Everolimus is too expensive
A new target for targeted cancer therapy
Olga Agafonova, MednovostiA new indication has been registered in Russia for the use of a targeted antitumor drug, the active ingredient of which is everolimus.
It has been successfully used in oncology for a long time, and its registration for the treatment of breast cancer would not have caused such a resonance if it were not for the hope of prolonging life, which tens of thousands of women associate with it. The experience of the first six months of using the drug according to the new indication, it seems, did not disappoint either patients or doctors.
Despite the achievements of modern oncology, breast cancer is cured in no more than a third of sick women due to the high propensity of tumors to metastasis. The main method of treatment of patients with inoperable tumors due to the presence of metastases is hormone therapy. But sooner or later there is resistance to hormonal drugs, and sometimes the tumor initially turns out to be insensitive to them. And then the only way to continue the fight for life becomes chemotherapy. Chemotherapy, as a rule, is poorly tolerated, accompanied by excruciating nausea, vomiting, baldness, it causes significant harm to health. Everolimus makes it easier and more comfortable to overcome resistance to hormone therapy. It is available in the form of tablets, so treatment can be carried out without changing the usual lifestyle and rhythm of life, and the absence of serious side effects characteristic of chemotherapy allows not to worsen its quality.
The target of everolimus is the protein mTOR, involved in the regulation of division and metabolism of tumor cells, the growth of blood vessels. The development of resistance to hormone therapy is associated, among other things, with excessive activation of this protein. Therefore, the suppression of the activity of the mTOR protein by everolimus makes it possible to overcome the developed secondary or existing primary resistance and continue hormone therapy. The results of clinical studies have shown that the addition of hormone therapy with this drug reduces the risk of tumor progression by more than 50% and increases the time during which the tumor process is not activated by more than 2 times.
As for the practical experience of using everolimus in the treatment of breast cancer, according to Professor Rashida Orlova, head of the chemotherapy department of the St. Petersburg Clinical Oncology Dispensary and Specialized Oncology Center, a member of the European Association of Medical Oncologists (ESMO), the results obtained at the moment of using everolimus allow us to expect a certain breakthrough in this field of oncology.
The situation is somewhat clouded by the fear that targeted therapy will not be available due to the high cost of the drug. Because, although it is included in the list of vital and essential medicines, that is, its price is regulated by the state, a monthly intake of the drug will cost the patient 160 thousand rubles. Such an amount will be an unaffordable burden for the absolute majority of family budgets. But everolimus must be taken constantly, for a long time, in addition to hormone therapy. This means a significant increase in the cost of treatment. But will the drug reach the patients within the framework of state guarantees of free medical care? It is no secret that these guarantees in the field of drug provision are often not fully implemented due to insufficient funding. These concerns are partly shared by Corresponding member of the Russian Academy of Medical Sciences, Head of the Department of Oncology of the Russian Academy of Medical Sciences of the Russian Federation on the basis of the Blokhin Cancer Research Center of the Russian Academy of Medical Sciences Irina Poddubnaya. At the same time, she believes that inadequate provision of cancer patients with the necessary drugs is often a consequence of the passive position of the heads of regional health departments and medical institutions. As a positive example, Irina Poddubnaya cited the situation in St. Petersburg, where all patients are provided with this drug at the expense of the state.
Well, targeted therapy with everolimus has received a new target. Time will tell how successful her defeat will be.
Portal "Eternal youth" http://vechnayamolodost.ru12.12.2012