As cancer treatment advances, so must availability

As cancer treatment advances, so must availability

A researcher works in a Roche laboratory. Roche Holding AG
A researcher works in a Roche laboratory. Roche Holding AG

New cancer treatments such as targeted therapies, immunotherapy and biological therapies could save thousands or even millions of lives from the deadly disease in Asia and worldwide, say experts.

The overall cancer picture in Asia is improving, thanks in large part to more accurate diagnosis and some advances in treatments, said Dr Sivabalan Sivanesan, Asia-Pacific medical leader for oncology with the Switzerland pharmaceutical company Roche.

Therapies that can be customised to suit the needs and circumstances of individual patients hold great promise, he told a recent briefing in Singapore.

"Targeted therapies are a type of cancer treatment that targets molecular changes in cancer cells," he explained. "Immunotherapy is a type of cancer treatment designed to boost the body's natural defences to fight the cancer, and biological therapies are a type of cancer cure that uses drugs derived from biological (not chemical) sources."

Dr Sivanesan said these new forms of treatment are unlike chemotherapy as they can go after specific cancerous cells while sparing the rest of the body from the deleterious effects of drugs.

"A problem with chemotherapy is that it turns one's entire body into an inhospitable environment for cancer cells, and over time you lose efficacy," he said. "Chemo drugs may work to shrink the cancer cells at the start of treatment, but after repeated exposure to these drugs, the diseased cells become immune. What new therapies like immunotherapy and the use of biologics do to fight cancer is to slow down cancer growth."

Dr Sivanesan said the new frontier in treatment involves individualised, targeted options tailored to every patient's condition, cancer type and stage. He likens them to "surgical strikes" that seek maximum impact with minimal damage, is in contrast to chemotherapy and radiation, the two most common treatments, which are akin to using "bombs" against targets on the ground.

Dr Christiane Hamacher, head of the Asia-Pacific division of Roche Pharmaceuticals Photos courtesy of Roche Holding AG

"The current data on cancer survival rates using chemotherapy only shows that the clinical benefits of the treatment fall over time, at times with sudden precipitous drops," he said. "But with the use of targeted agents, the drop in efficacy is much more gradual over a longer time."

However, Dr Sivanesan said cancer is a complex condition with more than 250 types identified so far, so there are still many gaps that the use of targeted agents has not reached yet.

Dr Christiane Hamacher, who heads the Asia-Pacific division of Roche Pharmaceuticals, said new treatment advances could reduce cancer morbidity and mortality. However, rates can vary greatly vary from country to country amid factors ranging from availability of patient education to infrastructure, speed of drug approval and availability of oncologists.

Unlike in wealthy countries where the world's top medical care is found, there may not be adequate treatment for many living in poor and developing countries, as 50% of people in Asia still lack regular access to essential medicines for cancers.

Dr Hamacher said more and more people in Asia are seeking personalised healthcare. However, there are no statistics on the number who have access to or are using such treatment.

"The cost of personalised healthcare now may be high for some groups of patients, but it will be more accessible and affordable in the future," she said.

She also noted that the drug approval process in Asia tends to lag the West by two or three years. This is usually because local health authorities wait until globally recognised regulators such as the US Food and Drug Administration and European Medicines Agency have approved a drug.

Cancer is the second-leading cause of death in the region, accounting for 15 of every 100 deaths, according to Chee Hew, senior principal for Asia Pacific with the Roche Economic Intelligence Unit.

The top five cancers in the region, she said, are lung, gastric, liver, colon and breast. But for women, breast cancer is the most common and most deadly of all cancers, and the fastest spreading, said Ms Hew.

"There are many reasons for this. Among them, the uneven standards of care where the lack of health insurance from state sources means most cancer care is self-paid," she said.

Ms Hew also said a general lack of public awareness in many cases leads to delayed diagnosis and treatment.

"Vulnerable populations experience delays in receiving their cancer diagnosis and treatment after they develop symptoms. They experience delays in starting cancer treatment, and they are less likely to complete life-saving therapies," she said. "We now understand that some of the largest gains in cancer survival can be achieved by ensuring equity in access to quality cancer care to all people."

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