Manifesto calls for action on cancer drug access as survey shows patient delays

Institute of Cancer Research | April 2019 | Manifesto calls for action on cancer drug access as survey shows patient delays

The Institute of Cancer Research has issued a 10-point manifesto which calls for action to accelerate access to innovative cancer drugs. The manifesto is the result of a survey conducted by the ICR, which involved over 1000 people who had been treated for cancer to contribute to shape recommendations to improve access to the latest treatments. 

The 10 points are:

1. NICE needs to prioritise the most innovative cancer treatments with the greatest potential to deliver step-change advances for patients. That means changing NICE’s definition of innovation to promote treatments that tackle cancer in brand new ways.

2. We need radical action to bring down the extremely high prices of modern cancer drugs, allowing as many patients as possible to benefit from advances in cancer treatment while not overburdening the NHS.

3. We need to embrace personalised medicine by developing tests for every drug developed. Better access to biomarker tests can ensure modern targeted drugs are directed at those who will benefit. This is better for patients and more efficient for the NHS.

4. We need to test drugs in smaller, smarter clinical trials to generate findings more quickly and cheaply – giving the NHS fast access to drugs at affordable prices.

5. We need to incentivise pharmaceutical companies to trial new medicines in novel combinations – including with other drugs manufactured by commercial rivals.

6. Drug regulators need to be more flexible in assessing evidence, so that innovative new treatments can reach patients as quickly as possible.

7. We need to ensure all cancer patients have access to suitable clinical trials at all appropriate stages of their disease, irrespective of where they are treated.

8. We need to increase access to precision medicine for children with cancer – so they can benefit from the same kind of advances in treatments that adults have.

9. We must be flexible on the age limits for clinical trials to avoid denying older children and young adults access to new treatments simply because they are judged too young or old.

10. We need to incentivise companies, universities and charities to work together to turn research into innovative, medicines for patients (Source: Cancer Drug Manifesto).

Full details from Institute of Cancer Research Cancer Drug Manifesto 

Press release Institute of Cancer Research  Manifesto calls for action on cancer drug access as survey shows patient delays

In the news:

The Daily Telegraph One in six cancer patients is being denied drugs recommended by doctors

The Independent One in 10 cancer patients denied drugs recommended by their doctor, study says

The Daily Mail Cancer drugs are NOT reaching the patients: One in six sufferers have faced an NHS block to treatments that are recommended by their doctors, report warns

University of Leicester research: Breast cancer relapse could be found two years earlier

University of Leicester | April 2019 | Breast cancer relapse could be found two years earlier

Research undertaken by the University of Leicester and Imperial College London and funded by Cancer Research UK,  has shown that a blood test was able to detect 89 per cent of all relapses for patients with breast cancer, with the blood test on average detecting the cancer 8.9 months quicker than imaging.

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The prospective national study enrolled 49 patients with early-stage breast cancer from three NHS trusts in the UK  who had recently completed treatment with surgery and adjuvant chemotherapy.

The study included a cross section of breast cancer subtypes, including HER2-positive, hormone receptor-positive, and triple-negative. Blood samples were collected every 6 months for up to 4 years from each patient, and results were correlated with radiographic and clinical outcomes.

Although this was an observational study, knowing that early detection of relapse could be possible presents the opportunity to conduct trials of treatments to prevent patients relapsing with symptomatic metastatic breast cancer (Source: University of Leicester).

Full press release from  University of Leicester

The study has been published in Clinical Cancer Research 

Full reference: Coombes, C. et al | 2019|Personalized detection of circulating tumor DNA antedates breast cancer metastatic recurrence |Clinical Cancer Research |  10.1158/1078-0432.CCR-18-3663

Abstract

Purpose: Up to 30% of breast cancer patients relapse after primary treatment. There are no sensitive and reliable tests to monitor these patients and detect distant metastases before overt recurrence. Here we demonstrate the use of personalized ctDNA profiling for detection of recurrence in breast cancer.

Methods: Forty-nine primary breast cancer patients were recruited following surgery and adjuvant therapy. Plasma samples (n=208) were collected every 6 months for up to 4 years. Personalized assays targeting 16 variants selected from primary tumor whole exome data were tested in serial plasma for the presence of ctDNA by ultra-deep sequencing (average more than100,000X).

Results: Plasma ctDNA was detected ahead of clinical or radiological relapse in 16 of the 18 relapsed patients (sensitivity of 89%); metastatic relapse was predicted with a lead time of up to 2 years (median=8.9 months; range: 0.5-24.0 months). None of the 31 non-relapsing patients were ctDNA-positive at any time point across 156 plasma samples (specificity of 100%). Of the two relapsed patients who were not detected in the study, the first had only a local recurrence, while the second patient had bone recurrence and had completed chemotherapy just 13 days prior to blood sampling.

Conclusions: This study demonstrates that patient-specific ctDNA analysis can be a sensitive and specific approach for disease surveillance for breast cancer patients. More importantly, earlier detection of up to two years provides a possible window for therapeutic intervention.

Rotherham NHS staff can request this article from the Library 

Redesigning cancer screening technology

University of Leeds | April 2019 | Redesigning cancer screening technology

Engineers at the University of Leeds have developed a prototype that could reduce the cost of manufacturing an endoscope from £800000 to £40. The team’s prototype is redesigned to make the endoscope cheaper to make, it is more intuitive to operate. It also does not need sterilising between patients as in this model- a narrow silicone tube and a tiny capsule housing the camera – a part of the device can be disposed after each endoscopy. 

Their innovation also has the potential to revolutionise cancer screening in low-to-middle income countries where the cost of equipment makes screening prohibitively expensive.

Project leader Pietro Valdastri, Professor of Robotics and Autonomous Systems at Leeds, said the international consortium of engineers had had totally redesigned the endoscope which had remained largely unchanged for the last 60-plus years.

The next stage for the research team is to trial the effectiveness of the low-cost device against conventional endoscopes (Source: University of Leeds)

Read the press release in full from the University of Leeds

 

Annual NHS cancer checks top two million for the first time

For the first time last year, the NHS in England carried out more than two million checks on people who feared they might have cancer.

In 2018, patients underwent a record 2.2 million cancer checks following urgent referral by their GP, almost 6,000 a day or more than four every minute. That was an increase of almost a quarter of a million on the 1.9 million people who were seen in 2017.

Record numbers of people also received treatment for cancer, with 308,058 receiving a first treatment in 2018, almost 13,000 more than in 2017 and the first time the number has topped 300,000.

Cancer survival is at an all time high with new figures showing 10,000 more patients surviving for at least 12 months after diagnosis than five years earlier. However, the NHS Long Term Plan aims to increasing the proportion of cancers caught early from half to three quarters, an improvement that will save up to 55,000 more lives each year.

Full story at NHS England