HAVING “targeted” drugs capable of selectively “recognizing” and “targeting” mutations has revolutionized the way many cancers, such as that of the lung, are treated. But these drugs are likely to be only half useful if molecular tests that detect mutations are not done to all patients who might benefit from them. This is partly because not all centers have the necessary equipment, and partly because these complex analyzes are not always reimbursed by the health system. To facilitate access to molecular testing – and thus to therapies and clinical studies – for European patients with advanced stage (III B / C or IV) non-small cell lung cancer (NSCLC, the most common lung cancer), the project was launched epropa (acronym of European Program for ROutine testing of Patients with Advanced lung cancer), which sees Italy as the leader and involves 7 other countries: Spain, Portugal, Romania, Serbia, Slovenia, Greece and Poland.
Lung cancer, it’s time for personalized and agnostic therapies
The project
Epropa is promoted by the association Walce – Women Against Lung Cancer in Europe and, thanks to the collaboration with the University of Turin, it allows free access to molecular tests. The request must be submitted by the oncologist, who assesses the need and opportunity for each patient to access the program. Once registered, the oncologist must send the biopsy samples to the laboratory of the Oncology Department of the University of Turin, where they will be analyzed.
Tumors and genomic tests: Italian patients among the most informed
by Letizia Gabaglio
At this point, three possibilities open up: the test does not reveal any “useful” mutation and traditional therapy is proposed; the test reveals a mutation for which molecularly targeted drugs are already available, which will be prescribed by the oncologist instead of or in combination with traditional therapy; the test reveals a mutation for which therapies are being tested. In the latter case, Walce offers both economic and logistical support so that the patient, if he so wishes, can participate in the trial, if the centers involved in the clinical trials are far from his residence.
Personalized medicine must be a right
by Tiziana Moriconi
Equal access to clinical trials and trials: the challenge of precision medicine
Ensuring equity of access to advanced genomic profiling analyzes and, consequently, to drugs and clinical trials is one of the challenges of precision oncology. An issue at the center of an advocacy action in Italy by the APMP Group – Patient Associations, together for the right to Personalized Medicine in oncology, but also beyond the border, solutions are being sought to improve the issue of genomic profiling. in the world of associations, even that of private insurance is moving. An example of this are two agreements signed by the pharmaceutical company Roche with Axa and Cattolica Assicurazioni: customers who have taken out health policies can access the molecular tests of Foundation Medicine (a partner company of the Roche group) for the genomic profiling of solid tumors – not only that of lung – metastatic or locally advanced. In the case of Axa, the coverage of the tests is provided for the policies that provide for the Advanced Second Medical Opinion, through the request of their own doctor, while in the case of Cattolica it is provided for the Active Benessere policyholders.
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