in Italy they are too few – time.news

2023-04-29 17:08:04

Of Health editorial

Only 20 interdisciplinary teams in our country are now indispensable for precision medicine and to guarantee each patient the most suitable therapy for his case

In Italy it is a priority to implement the number and functioning of the Molecular Tumor Boards. For now, only 20 of these multidisciplinary groups are active in which the cases of patients who can benefit from the selection of anticancer treatments through molecular profiling tests. There is a strong disparity in the levels of assistance guaranteed and there is no uniform coverage of the national territory. They are not present in all Regions as established by a Ministerial Decree. Not only. Molecular Tumor Boards need to work with an interdisciplinary approach. So individual specialists (oncologists, geneticists, molecular biologists, pathologists, computer technicians, big data managers, engineers and physicists) must collect as much information as possible. These must then be elaborated and integrated with each other, on the basis of individual skills, for enable the patient to receive the best and most effective treatment possible. This is what emerges from the international conference “Italian Summit On Precision Medicine” underway in Rome.

Choose the most appropriate treatment

«Thanks to innovative techniques of genetic sequencingas the Next Generation Sequencing (or NGS), we have a great deal of information available on a single cancer,” he says Paolo Marchettiscientific director of IDI of Rome, full professor of Oncology at La Sapienza University and president of the Foundation for Personalized Medicine —. Precision medicine is playing a key role in the fight against cancer, but it cannot be considered only as the search for molecular targets with which to associate therapies. One of our goals must be understand the reasons why a patient does not respond positively to treatment even in the presence of a target and a related active drug. For this too the Molecular Tumor Boards are fundamental, but they must not become a useless bureaucratic burden. Instead, they can give concrete support to encourage a more appropriate therapeutic choice».

“Therapeutic Reconciliation”

«Precision medicine cannot remain an abstract principle, but it must become a reality in the daily clinical practice of oncologists – goes on Joseph Curigliano, director of the Division of New Drugs for Innovative Therapies of the European Institute of Oncology (IEO) and professor of Medical Oncology at the University of Milan —. Medical-scientific research has made great strides in recent years and we must increasingly take many aspects into account biological and molecular nature of various tumors. We know more in depth some mechanisms, intrinsic to cancer cells, which are able to regulate the evolution of the disease and possibly also the resistance to treatments. Often our patients have chronic comorbidities and therefore take drugs for the treatment of other diseases. There is therefore the absolute need to obtain the so-called “therapeutic reconciliation”. Then there are complex systems such as the microbiota which plays a fundamental role in the mechanisms of resistance or sensitivity to immunotherapy”. “New exams like NGS present now relatively low cost Marchetti continues. The information we get is more, but it is necessary to give a correct interpretation so that really translate into clinical benefits. The teamwork of the Molecular Tumor Boards can put the patient in a position to respond positively to an innovative treatment. However, all of this must be demonstrated “in the field”, through the continuous production of new studies and scientific evidence”.

agnostic drugs

The «Italian Summit On Precision Medicine» conference reached its fourth edition in 2023 and is the main national meeting dedicated to precision oncology. «For this year’s edition we have decided to focus on the agnostic approach to cancer treatment – ​​continues Curigliano -. “Agnostic” drugs represent the new era of therapies and do not affect only one type of tumor, as most current drugs do. They target a group of mutated genes potentially responsible for the development of the disease. These are “ubiquitous” genes that are common to various tumors, regardless of the organ in which they originate. Patient access to these new therapies must begin with the implementation of a genomic profiling test, continues with the interpretation of the data to finally arrive at the therapeutic choice». «It is a totally new approach and an excellent demonstration of the extraordinary results obtained from precision oncology – concludes Marchetti -. The key point of this process is represented by genomic profiling and therefore patient selectionto whom genomic tests are to be carried out or not, turns out to be fundamental».

April 29, 2023 (change April 29, 2023 | 17:07)

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