Tumors, ‘I know too’ campaign: patients and doctors provide information on research progress
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Leaving hospitals, doctors’ surgeries and families affected by cancer to tell all those who will listen not only about living with an oncological pathology but also about the progress made over the years to treat and improve the quality of life even for more difficult to treat patients. This is the spirit that animates the awareness campaign ‘I know too’ which stops in Rome for its third stage from today until Sunday 18 June in Rome, in Piazza Re di Roma (from 10 to 18).
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The decrease in mortality
In Lazio, about 34,500 new cases of cancer are estimated each year. In 2022, in Italy, there were 390,700 diagnoses, with an increase of 14,100 cases compared to 2020. However, between 2011 and 2019, our country recorded a higher decrease in cancer mortality than the European average, with a reduction in deaths of 15% in men and 8% in women (-10% men and -5% women in Europe). A goal achieved also thanks to immuno-oncology which, with an innovative approach to treating the disease, has changed the history of various neoplasms that were once very difficult to treat.
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The turning point of immuno-oncology
After the first two great steps forward in the challenge to tumors represented by chemotherapy and targeted therapies, in the last ten years there has been a real turning point thanks to immuno-oncology. “Today it is the standard of care in various neoplasms in a metastatic stage or with a high risk of disease recurrence after radical surgery: from melanoma, to lung cancer, to mesothelioma, to renal cell carcinoma up to gastrointestinal and genitourinary ones. And they are studies are underway in many other malignancies,” he says Michele Maiopresident of the NIBIT Foundation, Director of the Oncology Department of the University of Siena and of the Immuno-Oncology Center (CIO) of the Siena University Hospital.
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Immuno-oncology in melanoma
Our country has always been at the forefront of immuno-oncology research. In the Center of Siena, thanks to studies conducted by the NIBIT Foundation, the foundations of experiments have been laid that have changed clinical practice. “About 50% of patients with metastatic melanoma – continues Maio – develop brain metastases. With the NIBIT-M2 study, for the first time in the world, we have broken the ‘dogma’ according to which immunotherapy does not work in these cases and approximately 50% of these patients are alive and free of disease at 5 years compared to the 4-5 months we were used to.”
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Immuno-oncology in lung cancer
Today about 75% of cases of lung cancer, one of the most difficult malignancies to treat, are diagnosed at an advanced stage. Even in this tumour, immuno-oncology has changed the treatment paradigm. “Dual immunotherapy, consisting of nivolumab plus ipilimumab, in combination with two cycles of chemotherapy, in the first line of metastatic non-small cell lung cancer, improved overall survival at four years with 21% of patients alive compared with 16 % with chemotherapy alone,” he explains Frederick Cappuzzo, director of Medical Oncology 2, ‘Regina Elena’ National Cancer Institute in Rome. The benefits are particularly important in patients with poor prognosis, i.e. tumor PD-L1 expression below 1% and squamous histology. In these cases, the combination therapy continues to reduce the risk of death by about a third compared with chemotherapy alone at four years. The further advantage of this therapeutic regimen is represented by the use of limited cycles of chemotherapy”.
Focus on prevention
Although lung cancer has been considered an almost exclusively male pathology, in recent years there has been a strong growth also among women due to the increase in cigarette smoking addiction in the female population. “Primary prevention – he underlines Stephanie Vallone, secretary of WALCE (Women Aganist Lung Cancer in Europe) – is one of the pillars of our Association, which also wants to contribute to the diffusion of greater awareness of the meaning of therapeutic innovation. Unfortunately, the diagnosis of lung cancer is still late, but new tools such as immuno-oncology are improving the chances of long-term survival, with a good quality of life”.
The role of laboratory research
Laboratory research is crucial to understanding the new frontiers against cancer. To increase the number of patients who respond to immunotherapy, studies on resistance mechanisms are needed and the key to discovering them goes in three directions. “First of all – Maio clarifies – the microenvironment in which tumor cells grow and multiply must be analysed, which plays a fundamental role in regulating the anti-tumor immune response. It is also necessary to improve studies on the sequence with which to administer these drugs. Finally, the third strategy to follow is to make tumor cells more ‘visible’ to the immune system, for example by using hypomethylating drugs administered in combination with immunotherapy, as we are doing in the NIBIT-ML1 study conducted by the NIBIT Foundation, also thanks to the contribution of Airc Foundation as part of a 5×1000 project coordinated by the CIO of Siena, in patients with melanoma and lung cancer in disease progression to a previous standard immunotherapy treatment”.
Countryside
‘I know too’ is a campaign created by Bristol Myers Squibb, with the participation of APaIM (Italian Melanoma Patients Association), Living without a stomach (you can), FIAGOP (Italian Federation of Parents and Healed Pediatric Oncohematology Associations), TUTOR ( Rare Thoracic Cancer Association), FAVO (Italian Federation of Oncology Volunteer Associations) and WALCE (Women Against Lung Cancer in Europe), and the patronage of AIOM (Italian Association of Medical Oncology). The campaign includes meetings in the squares, with the presence of patient associations and the distribution of information material, and the activation of a dedicated portal (www.bms.com/it/losoanchio.html). For this third stage, a gazebo will be set up in Piazza Re di Roma throughout the weekend and open to all, where a ‘time machine’ will be found to show the main stages in the history of immuno-oncology.
Information for everyone
Longer survival and better quality of life means for many patients having the possibility to plan their life even after the disease. “The time has come to consider cancer in all its aspects, biological, medical, psychosocial, but above all to prolong the commitment to ‘take charge’ over time, even after recovery, which must correspond to the return of each former patient to his own relational and professional life”, he concludes Maurizio Vannini, delegate FAVO (Italian Federation of Volunteer Associations in Oncology) Lazio. “FAVO has always underlined the importance of information, both for patients and citizens. For this reason we are committed to ‘I know too’, the information campaign to increase the level of knowledge on the progress of science in immuno-oncology “.
From the Nobel Prize to Artificial Intelligence
In 2013, the prestigious American magazine ‘Science’ placed immuno-oncology at the top of the ‘top ten’ of the most important scientific discoveries of the year. At the time it seemed like a gamble, today immuno-oncology is a consolidated reality in the treatment of tumors and many conquests are now considered acquired. “The Nobel Prize for Medicine awarded in 2018 to James Allison and Tasuku Honjo for their studies on this weapon – underlines Cosimo Paga, Executive Country Medical Director, Bristol Myers Squibb Italy – testified to the extent of the revolution underway. Bristol Myers Squibb was the first to believe in this approach and we continue to be pioneers in the development of new immuno-oncological molecules, such as relatlimab, which interact on different targets of the immune system, and various combinations of immuno-oncology with chemotherapy and targeted. Our goal is to extend the effectiveness of immuno-oncology to the greatest number of patients to improve their survival. To increase the effectiveness of therapies and give the right therapy to the right patient, it is necessary to improve diagnostics: for this reason Bristol Myers Squibb is investing heavily in this area and will also use IT tools such as Artificial Intelligence”.
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