One third of cancer patients are unaware of the fact that it is now possible to determine who is most likely to benefit from particular treatments, according to new survey data presented at ESMO 2012, the meeting of the European Society for Medical Oncology in Vienna, Austria (September 28 - October 2, 2012).
Cancer treatment is being transformed as scientists discovered the molecular changes at the heart of many cancers, but the survey conducted by Prof Sabine Tejpar,M.D. from University Hospital of Leuven, Leuven, Belgium and colleagues, suggests patients are not always aware of this revolution.
Tejpar and colleagues surveyed 811 patients diagnosed with cancer in the last five years using telephone-based questionnaires. The patients included 164 with late-stage breast cancer, 157 with stage III/IV non-small cell lung cancer and 490 with metastatic colorectal cancer from Argentina, China, France, Germany, Italy, Spain and the UK.
The results showed that 32% (260) of those interviewed thought that there were no tests available to determine which cancer treatments might work in certain individuals, while 53% thought that testing might be possible. The survey revealed breast cancer patients were the best-informed about testing, with 62% thinking testing might be possible, compared with 52% with colorectal cancer and 48% with non-small cell lung cancer.
On a positive note, the survey revealed that 66% (532) of respondents would be willing to delay treatment if this helped to select the most effective drug, and that 54% of these would be willing to delay treatment for more than two weeks. Furthermore, most patients (69%) would be willing to undergo additional tumor biopsies as part of the treatment selection process, and 91% would allow hospitals to retain their tumour samples for future research.
“It was really striking participants were willing to allow hospitals to retain their tumor samples even if this didn’t directly relate to their own treatment. It shows they want to advance research and help others with the disease,” Tejpar said
Matching patients to treatments
During the ESMO 2012 Congress, a session of the 9th ESMO Patient Seminar explored the “hype or hope” around personalised medicine and underscore the importance of good patient education. The presenterd explained that personalised medicine is about matching patients to the treatments that work best for them, with the ultimate goal of everyone being treated as an individual. In oncology, personalised medicine is becoming a clinical reality, with targeted treatments already in use. "The concept of one-chemotherapy drug fits all is now history. More and more we are defining treatments according to the molecular characteristics of individual tumors,” said Antanasio Pandiella, from the Salamanca Cancer Research Centre, in Salamanca, Spain. "For patients," he added, "personalised medicine holds the promise of preventing exposure to drugs with limited chance of success, reducing toxicity and improving quality of life."
A right to know
“But personalised medicine can be a really confusing concept for the public to get to grips with. Words like personalised medicine, targeted treatments and stratification get banded around, with few people actually understanding what it’s all about. Patient education is one of the biggest challenges, and there is a real need to improve the way it is delivered,” says Jola Gore Booth, CEO of EuropaColon, who explained the patient’s perspective at the 9th ESMO Patient Seminar (September 29 and 30). Gore Booth said: "Cancer patients have a right to know about personalised medicine to empower them to take responsibility for their own disease and achieve the best possible outcomes, she adds. “Such knowledge ultimately has the power to influence their overall survival.”
Patient education needs to be centred around managing expectations. “With some of the hype around personalised medicine, patients need to be helped to understand that they may not have the right biomarkers and new treatments do not work in everyone. They need to understand that even if these treatments are initially successful and extend overall survival they don’t represent a cure,” Gore Booth noted. There is also a need to educate the general population since they are the people who may become patients. “It is really helpful if they know about the concept of personalised medicine from the outset of diagnosis so that they can hit the ground running,” she added.
Educating patients about personalised medicine requires that oncologists establish much stronger relationships with their patients. “Doctors need to remember that the patient is at the centre of treatment, and providing good care isn’t all about the molecular characteristics of the tumor to the exclusion of all else. We must not forget that surgery, radiotherapy and palliative care all have a role,” Pandiella said.
Prof Fortunato Ciardiello, Chair of the ESMO Personalized Medicine Task Force, noted: “Once specialists understand the issues we hope that knowledge will start to trickle down to patients.”
1382P - Poster Presentation Sunday, September 30, 2012 - 1:00 PM - 2:00 PM - Hall XL
Picture: Sabine Tejpar,M.D., Translational Research in GastroIntestinal Disorders, University Hospital of Leuven, Belgium.