[Reporter's view] Homework left by ASCO 2023’ hot topic

There is one thing in common with the major studies that drew attention at this year's Annual Conference of the American Society of Clinical Oncology (ASCO 2023).

 

It has achieved successful results in adjuvant therapy targeting early cancer where surgery is possible.

 

New drugs used in terminal cancers, such as metastasis and recursation, have already surpassed the standard treatment in early cancers.

 

The CDK 4/6 inhibitor Kisqali has demonstrated post-operative adjuvant treatment in early breast cancer.

 

The risk of recurrence or death was reduced by 25% with a three-year dose of Kisqali after surgery.

 

The blockbuster immuno-oncology drug Keytruda completes the treatment journey not only after non-small cell lung cancer surgery but also before surgery-surgery-after surgery.

 

Patients capable of surgery from the second to third period used Keytruda before and after surgery, reducing the risk of recurrence or death by 42%.

 

It has been proven that using new drugs in early patients also improves the overall survival rate of actual patients.

 

One of the studies selected for this year's ASCO keynote lecture was the non-small cell lung cancer EGFR targeted anticancer agent Taglisso.

 

Looking at the overall survival (OS) of patients when using Tagriso as a post-operative adjuvant therapy, the five-year overall survival rate of the Tagrisso group was 88%, a 51% lower risk of death compared to 78% in the placebo group.

 

Kisqali, Keytruda, and Tagrisso are all drugs used in terminally ill cancer patients.

 

With the recent publication of adjuvant therapy studies of these drugs, they have built confidence that they can be effective enough on early cancer.

 

In addition to these, several anticancer drugs such as the CDK 4/6 inhibitor 'Burgenio', the immuno-oncology drug 'Obdevo', 'Imping', and 'T-Sentrick' have been named for pre- and post-operative adjuvant therapy.

 

In a situation where it is increasingly difficult to create new drugs, this is the result of the efforts of pharmaceutical companies to expand the use of new drugs to the early days of cancer.

 

Early use of new drugs is also welcome for medical staff and patients.

 

Even if they are diagnosed with cancer relatively quickly and have surgery, patients are always at risk of relapse.

 

For example, lung cancer is caused by about 20% of patients in the first period after surgery, and the recurrence rate increases by 75% for patients in the third period.

 

Early cancer is targeted for cure, but many patients follow the steps that progress to terminal cancer.

 

As the latest drugs advance to early cancer, more active treatment is expected for these patients.

 

An oncology professor I met at ASCO rejoiced, saying, "It's significant that the targeted and Immune anticancer agents that have been used for Care have ushered in the era of Cure." There is also a point for our society to think about at a time when more and more chemotherapy adjuvant studies are expected to be conducted in the future.

 

In the meantime, adjuvant therapy has been dismissed as a relatively less important treatment compared to the treatment of terminal cancer, which has often been pushed back from the salary priority.

 

There was no place for adjuvant therapy in front of the question of whether it was a life-threatening situation right now.

 

But ultimately, if the path of our society is to reduce the number of severe patients and lower the mortality rate through early diagnosis and treatment, it is now necessary to properly value adjuvant therapy.

 

Pharmacists should make an effort to find ways to screen patient groups that can maximize the effectiveness of new drugs.

 

Because it's not all-purpose because it's a new drug.

 

Some of the adjuvant therapy studies showed data showing that it was dramatically effective in some groups of patients, while some groups had a tilted head.

 

In the end, it is the challenge of the pharmaceutical industry to find a clear group of patients who can maximize their effectiveness and persuade regulators.

 

This will be a necessary process in the reality that all new drugs are becoming more expensive and health insurance finances are limited.