Innovative cancer diagnostics must be seen as investment, says patient group chief

EU countries need to see biomarker testing – an innovative form of cancer diagnostics – as an investment and address the current lack of knowledge about its benefits, the head of Cancer Patients Europe told Euractiv. 

Cancer is the second leading cause of mortality in EU countries after cardiovascular diseases. Every year, 2.6 million people are diagnosed with the disease, which kills another 1.2 million people.

To reduce the burden, prevention is crucial, followed by early and accurate diagnosis, according to Antonella Cardone, the chief of the pan-European all-cancer types patient association.

“For cancer, intervening early means saving a life, increasing the survivorship rate. So it’s important to intervene as soon as possible,” she said.

“But also it is important to detect right cancer, the right mutation,” Cardone added. “This is why innovative diagnostic for us is crucial.”

By innovative diagnostic, she means going beyond cancer screening by introducing biomarker testing, also known as genomic diagnostic.

“Biomarker testing is very, very important to identify the right kind of cancer,” she explained.

Biomarkers can be molecular, anatomical, physiological, or biochemical features of genes, proteins or other substances which, when measured, can indicate normal or pathological biological processes. According to a study published in Cancer Cell International journal, “biomarkers are the basis for accurate diagnosis”.

Cancer Patients Europe’s white paper on genomic testing says that “when applied to tumour tissue from cancer patients, genomic tests can assess how likely the cancer is to return (prognostic) and some tests can predict whether a tumour is likely to respond to
treatment (predictive)”.

Therefore biomarkers not only help with diagnosis but also with personalised treatment.

“Each mutation requires a different treatment,” Cardone said. Therefore, according to her, it is essential to do biomarker testing at an early stage “rather than having several attempts of different treatments and then maybe identifying the right, biomarker”.

Lack of awareness 

While the benefits of biomarker testing can in turn increase cancer survivorship, a survey conducted by Cancer Patients Europe in 2022 found a lack of knowledge on this type of diagnostics.

“The data demonstrated an acute lack of awareness and understanding of genomic testing amongst both the general population and cancer patients as well as a lack of communication on the topic by healthcare professionals,” was the key survey finding, which was done in five European countries: France, Germany, Italy, Spain and the UK.

Over 60% of respondents – representing voices from the general population, cancer patients, breast cancer patients and breast cancer patients eligible for genomic testing – never heard of genomic testing.

Consequently, four out of five breast cancer patients eligible for genomic testing were not told it was available to them. Breast cancer is the most common cancer among adults, with more than 2.3 million cases worldwide each year.

“Four out of five breast cancer patients eligible for genomic testing, in countries where genomic testing is available and reimbursed, such as the UK, Spain, France, Italy and Germany, were not told by their oncologist that genomic testing was an option to them,” said Cardone.

“This is unbearable.”

Genomic testing can show if chemotherapy is needed, in turn making it possible to avoid chemotherapy and the associated side effects. “They [breast cancer patients] could have avoided the toxicity and all the problems related to quality of life that go with them,” she added.

In addition, the survey showed that over 80% of respondents did not have enough information to make a decision and 75% of breast cancer patients who could have taken a
test did not do so.

Countries need to see the biomarkers as an investment 

Cardone said there is “a lot that needs to be done in raising awareness among patients so that they can also ask the question to their oncologist, but also to understand what the reason is for the oncologist, not to recommend genomic testing for a breast cancer patient eligible for that”.

“We now see that there are new methods of biomarker testing, not only tissue biopsy but also liquid biopsy – a simple blood test. When something is new, it may take a while before it is part of clinical practice.”

This survey covered only five countries but according to Cardone, the situation in eastern countries is even worse.

“Unfortunately, in the Eastern European countries, biomarker testing is less used, less common, and less known about while in Western Europe they are reimbursed and available,” she said.

She said the responsibility falls on the guidelines that exist in the countries, competencies among the healthcare providers and the labs, the lack of resources and prioritisation by the healthcare system on biomarker tests.

“The thing is that, yes, biomarker tests have a cost, but they need to be considered,” Cardone said.

“This cost is not a cost per se, but it is an investment because when you spend in advance this money, you can provide a more targeted treatment. That could help us save a life and then reduce the costs in other sectors.”

The fight against cancer has been a top priority for Commission President Ursula von der Leyen in her five-year mandate, with an EU Beating Cancer Plan aiming to address the entire cancer pathway presented in February 2021.

This includes initiatives on early detection and improving patient outcomes and reducing disparities across the European Union when it comes to cancer diagnosis and treatment.

Europe’s Beating Cancer Plan comes with €4 billion of funding, including €1.25 billion from the future EU4Health programme.

According to Cardone, the European Commission is doing its part in identifying the priorities and putting forward the recommendations together with allocated funding and it is on countries to act as health is member state competence.

“Countries have to play a key role there. They have to allocate resources and optimise resources because it is not only about spending money, but it is using money with the concept of investing,” she said.

In early 2024 a report is to be published on the implementation of Europe’s beating cancer plan in the member states.

[Edited by Zoran Radosavljevic]