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ESMO 2017: EAPM roundtable at ESMO Congress on education, innovation and beyond

11 Sep 2017

The high-level discussions under the banner ‘Personalised Medicine: Translational Continuing Education Initiative’ held in the Spanish capital, represented the fifth such roundtable conducted by the Alliance at the Congress.

This type of interaction is one key aspect of EAPM’s stated goals - to engage with the medical community whenever possible, and at every level.

Attendees at the roundtable included HCPs, patients, public health experts, economists, industry representatives from ICT and pharmaceutical companies, and other specialists from across multiple disciplines.

Education

EAPM’s multi-stakeholder, high-diversity meeting took into account the fact that new discoveries - generated from a deeper understanding of the human genome - are driving a paradigm shift in medicine from a one-size-fits-all approach to one which is personalised and targeted to the individual.  

This shift is rapidly progressing in oncology but is slower in other areas.

And, while there are many barriers to innovation in clinical practice - including market access, scientific, and/or regulatory challenges - the biggest challenge across the healthcare system is continuing medical education for healthcare professionals.

EAPM and its stakeholders firmly believe that education should be a top priority when it comes to modernising healthcare systems, and this was reaffirmed at the roundtable.

However, most educational programmes are less than optimal (an area that EAPM has already begun to address through its Summer Schools held in 2016 and earlier this year).

A changing society, with changing needs

As we all know, a key difference between personalised medicine and conventional methods of treating patients is the setting aside of a ‘one-size-fits-all’ philosophy in favour of a much more targeted process.

A major reason for this is the fact that patients respond differently to the same medicine being used to treat the ‘same’ disease.

Figures show that, for example, 38% of citizens on anti-depressants do not respond to their treatment, while the non-response figures for asthma, diabetes, arthritis and Alzheimer's are, respectively, 40, 43, 50 and 70 percent.

Cancer patients overall have a non-response rate of a massive 75 percent.

This for a disease that is the biggest healthcare cost burden of all, as well as being the biggest killer.

Meanwhile, sickness and disability costs form a large portion of GDP and government social spending while overall healthcare costs are rising all the time with Europe’s ageing population.

Indeed, the average lifespan has increased by around 25 years in the space of a century.

Quality of life, thankfully, is also on the up.

Society is clearly changing and, therefore, so are healthcare needs, as we move from an emphasis on acute diseases to more chronic, lifestyle-related ones with the additional burden of co-morbidity.

We need, quickly, to move towards giving the right treatment to the right patient at the right time.

Innovation is key

A major pillar in bringing new, targeted medicines to patients is, of course, innovation.

This, in the realm of health, means the translation of knowledge and insight into what we can call ‘value’.

And that value covers the value to patients but also has to take into account value to healthcare systems, society and, of course, the manufacturers.

Education, as discussed above, as well as innovation, are key to moving personalised medicine forward.

There will always be innovation, of course, but the major issue regarding it is the way that we dovetail all these amazing advances into personalised medicine and EU healthcare systems for the benefit of patients across Europe.

Therefore the workshop in Madrid addressed new developments while covering the hot topic of what is needed to facilitate their introduction into everyday healthcare and in what areas stakeholders should focus their energies.

Innovation-wise, progress has been made (and reported at the ESMO Congress) in such areas as DNA sequencing and new drug indications for patients with rare cancer, genomic-based cancer diagnostics and blood tests that could help to personalise cancer immunotherapy.

Presentations at the Congress also showed improvements are underway in holding off EGFR lung-cancer growth, as are other treatments, such as drug/chemotherapy combinations, while developments in the field of biosimilars also came under the spotlight.

Clinical trial methodology, and the psychological side of chemotherapy from the patient perspective were also featured at the event, alongside many other cancer-related topics ahead of World Cancer Research Day, which this year will be held on 24 September.

From a personalised medicine perspective, EAPM is aware that a targeted or personalised approach is not always required.

But, when it is, Europe should be working towards segmenting the use of even existing medicines (many of which do their job perfectly well) into responders and non-responders, which will in turn assist in the development of novel medicines.

On top of this, the technology now exists to apply the personalised medicine, genetic-based techniques in prevention, possibly via individual risk maps which may suggest specific guidance on living a healthy life.

All of this is built upon thorough research, of course, which then needs to be translated via various processes on the way to market, not least of which are regulatory approval and pricing.

Also, communication and Implementation are key if a new drug or treatment is to prove a success and of value to society.

Generally speaking, the EU has recognised that innovations in healthcare can contribute to the health and well-being of citizens and patients through access to innovative products, services and treatments that have added value.

It is also aware that in order to stimulate development, there is a need to facilitate the translation of scientific advances into innovative medicinal products that meet regulatory standards, accelerate patients’ access to innovative therapies with added value for patients and are affordable to the Member States’ health systems.

And it is clear that early dialogue between technology developers, regulatory, health technology assessment and, where relevant, pricing bodies will promote innovation and quicker access to medicines at affordable prices, to the benefit of patients.

With better medicines, plus smarter IVDs, telemedicine and other technological advances patients can live longer, healthier, and much more independent lives.

But it would be impossible to manage all this without innovative research.

Essentially, Europe needs to tear down the barriers lined up in front of our undeniably excellent innovators.

EAPM executive director Denis Horgan said after the roundtable event: “As ever, it’s extremely important to hold a roundtable at the ESMO Congress. It’s one way that we can reach out to the many experts in cancer and personalised medicine, as well as hearing their’s and patients’ views on all of the issues, including ongoing education for healthcare professionals and the implementation of innovation.”

“The stakeholders at the ESMO Congress and the EAPM roundtable are vital in the battle to implement the incredible advances of personalised medicine into healthcare systems across the EU,” he said, adding that: “Arriving at consensus across a range of areas and expertise is key to furthering the personalised medicine agenda.”

“‘Integrating science into oncology for a better patient outcome’ was the slogan of ESMO 2017,” Horgan pointed out. “Which synergises perfectly with the aims of EAPM and its stakeholders.”

Screening, incentives and more…

Further topics discussed in depth were incentives and screening.

Siemens Healthcare put forward a presentation on the role of screening, while Maarten Izjerman, Dean of Health and Biomedical Technology, faculty Science and Technology at the University of Twente, spoke about the issues of economics and rational use of resources.

Patients were represented, meanwhile, by Natasha Bolanos, of the Spanish Group for Cancer Patients (GEPA).

Other matters arising at the all-day roundtable on Sunday 10 September took into account the ongoing developments in the field of personalised medicine, such as DNA profiling, concepts of ‘value’ and biomarkers and, because of the diversity of the disciplines of the delegates attending, the meeting constituted a bridge between new developments and those that will implement them, as well as the patients who will eventually benefit.

Source: European Alliance for Personalised Medicine

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