We won't rest until lung cancer patients can achieve the best possible outcomes

Over the past decade, scientific advances have led to significant progress in lung cancer survival. Today, 22% of people with lung cancer are alive 5 years after diagnosis, a 6 % increase compared to 2016[1]. A figure which increases to 26% for NSCLC[2], the most common type of lung cancer. For people living with cancer, the result of innovation means new experiences, moments shared and memories made.
The introduction of targeted treatments and immunotherapies – which have rapidly become the standard of care – are contributing to better outcomes. And research continues at pace. The pharmaceutical industry is engaged in researching and developing new treatment options to continue to improve outcomes for patients living with lung cancer. The number of clinical trials for lung cancer in Europe has followed a steady upward trend over the last decade, increasing by over 1000% since 2010[3].
Still, despite significant advances, there is a long way to go. Lung cancer imposes a serious burden on Europe with the highest mortality among all cancers, and almost equal to the mortality from breast, colon and prostate cancer combined[4].

The poor outcomes in lung cancer have a range of causes, including late diagnosis, inconsistent access to treatment, inadequate biomarker testing infrastructure, along with stigma. In addition, lung cancer is a highly complex condition with numerous subtypes, where gene alterations can drive cancer cell growth and proliferation. This makes finding them and treating them a challenge.
Today’s Lung Cancer Day reminds us and the whole cancer community that we can’t rest until all patients have access to optimal prevention, screening, diagnosis and treatment.

Prevention, diagnosis, treatment

No solution alone delivers a critical improvement in survival, but a combination of solutions along the pathway may do. Prevention and screening have a significant impact on the overall burden of the disease. Europe’s Beating Cancer Plan and the upcoming revision of the Council Recommendation on cancer screening are real opportunities to improve outcomes for patients with lung cancer. Extending screening programmes to lung cancer could result in around 12.5 years of additional life and could prevent up to 22,000 lung cancer deaths in Europe every year.[5] Still, alone, that’s not enough. We must also ensure that diagnosed patients have fast access to treatment. Within Europe, for example, large variations still exist, with up to 30 percent of diagnosed patients in late-stage lung cancer being untreated[6][7]. Many more lives could be saved if treatment guidelines are followed.

As said, lung cancer is a very heterogeneous disease. Testing patients early for different biomarkers, using the right diagnostic tools including Next Generation Sequencing (NGS) testing, can help detect tumours and guide individual treatment choices, delivering significant advantages to both patients, healthcare systems and payers.
The clinical benefits of a precision medicine approach, which enables clinicians to choose the right medicine for the right patient, can be significant. But access to comprehensive genomic profiling for cancer patients is just as vital as access to the latest therapies. Without genomic testing, there is no prospect of personalized treatments.
After diagnosis, different treatment approaches are needed to improve patient outcomes. Scientific advances are making a real difference, contributing to our understanding of the complexity of lung cancer and the different ways in which subtypes behave and therefore increasing the chance of tackling them.

Patients cannot wait

There is no value from innovation if patients for whom it is intended cannot have access to it. It takes an average of 436 days for the European Medicines Agency to assess a new active substance. Compare this with 244 days in the United States, 323 in Japan, 348 in Canada and 363 in Australia[8].

This inevitably delays access to innovative treatments for European patients. It also positions Europe as a ‘follower’ rather than a leader in the fiercely competitive global environment. We must ensure that our regulatory system keeps pace with advances in science and technology to deliver more for patients.

Getting the green light from regulators does not guarantee patient access to innovative therapies. The Patient W.A.I.T indicator survey conducted by EFPIA underlines significant variance in access to new oncology medicines across Europe. The time period from a market authorisation being granted to patients getting access to that medicine can vary from 2.5 months to over 2.5 years[9].

Through the “Time to Patient Access” project, the EFPIA Oncology Platform has brought together diverse stakeholders to jointly identify factors which cause delays, and co-create practical solutions that could accelerate time to patient access.

For patients, every day counts.

A joint effort

While we believe a proper legislative environment is needed in Europe to continue our work in research to discover new medicines, we also believe that faster, more equitable access across Europe is an achievable goal.

EFPIA’s members have committed to file for pricing and reimbursement in all EU countries as soon as possible and no later than two years from the central EU market authorisation, provided that local systems allow it. Companies’ progress against this commitment will be tracked in a portal so to increase transparency around launches in member states and to gain a deeper understanding of the kinds of solutions stakeholders will need to overcome key access hurdles.

We are opening discussions on a more equitable system where the price of innovative medicines can vary depending on countries economic level and ability to pay.

We are also proposing a greater push towards novel pricing and payment models that will make it easier for Member States to introduce highly innovative medicines, such as cell and gene therapies.

World Lung Cancer Day (1 August) is an opportunity to re-affirm our commitment to researching and developing new treatments to address the unmet need in lung cancer. It is a reminder of the scale of the challenge we face in improving lung cancer outcomes, and of the potential progress we can make if we work together.

With the EFPIA Oncology Platform, we have a platform that engages in dialogue and partnership with patient advocacy groups, healthcare professionals, academics, payers and policymakers to reduce the number of people dying from lung cancer. Together, we can raise standards for patients across Europe.   

This is a joint blog by:
Santiago Aguirre, Market Lead Oncology Europe, Sanofi

Haseeb Ahmad, President Europe, Novartis
Johanna Bendell, Global Head Oncology, Pharma Research and Early Development, Roche
Francesco Di Marco, Therapeutic Area Head Oncology, Boehringer Ingelheim
Klaus Feldmann, Vice President Oncology Commercial, Europe & Canada, MSD
Michael Glover, Vice President, Head of Market Access, Oncology, GSK
Yariv Hefez, Senior Vice President, Head Global Business Franchise Oncology, Merck Healthcare
Gilles Marrache, Senior Vice President and General Manager Europe, Latin-America, Middle-East Africa, Canada, Amgen
Bryan Qvick, Head of Global Medical Affairs Oncology, Ipsen
Christine Roth, Member of the Executive Committee of Bayer AG’s Pharmaceuticals Division and Head of the Oncology Strategic Business Unit

[3] Clarivate Analytics Cortellis
[6] Carrato, A., Vergnenègre, A., Thomas, M., McBride, K., Medina, J., & Cruciani, G. (2014). Clinical management patterns and treatment outcomes i npatients with non-small cell lung cancer (NSCLC) across Europe: EPICLIN-Lung study. Current Medical Research and Opinion, 30(3), 447-461. doi:10.1185/03007995.2013.860372
[8] CIRS, RD Briefing 70, New approvals in six regulatory authorities 2009-18,