Cholangiocarcinoma: tests are needed for precision therapies
Cancers that affect the liver are not all created equal. And there is a rare and aggressive one, cholangiocarcinoma, which affects about 5,000 people every year, and which until recently had little chance of a cure. We are talking about a tumor of the biliary tract and precision oncology has arrived to improve the expectation and quality of life for these patients: targeted drugs that can give new hope to about 40% of patients with particular genetic alterations. To identify them, however, there is a need for genomic tests, those performed thanks to Next Generation Sequencing (NGS).
Tumors, a national program for free access to the most advanced genomic tests is underway
by Tiziana Moriconi
The point on cholangiocarcinoma
Timely access to new therapies for those with cholangiocarcinoma is one of the great unmet needs that emerged today during the meeting "The unmet needs of patients with cholangiocarcinoma in Italy" held in Rome by ISHEO, with the sponsorship of the Italian Patients Association Cholangiocarcinoma (APIC) and the Federation of Volunteer Associations in Oncology (FAVO), and with the non-conditioning support of Gruppo Servier in Italy. During the event, a report created by ISHEO was presented, which interviewed oncologists and patients from our country. “Cholgiocarcinoma is a disease that is often diagnosed when it is already in an advanced stage – he underlines Carmine Pinto – Director of the Medical Oncology Complex Structure of the AUSL-IRCCS of Reggio Emilia, Institute of Advanced Technologies and Care Models in Oncology - Only 35% of patients who receive a diagnosis, in fact, are operable and of these, about 60% tend to have relapses". Hence the importance of new treatment options, such as molecular target therapies, a therapeutic opportunity for those conditions in which the tumor is inoperable, or there are recurrences or metastases. "A key aspect - continues Pinto - is therefore the execution of NGS tests right from the diagnosis, because the time factor plays a crucial role in the treatment of this pathology".
Cancer of the biliary tract, European green light for immunotherapy
by Dario Rubino
From NGS testing labs to concurrent care
The expertise of the professionals who perform gene expression tests is the basis of a global care pathway aimed at guaranteeing the best assistance, but unfortunately the distribution of laboratories is not uniform throughout the country, as recalled Nicola SilvestrisNational Councilor AIOM (Italian Association of Medical Oncology: "In this context, the Oncological Networks can play a role of fundamental importance, allowing patients to be taken care of, even where the reference center may not be in the immediate vicinity". always, the preparation of the entire multidisciplinary team that takes care of the patient is fundamental: in fact, it is the 'simultaneous treatments' that make the difference for these patients - underlines the expert - and it is therefore necessary to ensure a global care that take into account the psychological, nutritional, pain therapy and rehabilitation aspects.
A pathway for patients with cholangiocarcinoma
by Tina Simoniello
From precision oncology to personalized oncology
"In recent years we have moved from precision to personalized oncology, with the increasingly realistic possibility of constructing precise and effective therapeutic options - he adds Paolo Marchetti, president of the Foundation for Personalized Medicine -. Institutions are looking for a common management path, a homogeneous collection of information, because specific molecular determinants must be identified, predictive factors of lower efficacy of treatments and greater toxicity for factors that are not usually taken into consideration in clinical cases. This way we can save more lives and give patients a better quality of life."
Cholangiocarcinoma, in one in 4 affected people is discovered by chance
by Valentina Guglielmo
The voice of the patients
To the voice of the clinicians is added that of the patient associations. "Strengthening the resources intended for the use of NGS is a fundamental step for DNA sequencing in the field of clinical oncology, with diagnostic, prognostic, predictive and monitoring purposes that can give access to personalized therapies also for affected patients from cholangiocarcinoma – says the lawyer. Elizabeth Iannelli, Vice-President of the Italian Association of Cancer Patients, Relatives and Friends (AIMAC) and Secretary General of the Federation of Voluntary Oncology Associations (FAVO) -. Talking about personalization of care - Iannelli points out - also means talking about better management of available resources, so that the patient is guaranteed targeted therapies that increase effectiveness, reduce side effects and health care costs, as well as the social and health costs borne by the sick.
Psychological support, inside and outside hospitals
Last but not least, there is the need to provide psychological support to patients: "The discovery of the disease dramatically affects people's lives - he explains Paul Leonardi, President of the Association of Italian Cholangiocarcinoma Patients (APIC) - The moment the diagnosis is communicated, people are able to immediately realize the seriousness of their situation, with a search on the net. Simultaneous care alongside oncological care is essential in a continuum of care. However, psychological support is often neglected, which is offered in some hospitals, but outside of these, cancer patients rarely find it". In fact, a patient with cholangiocarcinoma spends most of his time, fortunately, outside the hospital, and in some cases psychological support is also sought by caregivers.
“Scientific research is making giant strides, in recent times therapeutic strategies have considerably expanded and the Health System must run at the same speed - concludes the Hon. Annarita Patriarch, Member XII Commission (Social Affairs) of the Chamber of Deputies. The allocation of funds for Next Generation Sequencing (NGS) to guarantee access to these tests is a strong signal from the State that shows the commitment of the institutions in this battle, now let's commit ourselves to equal access to all patients, so that we can change the story of this disease for thousands of people".