This article is part of our special report Driving progress in Europe’s cancer care.
We’re all in the race of our lives to beat COVID-19. Scientists are setting an astonishing pace in a team effort with healthcare professionals, policymakers and entire populations. But at the same time it’s imperative we maintain the momentum we’ve gathered in the fight against cancer.
Françoise Bartoli is Vice President and Head of Europe and Canada Region, Oncology Business, AstraZeneca.
COVID-19 is threatening the major reductions in death rates achieved in some cancers over the last few years by delaying diagnosis and disrupting treatment pathways. Cancer diagnoses fell by approximately 40% by the third quarter of 2020. Many countries have experienced deferrals of cancer surgery and radiotherapy and reductions in the use of cancer drug therapies because healthcare resources have been reassigned, likely to result in substantial increases in avoidable cancer deaths.
I’m encouraged to hear from Bartosz Arłukowicz, chair of the European Parliament’s Special Committee on Beating Cancer, that COVID-19 is not going to slow the committee’s work. MEP reactions to Europe’s Beating Cancer Plan underline the need for ambitious efforts to develop legislation and measures that can help prevent and control cancer, in addition to supporting research.
At AstraZeneca we stand ready to play our part in the team effort to improve outcomes for people with cancer. I would like to highlight three key areas where we see potential to achieve rapid and major improvement in cancer outcomes.
Increasing screening for lung cancer
The European Mission Board for Cancer have set a target of saving more than 3 million lives by 2030. As one in every five cancer deaths in Europe are due to lung cancer, any reduction in deaths from lung cancer will have a significant impact on overall reduction of cancer mortality.
The past few years have seen considerable advances in treatment options for lung cancer, yet fewer than 20% of patients survive up to 5 years compared to over 90% of those with breast cancer. One of the main reasons for this poor prognosis is that a large proportion of people with lung cancer are detected at an advanced stage, when treatment options are limited.
Detecting and treating lung cancer earlier is our best opportunity to improve outcomes. The evidence supporting lung cancer screening reached a turning point recently with a key European trial showing targeted screening reduced mortality in smokers by 24%, leading experts to suggest that the case to invest in lung cancer screening programmes for high-risk populations is now indisputable. The challenge for governments is now to determine the optimal and most cost-effective way of implementing high-quality targeted screening programmes.
At AstraZeneca we are partnering in several initiatives to support improved lung cancer patient outcomes. The Lung Ambition Alliance, a stakeholder collaboration making screening and early diagnosis of lung cancer a priority, has the aim of doubling five-year survival in lung cancer by 2025. We also partnered with leading solution providers, scientific societies and clinical experts to create HAYA, an integrated oncology care management platform to support continuity of care and connectivity between healthcare professionals and patients with cancer, no matter what their tumour type or stage of their disease.
Ensuring access to biomarker testing
Increased understanding of the molecular biology driving many cancers has transformed treatment, with the development of precision medicines targeting specific abnormalities. Evidence shows that biomarker testing and treatment with matched targeted therapy improves patient outcomes compared to traditional chemotherapy.
But there is huge variation in testing for predictive biomarkers. Testing rates for important biomarkers in several common cancers are much lower in European countries than in the US. Reasons for variations in biomarker use include a lack of common standards for regulatory decisions, patient and physician awareness and differences in reimbursement pathways for testing compared to drug treatments.
As part of our commitment to find practical solutions to enable patients to benefit from innovations we supported a recent initiative led by the European Alliance for Personalised Medicine to develop a consensus on the policy needs for improving access to biomarker testing in Europe. The consensus group recommended that European health authorities develop a policy framework to support diagnostics in the EU with guidance on minimal testing standards.
Accelerating access to new cancer treatments
Nearly 60 new oncology medicines to treat 23 different cancers were approved between 2014 and 2018 and breakthroughs continue, but cancer patients must be able to access these new treatments to benefit. A recent survey revealed huge variation in the average time to patient availability for new cancer medicines across European countries, ranging from 86 days in Denmark to 981 days in Latvia.
Action is needed based on a holistic view of factors that delay cancer patients’ access to new medicines. We recommend measures supporting readiness for value-based payment models that can accelerate patient access to new oncology medicines, allowing payers to manage clinical uncertainty and budget impact.
Early intervention is important to improve cancer patient outcomes and this is where our science strategy is focussed. But to reach patients with early disease we need a dialogue about endpoints supporting approval of new treatments. For therapies trialled in earlier disease, mature overall survival data may not be available at the time of evaluation or feasible to obtain at all in some scenarios, therefore posing challenges to the disease management of patients waiting for new medicines to be made available, unless data using other endpoints can be considered.
Keeping up the pace
The scale of the challenge to reduce deaths due to cancer in Europe is huge and has been made even more daunting by COVID-19, but there is no time for setbacks. Urgent action from the community on screening for lung cancer, biomarker testing and access to new cancer treatments will go a long way towards meaningful progress and we look forward to seeing Europe’s Beating Cancer Plan. We stand ready to continue working in partnership with patients, clinicians and policymakers across Europe to transform scientific innovation into healthcare solutions for people with cancer.
This article has been funded and authored by AstraZeneca