Револуција у европским здравственим системима за пацијенте са раком плућа: Позив на акцију за побољшање превенције, раног откривања, лечења и праћења помоћу нових технологија

The call to action is entitled: 'Revolutionising Europe’s healthcare systems for lung cancer patients: A call for action on improving prevention, early detection, treatment and monitoring with new technologies.'  

Politicians of all colours struggling to crash through healthcare barriers to tackle lung cancer.   All governments and politicians of whatever hue want their citizens, who have or may get lung cancer, to have a better and healthier way of life. ‘  The left’s, right’s and indeed centre’s ideas on how best to keep the population alive and well may differ through fiscal policy and more, but the basic tenets of keeping healthcare systems sustainable are no different under whichever ‘colour’ of government is in power at any one time. Or shouldn’t be.

But the barriers to facilitating access to lung cancer patients to the best healthcare available, and thus keeping people healthy can be taken collectively, through policy initiatives such as the upcoming EU Beating Cancer Plan.

Progress so far to tackle lung cancer, what the experts have highlighted…

Progress towards a targeted program for lung cancer screening is limited. In half the countries surveyed, it is not even planned and in only one is it fully implemented, and there are wide variations in the proportion of key centres that have the capabilities or infrastructure to perform comprehensive genomic profiling and at what point it is initiated. Multidisciplinary tumour boards serve lung cancer patients in only half the countries; they often lack comprehensive skills, and are not supported by an infrastructure or legislation to share patient data-

Приступ clinical decision support software is scant – although scientifically supported molecular guided treatments can be prescribed and reimbursed off-label in many countries. 

реклама

App-based questionnaires are used by key centres to generate Patient Reported Outcomes, but with little use of digital monitoring devices, and less of algorithms to prompt personalised interventions.

Epidemiological registries for lung cancer patients rarely include outcome data at national level, or connect their personal diagnostic and outcome data. Delivery of lung cancer care is a low priority and not widely centralised.

The survey results are amplified – and in many cases confirmed – by the round tables with experts, which identified deficiencies in national plans for lung cancer and the expertise available via MTBs and MDTs, limitations on reimbursement, and diversity of IT systems impeding data sharing. 

National reports highlighted delays from presentation to treatment and in transmission of test results, lack of awareness of treatment options among HCPs, variability of guidelines, lack of routine use of molecular testing and NGS and of clinical decision support software – all resulting in divergences in quality of care.

(A more detailed breakdown is available in the call to action.)

Upcoming EU Beating Cancer Plan

Improving outcomes in lung cancer depends heavily on early and accurate diagnosis including staging, permitting rapid and appropriate treatment and decreasing the advanced/metastatic stage rate. Primary prevention in the form of smoking cessation is of utmost importance in lung cancer, but without implementation of an effective screening this disease could not be conquered within the next decades. As novel approaches to diagnosis and treatment emerge, discussion develops over their clinical utility. 

Notably, routine use of Секвенцирање следеће генерације (НГС) on tumour samples is now recommended by the European Society of Medical Oncology (ESMO) in advanced non-squamous non-small cell lung cancer (NSCLC). Innovations also extend to management, with a shift towards multidisciplinary teams. Advances already allow a more personalized approach to treatment for patients with advanced non–small cell lung cancer, with Molecular Guided Treatment Options (MGTOs) moving from concept towards routine practice. 

But barriers exist in Europe, as demonstrated by the limited access to NGS in many countries, by a range of factors:  delays in approval, constraints on reimbursement and funding, inadequacies in infrastructure and capacity, lack of access to diagnostics and related treatments, limited mobilisation of digital monitoring and data,  insufficient attention to outcomes and quality of life in patient follow-up, and uneven levels of information and education. 

Within the EU, action is required to catalyse improvements and grasp opportunities, notably through making a reality of early dialogue, early use of advanced diagnostics and therapeutics, more sensitive value assessments, better mobilisation of specialists, clearer guidelines, and data standardization and infrastructure.

As mentioned, an additional breakdown of the above information је доступан ovde and a more detailed report will be coming out in later this month.