other diseases, for which he takes other drugs, with his eating habits, sometimes incorrect, with his lifestyles, often inadequate. Of all this, oncologist must take into account when choosing a therapy. The platform of the Oncological Pole of Sapienza, through the Molecular Tumor Board, serves to integrate these thousands of information to make it accessible to the clinician, with the objective of increasingly achieving a profound integration of knowledge aimed at reducing toxicity e To improve the effectiveness of the many available treatments, “explained Paolo Marchetti, director of Medical Oncology B Aou Policlinico Umberto I Rome
The use of innovative and effective drugs, already from the first line of treatment, in patients with lung cancer, brings a benefit not only in clinical but also economic terms: by significantly improving patient survival, you have the opportunity to positively affect the direct/indirect costs and the productivity of the health system. In addition to the funds currently allocated for innovative drugs (500 million euros per year) the need to identify new governance methods capable of responding to regional needs in an ’.
Every year in Italy about 41 are diagnosed.100 new cases
“Every year in Italy about 41 are diagnosed.100 new cases of lung cancer: 29.400 in men and 11.700 in women (the numbers of cancer in Italy, 2015). Lung cancers represent the second most frequent neoplasm in men (15% of cases) after the prostate and the third in women (6%), after the breast and the colorectal. The cost of lung cancer in Italy is estimated to be approximately 2.4 million euros between direct health costs and indirect and social costs.
In social security terms it is important to underline that lung cancer is characterized by an increase in both ordinary disability checks and disability pensions.
New pharmacological therapies are improving
The new pharmacological therapies are improving significantly and evidently the life expectancy of patients with a consequent improvement of the quality of life. All this translates into an important economic and social value, especially in terms of reducing production loss. Select patients responding (PDL 1 test) to immunotherapy leads to an improvement in quality life, lengthening survival and reduction of adverse events with marginal increases in pharmaceutical expenditure.
These evidence demonstrate once more as only with the abandonment of silos budgets and following an appropriate PDTA it is possible to carry out assessments that allow the decision maker to overcome the concept of healthcare cost to move on to a concept of investment in view of a improvement of health care. The funds currently allocated for innovative drugs (500 million euros) do not seem to be sufficient to face the planned needs. It would be important to protect the on the therapies through a multidimensional approach (Pdta accompanied by HTA assessments) “, said Francesco Saverio Mennini, professor of health economics, Eehta Ceis; University of Rome “Tor Vergata”, Kingston University London UK
The appropriate use of the PDTAs should represent a guaranteed right to each patient. The correct implementation of therapeutic and welfare diagnostic paths would allow to improve the quality and efficiency of care, ensure multidisciplinary management, involving a faster diagnosis and greater probability that the patient receives the most appropriate treatment, with a positive impact on the prognosis. For this purpose it is essential that health facilities, at regional level, are connected in a network capable of optimizing the taking charge of the oncological patient.