World Cancer Day, progress in therapies but the approval times for new drugs must be speeded up – Corriere.it

by time news

2024-02-04 10:29:41

by Francesco Cognetti *

Primary prevention also represents a problem, due to the marked worsening of lifestyles and the absence of information, education and awareness programs among the population

On February 4th we all celebrate World Cancer Day, established in 2000 by the Union for International Cancer Control (UICC). The main objective of the Day is to support the contents of the World Cancer Declaration of 2008. It is an appeal to all Governments to promote initiatives that go in the direction of ever greater equity towards all citizens with regards to health , ever greater accessibility of services, a reduction in disparities in the incidence and mortality of cancer (around 10 million per year worldwide) and in care for these diseases.

The most difficult tumors

What is the current situation in our country? We register around 400 thousand new cases annually, with around 175 thousand deaths (slightly but constantly decreasing in recent years), with some partial successes for deaths avoided in lung cancers in men (smoking cessation), breast cancers (early diagnosis and better treatments , both in the initial phase and in the advanced phases) and colorectal (as for the breast). But very critical situations still remain, such as those relating to lung cancer in women (increase in cigarette smoking), melanoma (sun exposure but recently there has been notable progress thanks to biological treatments and immunotherapy), pancreatic cancer (really difficult and difficult tumor, both in terms of prevention and treatment).

Primary and secondary prevention

Primary prevention in our country represents a real problem, due to the marked worsening of lifestyles and the absence of information, education and awareness programs among the population (especially young people) towards these issues. And to say that approximately 40% of tumors could be avoided with primary prevention and consequently the 20 billion euros that are spent annually to treat cancer patients could be greatly reduced. Secondary prevention (screenings) is equally neglected, with a participation of 35-40% on the national average for the year 2022 and with the Southern Regions presenting data of 12-30%. While Europe (with Europe’s Beating Cancer Plan) asks all member countries to reach, by 2025, 90% participation of the target population for all screening.

Progress in treatment

Progress in the treatment of tumors has been enormous in recent years: various research groups and brilliant experimental and clinical researchers in our country have contributed to them. Think of the exceptional diffusion of new biological drugs, resulting from the genetic-molecular characterization of tumors, of immunotherapy with bispecific antibodies capable of acting simultaneously on multiple cellular sites, of drug conjugated antibodies (Adc), which convey the cytotoxic drug specifically on tumor cells, the development of anti-PD1 drugs and their combination with mRNA anti-tumor vaccines, in studies involving numerous tumors. All these treatments have changed the natural history of many tumors and many patients. But the problems, quite a few, concern patient access to clinical trials after the delay accumulated in our country regarding the adaptation to the European Regulation on trials of 2014, with the establishment of the Clinical Trials Information System (Ctis), the single continental portal for trials.

Long lead times for new drugs

Another big problem represented by the registration times of the Italian Medicines Agency (Aifa) after the approval of the European Medicines Agency (419 days on average), to which are added in many cases the (very long) times relating to the registration of new drugs in regional therapeutic handbooks, a true outrage against article 32 of the Constitution (The Republic protects health as a fundamental right of the individual and interest of the community). We are thirteenth in Europe and last among Western European countries in terms of drug approval times. All these aspects require our commitment, which has never been lacking in recent years in terms of analysis and description of the critical issues as well as concrete proposals. But a great effort of listening, availability and action is necessary on the part of the institutions concerned and we are certain that with the right attitude on the part of everyone, cancer patients in our country (but I would say all citizens) can be better protected and help yourself in the fight against this disease.

* President of the Confederation of Oncologists, Cardiologists and Hematologists (FOCE)

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February 4, 2024 (modified February 4, 2024 | 11:29)

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