Customize diagnosis to personalize treatment. This is the concept of precision medicine or personalized medicine in oncology, which makes it possible to provide a diagnosis and treatment adapted to the individual characteristics of each cancer patient and is based on know the biology of each tumor, search for potentially treatable genetic alterations and offer the most effective treatments for each patient, which may also vary at each stage of the disease.
This has been discussed at the Forum «In the face of cancer, we keep moving forward» which ABC Health has organized in collaboration with Roche on the occasion of World Cancer Day, which is celebrated on February 4.
We are in “the era of cancer biomarkers,” he said. Xavier Castro, Head of the Medical Oncology Section from La Paz Hospital in Madrid
and president of Icapem. It is about, he commented, “personalizing the diagnosis to personalize the treatment”.
De Castro added that “biomarkers provide information on the type of cancer of each patient and also offer the possibility of selecting treatments.”
Because, as pointed out Frederick Plaza, Director Corporate Affairs of Roche, “it makes no sense to approve drugs that, for their correct administration, require a precise molecular diagnosis”.
Plaza recalled that Roche championed precision medicine from the very beginning. «It supposes a paradigm shift that is based on basic research: genome sequencing and patient data management».
And he recalled that most cancer treatments are “based on personalized medicine.” First, he said “stratified”, patients who share the same mutation, but now “we have the possibility of treating each patient individually.”
Ruth Vera, Head of the Medical Oncology Service at the University Hospital of Navarra, warned that “there is still much to know about cancer” and acknowledged that “we do not have the foundations in place. We should have the ABC’s of cancer for the standardized molecular diagnostics» and, to date, «we do not have it in the portfolio of health services».
And this, he said, generates “inequity between the different autonomous communities”, in a way similar to what happens “with access to precision medicine drugs”.
For example, said Miguel Martín, Head of the Medical Oncology Service at the Gregorio Marañón Hospital in Madrid and president of GEICAM, some Autonomous Communities, such as Catalonia, have assumed it individually, but this “generates more inequality.” They should, he stressed, “exist mandatory global standards to be able to guarantee all cancer patients that they will receive the best clinical, molecular or imaging diagnosis and the best possible treatment”.
Because, as highlighted by Drag. Vera, «molecular knowledge is necessary, not only for treatment, but also to assess prognosis. Cancer already needs the implementation of precision oncology”. “The improvement in the survival of cancer and its treatments goes hand in hand with this concept,” he stressed.
To implement precision medicine and for it to be homogeneous throughout the health system, he said Frederick Plaza, it is enough to “incorporate it into the portfolio of health services on a mandatory basis as are others”. It is, he said, “political will.”
De Castro recognized that “resources are needed and these resources must be optimized.” Because, he pointed out, “the patient, wherever he lives, must have the right to be treated in the best possible way. And this, for example, “must include a mobility plan, with the necessary resources.”
For Isabel Orbe, General Director of the AECC Scientific Foundation, it is urgent to implement this diagnosis, especially because the Covid-19 pandemic “has caused a significant diagnostic delay in many tumors.”
In this sense, Dr. Vera pointed out that Covid-19 “has slowed down everything that had been advanced in early diagnosis.” We have said “screening campaigns stopped for more than a year and many of them have not caught up again pre-Covid. For example, breast and colon cancer screening programs, which have not been recovered in many Autonomous Communities.
This has led to late diagnoses and advanced disease and, also, a delay in precision medicine in the diagnosis of cancer. “We have a lot to recover,” he said.
Castro He commented that according to data from the AECC, in 2020 almost 25% of cancer diagnoses had been lost. And he warned of the psychological damage: «45% of cancer patients recognize high levels of psychological distress, especially women and those over 65.
“The psychological impact of cancer has been tremendous, but also the economic one,” he said. Elizabeth Orb. «We forget, sometimes, that a patient is more than the physical part. Support is important, and with the fear of going to the centers, that has been lost ». “We’re scared of diagnostic delays and what it’s going to do to patients,” he said.
Orbe also referred to the importance of prevention, since 40% of cancers can be prevented with healthy lifestyle habits. “There is enough information to know how to avoid many cancers. And it is the public administrations that must take that step”, he pointed out.