2023-09-14 15:22:31
70% of women with ovarian cancer already know about the disease before diagnosis: 10 years ago just 30% had heard of it. Less than 3 out of 10 patients, however, choose to be treated in a specialized center for this neoplasm, ignoring how much this decision can make a difference in the treatment process. Again: 70% of patients discover the tumor when it is already in an advanced stage, due to non-specific symptoms and the lack of effective screening tools. These are just some of the results of the survey conducted by Acto Italia on over 100 patients nationwide, reported in ‘Let’s change course’, the first illustrated white paper of voices, needs and proposals of women with ovarian cancer, presented today to the Ministry of Health. Created thanks to the contribution of over 20 professionals, including clinicians and experts, and the testimonies of 9 women who tell their journey along the path of diagnosis and treatment, the volume contains contributions from institutional representatives who have proven sensitive to the topic, including the preface by the Minister of Health Orazio Schillaci.
“I would like to express my appreciation and gratitude to Acto Italia – writes Schillaci – for the creation of this particularly significant text and for the constant commitment alongside women affected by ovarian cancer and all gynecological tumors. Prevention, early diagnosis and timely and appropriate management are the strategic lines outlined by the National Oncology Plan 2023-2027, as well as the fundamental levers on which to focus with renewed commitment, also fully seizing the opportunities offered by new technologies”.
The Manifesto Acto 2.0 – recalls the association – summarizes the 7 priority actions to improve the global care of women with ovarian cancer and was drawn up starting from the analysis of their needs and the indications of the leading clinicians and experts in this scope. The ‘Let’s change course’ project, presented a few days before World Gynecological Cancer Day which falls on 20 September, is promoted with the patronage of Acto Italia, Alliance against Ovarian Cancer ETS, and sponsored by GSK and Roche. It has also received the patronage of Aiom (Italian Medical Oncology Association), Mango (Mario Negri Gynecologic Oncology Group), Mito (Multicenter Italian Trials in Ovarian Cancer), Salute: an asset to be defended, a right to be promoted, Sic (Italian Society of Cancerology ), and the membership of the Loto and Mai Più Sole associations. Exceptional godmother Nancy Brilli.
“It is necessary and urgent to promote a new change of direction in the management of ovarian cancer – states Nicoletta Cerana, president of Acto Italia – Therefore, increase information on the disease and on specialized centers to promote more informed treatment choices; support research to early diagnosis which still remains a chimera today; opening up to genomic tests to make personalized treatments possible; starting to talk about sexuality and oncology, a completely forgotten area of needs which is emerging ever more strongly among patients. more so even with ovarian cancer, consequently it has become necessary to take care of the person, as well as treat the disease.”
“In the last 5 years – underlines Nicoletta Colombo, professor at the University of Milan-Bicocca, director of the Ieo Milan Gynecology Program – what I define as a tsunami has happened in the treatment of ovarian cancer: for the first time we have managed to increase the percentage of potentially cured patients. We have discovered the first ‘target’ of ovarian cancer that can be hit with targeted drugs: it is called Homologous Recombination Deficiency (HRD), present in the tumors of all patients with Brca mutations and another 25% of patients without mutations of these genes. Therefore in half of the total cases. It is therefore necessary to guarantee two types of tests: genetic, for prevention purposes in healthy people, and genomic on tumor tissue, such as the HRD test, to personalize treatment for sick women” .
The research shows that less than 45% of patients access genomic profiling and that there are 12% of patients who have not been offered genetic testing for BRCA mutations. To date, however, only the search for BRCA mutations (genetic test) is in the Essential Levels of Assistance (LEA), while the search for HRD (genomic profiling) is not yet reimbursed by the National Health Service. “The risk – warns Umberto Malapelle, Chair of the Laboratory of Predictive Molecular Pathology, Department of Public Health, Federico II University of Naples – is that not all patients can access tests uniformly across the territory and, consequently, have the same opportunities for treatment”.
Tests therefore represent an essential requirement to guarantee each patient a personalized therapeutic strategy. “The results of this personalization – adds Domenica Lorusso, associate professor of Obstetrics and Gynecology at the Catholic University of the Sacred Heart and head of the Uoc clinical research programming at the Fondazione Policlinico Gemelli Irccs in Rome – concern above all medical and maintenance therapy, and translate in a concrete opportunity to draw on new classes of targeted and molecularly targeted drugs – Parp inhibitors, immunotherapies, drug-conjugated antibodies – which require management and management by a multidisciplinary team. Hence the need to identify specialized oncology centers where these patients can be treated.” However, women are not aware of this: according to the survey, only 27% of patients declare that they have chosen their center based on its specialization in the treatment of ovarian cancer.
“Surgical treatment today – remarks Giovanni Scambia, director of the Uoc Gynecology Oncology Foundation Gemelli Irccs University Polyclinic – represents the therapy of choice in all phases of the disease: in the initial stage, where surgery and chemotherapy allow recovery rates to be achieved even 80-85%; in advanced stages, where surgery alone manages to eradicate the disease in approximately 60% of patients. Only specialized centers can in fact also guarantee the expertise of the surgical team”.
Laura Cappellari, Patients Affairs Director of GSK, declares: “We are proud to have been able to support ‘Let’s change course’ and the great contribution of patient associations in the creation of the first White Paper on ovarian cancer, also in view of Gynecological Cancer Day on 20 September “In our work, it is essential to collaborate with patients and their caregivers through the organizations that represent them. Renewing our commitment alongside them is a priority objective for us, to which a team entirely dedicated to advocacy and engagement works” .
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