He average time since the European Medicines Agency (EMA) approves a innovative drug until this is accessible to patients in the various Spanish hospitals are 661 days (almost two years). In the case of the oncology drugs It’s 725 days (about two years). The EMA itself proposes that this time should not exceed 180 days. These are figures that were reported this Thursday by the Spanish Association of Metastatic Breast Cancer (AECMM) within the framework of the annual congress of the European Society of Medical Oncology (ESMO, for its acronym in English), which is being held from this Friday in Barcelona. This reality, according to the AECMM, is due to the fact that the deadlines are being extended too much. periods of price agreement between the Government and pharmaceutical companies.

“I have traveled half of Spain asking that the incorporation periods be shortened of these drugs to the health portfolio. We are far below the European average”, has pointed out Pilar Fernandez, the president of the AECMM at an informative breakfast organised by Medsir, a company dedicated to promoting oncological research. Many patients, Fernández warned, die before the drug reaches the country.

The great paradox is that Spanish patients are the ones who participate the most in clinical trials: 80% say yes, compared to 15% of Americans.

“We, the patients, do not have time,” Fernandez added, while asking “more percentage of Spanish GDP dedicated to health” and “more resources for research.” He has denounced not only the “inequity” of Spain with respect to other countries, but among the communities themselves and the different Spanish hospitals when it comes to offering the latest drugs to their patients.

The great paradox It is that Spanish patients, who are among those who wait the longest for the newest drugs, are “world power” in clinical trials. That is, they are those who collaborate the most in research on these drugs. “In Spain there is a extraordinary predisposition for clinical trials: 80% of patients say yes. In the US the recruitment rate is 15%,” said the head of Medical Oncology at the Arnau de Vilanova Hospital (Lleida), Antonio Lombart

Objective: chronicity

He “enemy number one” of cancer, said the president of the association, is “the time”, even more so in the case of the patients with metastatic cancer. Fernández was diagnosed with breast cancer 31 years ago and has been living with metastasis for eight years. metastasis It remains an incurable disease, although Our survival has improved greatly thanks to precision medicine and the targeted therapies. We must find a solution for this to be chronic,” has said.

The “number one enemy” of cancer is “time”, even more so in the case of patients with metastatic cancer

According to her, the metastatic breast cancer has become the leading cause of death in women between 35 and 55 years old and represents more than 6,500 deaths annually in Spain. “We want make this degree of the disease visible. Metastasis has always been the great forgotten within breast cancer”, has pointed out.

Replacing chemotherapy

For Dr. Llombart, the main challenge for Oncology for the next decade is “increase” cure rates. But not only. “One of the questions we are asking ourselves is whether the new drugs will be able to replace chemotherapy “or if they will help to ‘de-escalate’ it,” said this doctor.

Chemotherapy is necessary and effective for the treatment of cancer, but it causes side effects. “There are already scenarios where we can avoid chemotherapy. There are already tools for the breast and colon cancer, that predict which patients would and would not benefit from chemo. And this will also come for the lung cancer”, This oncologist has stated.

“One of the questions we are asking ourselves is whether new drugs can replace chemotherapy”

Antonio Lombart

— Head of Medical Oncology at Arnau de Vilanova

Besides, There are already scenarios -and increasingly they will be a greater reality- in which chemotherapy can be de-escalated with targeted therapies. “Although we must always be sure to de-escalate treatments It is not a waste of opportunity for patients,” Llombart added.

Lung cancer

Lung cancer is one of the types of tumor with the worst prognosis, but at the same time it is one of those who, in recent years, has experienced major advances. “10 years ago the first targeted therapies for lung cancer and were a paradigm shift. Much progress has been made thanks to the fact that We know more about genetic biomarkers,” He said for his part Alfonso Aguaron, spokesperson for Lung Cancer Europe (LuCE), the European platform for those affected by lung cancer. In this regard, the artificial intelligence (AI) It is, according to Aguarón, “a very promising step forward.” “AI can predict what type of patients can benefit from certain types of chemotherapy. That is, AI allows customize, even more, these types of treatments,” he said.

The incidence of cancer is increasing in those under 50, showing that this disease is not only age-related, but also with the exposure to toxins and other environmental factors. “In addition to the good habits, he early diagnosis -like the one offered by screenings- also is part of prevention. In breast cancer It is very difficult to do primary prevention. When I was studying, one prevention factor was having three pregnancies before age 23: “This is now impossible due to the social reality we have,” said Dr. Llombart.