In Italy, in 6 years (2015-2021), cancer mortality decreased by 10% in men and 8% in women. 3.6 million citizens live after diagnosis, and one in 4 patients (over 900 thousand people) has the same life expectancy as the general population and can be considered cured. The road to chronicity was opened by blood cancers: today, in fact, 70% of patients affected by onco-haematological diseases are alive 10 years after diagnosis or can be considered cured. Significant achievements, to which the prevention campaigns and innovative therapies have contributed in a decisive way, which in many cases make it possible to make the disease chronic or to obtain a cure, with substantial savings for the health system. The new paradigm in the fight against cancer consists of the possibility of anticipating treatments at an early stage, i.e. before (neoadjuvant therapy) or after (adjuvant) surgeryto increase the number of chronic or cured patients.
A challenge that sees in the front row AstraZeneca that today and tomorrow in Rome, at the La Nuvola all’Eur congress center, organizes a scientific event with the most important experts. With 97 projects under study, the company is committed to identifying innovative therapeutic solutions for 11 onco-haematological diseases (lung, breast, gynecological, blood, prostate, bladder, stomach, liver, pancreas, cervix, gastrointestinal tract cancers). On the one hand, the clinical development program demonstrates AstraZeneca’s commitment to a trmore and more precocious actuation of different types of neoplasia, on the other hand it continues to develop therapies for metastatic or resistant pathologies, starting from breast cancerthe most frequent in our country with 55 thousand new diagnoses every year (in 2020 there were 377 thousand total cases).
“A real revolution is underway in breast cancer therapy, based on increasingly targeted and effective treatments – he says Saverio Cinieripresident of Aiom (Italian Association of Medical Oncology) – A new subtype is emerging, that is with low expression of the Her2 proteinwhich has important therapeutic consequences, because it can redefine care for about half of patients with metastatic disease, today you are not treated with targeted therapies because they are considered Her2 negative. Research results in early stage hereditary breast cancers are also important, occurring in women with mutations in one or both of the two specific genes called Brca1 and Brca2 – the specialist continues – Olaparib, targeted therapy progenitor of the class of Parp-inhibitors, affects the mutations of these genes, to further reduce the risk of recurrence and increase the chances of recovery. In the OlympiA study, adjuvant, i.e. post-surgery treatment with olaparib demonstrated a significant improvement in overall survival, reducing the risk of death by 32%. The results of this study represent a potential breakthrough for patients with early breast cancer and at high risk of relapse and support the importance of testing at diagnosis for Brca1 and 2 mutations. “
Olaparib is reimbursed in Italy in the first-line maintenance treatment of ovarian cancer and in the treatment of triple-negative metastatic breast cancer with the gene mutation. It is also reimbursed in castration-resistant metastatic prostate cancer with Brca1 / 2 mutations, progressing after previous therapy with a new hormonal agent.
“Olaparib has opened the era of precision medicine also in prostate cancer, the most frequent neoplasm in men with 36 thousand new diagnoses every year in our country – explains Romano Danesi, director of the Department of Laboratory Medicine of the Pisan University Hospital – The molecule has more than tripled survival free from radiological progression, ensuring a good quality of life. The Brca test therefore becomes a fundamental step in the diagnosis and choice of treatment not only of breast and ovarian cancers, but also of metastatic prostate cancer. Knowing the mutational status of the Brca genes is very important and testing should be done on all patients upon diagnosis of any of these three malignancies. The identification of variants in the Brca1 / 2 genes allows in fact to undertake a path of oncogenetic counseling in family members to identify high-risk carriers. To the latter we can offer targeted programs for the early diagnosis of tumors associated with Brca family transmission syndromes and strategies aimed at reducing the risk “
Genetic mutations are able to guide the choice of therapy also in lung cancer. “It is the third most common cancer, with about 41 thousand new diagnoses every year in Italy, but it remains the big killer with 34 thousand deaths in 2021 – continues Danesi – In patients with early stage non-small cell lung cancer (IB-IIIA ), the post surgical treatment with osimertinib, targeted anti-Egfr therapy, has curative intent. Talking about healing in this very difficult to treat disease is a great result, unthinkable only a few years ago. A goal that immunotherapy with durvalumab, in unresectable stage III non-small cell lung cancer. “
Healing has long been a reality in most blood cancers. Chronic lymphatic leukemia, with 3,400 new diagnoses every year in Italy, is the most frequent among leukemias. Traditional immuno-chemotherapy is still effective, but only in some cases. “After the revision of the European guidelines, which reduced the number of patients eligible for this approach, targeted therapies are destined to increasingly become the standard of care – remarked Armando Santoro, director of the Humanitas Cancer Center at the Humanitas Irccs Clinical Institute in Rozzano, Milan – In the pathologies of B lymphocytes, the inhibitors of the Btk protein, which belong to the class of targeted therapies, allow to control the disease effectively. In particular, acalabrutinib has shown a significant benefit in terms of efficacy and long-lasting tolerability. term in both first-line treatment and relapsed or refractory disease. Clinical trial results have demonstrated non-inferior progression-free survival and fewer atrial fibrillation events for acalabrutinib than for the first generation of this class of drugs. “
That of haematological tumors is the other therapeutic area in which AstraZeneca’s investments are concentrated which, starting from the success of acalabrutinib, a new generation Btk inhibitor, is working on a portfolio of molecules with innovative mechanisms of action. “The goal is to bring therapeutic innovation to all the main oncohematological pathologies: lymphomas, myelomas, myelodysplastic syndromes and leukemias – highlights Santoro – This is possible by anticipating the evolution of the next standards of care, offering patients more and more effective treatment opportunities oriented to their needs, with the maintenance of a good quality of life”.
“Our research pipeline covers nearly all major cancers,” he says Mirko Merletti, Vice President Oncology AstraZeneca – Many are considered difficult to treat and have not benefited from therapeutic innovations for many years. In this sense, important perspectives are also opening up in tumors of the liver and biliary tract. Furthermore, thanks to diagnostics, we are able to identify the patients most likely to benefit from a particular treatment. We have worked on the development of diagnostic testing platforms on the national territory such as AZFastNet, today the only reference in the country for the health system and the scientific community in the field of precision medicine in oncology and genetic data. Finally, we are committed to promoting projects aimed at speeding up the diagnosis and leading to a chronicization of cancer. For example, we are founding partners of the LungAmbition Alliance, which aims to overcome barriers to lung cancer screening and early detection. In this way, patients can have more therapeutic alternatives and greater chances of survival and cure “.
Over 900 thousand people in Italy today have recovered from a tumor. Even if they have overcome the disease, they risk facing difficulties in accessing some services, such as applying for mortgages and loans, taking out insurance and adopting children. The campaign ‘I am not my tumor’, promoted by the Aiom Foundation, fits into this context, which would allow Italy to follow the virtuous example of other European countries (France, Luxembourg, Belgium, Holland and Portugal), which already protect their citizens former cancer patients with an ad hoc law.
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