Rédaction Africa Links 24 with Angus Chen
Published on 2024-01-31 16:00:33
Fabrice André, a medical oncologist at Gustave Roussy in France and the president-elect of the European Society of Medical Oncology, believes that the conventional way of naming cancers based solely on the organs they originate in is outdated. Instead, he advocates for a new naming system that emphasizes the molecular characteristics of cancer, irrespective of its tissue of origin.
Advancements in science over the last few decades have revealed the role of genetic alterations in driving the growth and development of cancers, and how these alterations can be targeted with medications to shrink tumors. In many cases, these mutations are not limited to cancers of a specific organ, nor do all cancers from an organ share the same mutations. For example, two patients may both have breast cancer, but if one has triple-negative cancer and the other has HER2-positive cancer, their treatment plans would differ significantly. This variance in cancer treatment can lead to confusion for patients, as they question why their treatments differ despite having the same organ-based cancer diagnosis.
The genetics of the tumor underpin its real identity. André highlights that naming conventions for cancer can have tangible consequences for patients. He mentions the example of drugs that target the immune checkpoint PD-1 and how they can affect patients with certain tumor types. While Melanoma was the first cancer to be treated with drugs targeting the immune checkpoint PD-1, many other tumor types can also benefit from this therapy. However, patients with these cancers had to wait several years for trials to be completed on their tumor type, preventing them from accessing the relevant drugs. This delay in accessing timely treatment can adversely impact patients with specific cancer types expressing high levels of PD-L1, limiting their access to PD1 inhibitors.
In a Nature commentary article, André stresses the necessity of rethinking the popular cancer naming conventions to address the challenges patients face in accessing particular therapies. He highlights the need to consider the biological make-up of the cancer for proper treatment and proposes a transition from an anatomy-based to a biology-based cancer classification system.
André does not propose abandoning organ-based classification altogether, as it still holds relevance for certain treatments. However, the main idea is to represent cancer based on its biological traits, as many cancer therapies currently target specific proteins common across different cancer types. He emphasizes that patients may find it easier to understand and engage with their treatment plans if cancer is named based on its biology rather than its anatomy. This shift in classification systems could also potentially accelerate access to new medicines for patients.
André discusses that the current framework for cancer classification is not suitable for the types of treatments available, creating an environment where multiple trials are conducted sequentially, delaying access to therapies. Transitioning to a more biology-based classification system that targets molecular alterations could expedite drug development and provide quicker access to treatments for patients.
Furthermore, this shift in classification can be vital for patients with rare cancers. By including patients in clinical trials based on the presence of biomarkers and molecular characteristics, drugs that were previously unavailable for certain cancer types can be considered for approval. By focusing on the biological aspects of cancer, treatments can be developed faster and more effectively, ensuring timely access to life-saving medications for patients.
In conclusion, transitioning to a biology-based cancer classification system, as proposed by André, is a crucial step toward addressing the shortcomings of the current classification. It would facilitate timely access to effective treatments and benefit patients, particularly those with rare cancers. This approach aligns with the philosophy of putting the patient first and reflects the changing landscape of cancer care, driven by advancements in scientific knowledge and treatment modalities.
