Two days of meetings between oncologists, psychologists, caregivers, institutions, scientific societies, family members and patients with cancer. Not just any cancer, but a specific form: non-small cell lung cancer (NSCLC, a form that affects about 85 percent of patients with lung cancer), with DNA alterations and in advanced stages. Two days to discuss therapies, to update on news, to plan actions capable of improving care, access to tests and clinical trials, but also to exchange support and closeness, therefore to network. This is BeMUTualDays, an event organized by Walce – Women Against Lung Cancer in Europe Onlus, now in its third edition. “The goal is to bring together patients, each with their own subjective needs, and make them meet on a common ground of shared needs”, explains Silvia Novello, President of the non-profit organization, professor of Medical Oncology at the University of Turin and Head of the Simple Departmental Structure of Pulmonary Oncology, AOU San Luigi Gonzaga of Orbassano. A moment to share information, in short, which, as Roberta Costa, patient and member of Walce Onlus recalls, helps to elaborate the awareness of having a tumor, of living with a tumor, but also the awareness of what happens in the lives of others.
The two days will also serve to strengthen ties within a world not yet adequately represented. Unlike other European countries and the United States, Novello continues, in Italy there are no strong patient associations specifically committed to the single molecular alterations of this particular tumor. It is, explains the oncologist, of mutations – even if the term is improper – in the tumor cells, which guide the various stages of growth and development and which are detectable by performing various types of molecular diagnostic tests. Identifying a specific molecular biomarker (the best known are EGFR, ALK, ROS, BRAF) allows the treatment of lung cancer with innovative therapeutic strategies, such as the so-called targeted therapies, molecular target therapies that act specifically and selectively on the factors it depends on the growth of cancer cells. This will therefore be discussed at BeMUTualDays, about the so-called precision medicine: drugs capable of acting on these specific genetic mutations, which not only improve survival and quality of life, but are also very tolerable. Today, molecularly targeted therapies are changing the natural history of this neoplasm. First, because today only 25% of patients with this disease can be treated with biologics. However, the research goes on and is trying to extend this percentage and reach much higher numbers: it is thought that approximately 70% of patients with non-small cell lung cancer can be treated with precision medicine at the time of diagnosis. Secondly, because in the next few years, the survival of patients treated with target drugs, which today stands at 15-19% at 5 years, could exceed 60% thanks to the amount of data and knowledge on molecular alterations and drug development. innovative.
The molecular characterization of NSCLC therefore becomes a fundamental and necessary step in the patient’s diagnosis and treatment process. And this, continues Novello, occurs thanks to tests conducted on small portions of tissue which, however, may not be sufficient if a large number of biomarkers are to be sought. For this reason, the so-called NGS tests, Next Generation Sequencing, are increasingly widespread – but still patchy on the Italian territory, which allow to explore several alterations at the same time (from ten to several hundreds). “Today about 30 percent of Italian cancer centers are able to offer NGS tests. Other centers are further behind. Perhaps – is the comment of the oncologist – we can begin to imagine a centralization of diagnostics “.
At the center of BeMUTualDays there will also be another fundamental theme: access to experimentation. “The clinical trial can represent a valid therapeutic option for Italian patients, given that the approval by our regulatory agency (AIFA) often comes later than in the United States. The clinical trial can therefore bridge this transition period or latency between the US indication and that of EMA, the European regulatory agency, and that of AIFA in which the drug is not available, ”says Novello. Yet in Italy there are still few patients enrolled in clinical trials. A problem due not so much to the lack of studies, which are instead well present on the national territory, as can be seen clearly from the site managed by the Italian Association of Medical Oncology (AIOM) – studiclinici.aiom.it. “A limiting factor is certainly the limited time that can be devoted to a patient during the visit. But it is also true that we are paying for a lack of information: patients are still afraid of being considered guinea pigs, and few know the true meaning of the trials ”, adds the President of WALCE. That is why he designed EPROPA, a European program that guarantees access to adequate molecular profiling in a completely free way and always with the mediation of the referring physician oncologist, only by moving the diagnostic material. If a molecular alteration is then identified for which the drug and / or the specific clinical study are not available at the center where the patient is followed, EPROPA guarantees logistical support for the movement of the patient and his caregiver in order to guarantee access to care.
.