Thousands of Australians who face imminent death from cancer could live longer if the use of new medicines that harness the immune system to fight cancer cells became the norm.
This is a key finding of “The New Wave of Immunotherapy Cancer Medicines: The Untapped Potential for Australians” report by Deloitte Access Economics. It concludes that nearly one-in-six (approximately 7,500 of the 47,753) Australians who will die from cancer this year could benefit from greater than 30 per cent reduction in tumour size if treated with one type of immunotherapy known as checkpoint inhibitors. Tumour shrinkage of this percentage is considered a response to treatment, and could be associated with increased survival or improved quality of life.
“The challenge is getting these medicines into the hands of those patients who are most likely to benefit,” Professor David Thomas
The report, which was sponsored by MSD, states: “This figure – 7,500 patients – is conservative, as there are many more patients with cancer who will not die in 2017, but would benefit from immunotherapy.”
It also notes that fewer than 1,500 Australian cancer patients currently receive immunotherapy via the PBS. This equates to a mere 20 per cent of those in whom this form of treatment may be most effective.
Professor David Thomas from The Kinghorn Cancer Centre and the Garvan Institute of Medical Research, who was interviewed for the report, says that immunotherapies are being studied in more than 30 tumour types, and “have the potential to change the way cancer is treated”.
“The challenge of course is getting these medicines into the hands of those patients who are most likely to benefit,” he said.
Professor Thomas stressed that not all cancer patients respond to immunotherapy, “but when they do, it can be at a level that leaves us speechless”.
The report quotes Ross Stainlay, a cancer patient who is self-funding immunotherapy treatment: “It is expensive but it’s my lifeline. Tumours had spread to various parts of my body, but the scans show I am now clear. I’m not coming off it. I feel lucky to have this option – and feel for those who cannot afford this life-saving treatment”.
Melissa Baker, who was diagnosed with Hodgkin lymphoma in 2013, told the report that: “Soon after starting immunotherapy, I was able to return to work and live an almost normal life again. My kids got their mother back. My youngest child is starting primary school next year and I have no doubt that if it wasn’t for immunotherapy, I wouldn’t be there for his first day”.
The report notes that immunotherapies are only listed on the Pharmaceutical Benefits Scheme for a limited number of patients with advanced forms of melanoma, lung cancer and kidney cancer and eligible often only after other treatments have failed.
“It’s hard to explain to people why their cancer is not covered by a PBS listing or why they have to be treated with chemotherapy before qualifying for immunotherapy,” Professor Thomas said.
The report notes that reimbursement delays and capacity constraints remain barriers to access in Australia, with it taking 597 days on average for a cancer medicine to be listed on the PBS – 200 days longer than other disease areas – a problem which is set to worsen as more immunotherapies are submitted for review.
The report calls for medicine approval and reimbursement systems in Australia to be overhauled to expedite access to immunotherapies; including adopting a pan-tumour approach similar to the FDA (the US regulator can approve a prescription drug for the treatment of solid tumours with a specific genetic signature in any organ – regardless of the tumour’s organ of origin). This would avoid the same medicine having to undergo multiple reviews across different cancer types.
Deloitte Access Economics Health Lead Partner Lynne Pezzullo said, “This report provides critical insights into the benefit of these cancer therapies and sets out what Australia needs to do to ensure that the promise of immunotherapy is fully realised”.