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What is an innovative anticancer therapy, as it is available to Russian patients, and should we be afraid of generics, said “Mednovosti” Deputy Director for science of fsbi “Russian oncological scientific center named. N. N. Blokhin”, head of Department of chemotherapy and combined treatment of malignant tumors, academician, Mikhail Mrlichinitser.
Michael Mrlichinitser. Photo: press service of the Russian cancer research center
Mikhail Romanovich, a lot of talk about “breakthroughs” in the therapeutic treatment of cancer. What are you talking about?
Is no doubt about it. Today there are encouraging achievements in practical Oncology. Effective new drugs provide an excellent chance for life, and many forms of cancer, which ten years ago was deadly, now cured. Significant successes have been achieved in the treatment of melanoma, breast cancer (BC), ovarian, prostate, lung and kidneys. And the list goes on. Oncology has always been the locomotive of development of medicine. We have a world-class talent. Including chemiotherapeutic who are engaged in drug therapy.
Modern science is moving away from traditional chemotherapy to evidence-based. Created the so-called targeted therapies that suit individual groups of patients. The characteristics of tumors that determine rational treatment and achieve outstanding results. Thanks to modern therapy, patients who 10 years ago had a poor prognosis, today, live long and often cured.
For example, patients with breast cancer with the genetic characteristics of HER2 overexpression had a poor prognosis. This form of the disease occurs in approximately 25% of all cases of breast cancer quickly progresses and metastasizes. 15-20 years ago such patients were dead within six months, but, fortunately, the situation has changed. The first drug for the treatment of this disease appeared in the 90-ies of the last century, marking the beginning of personalized medicine, which provided early detection of the disease, breast cancer began to cure in 95% of cases. And survival of women with the most aggressive forms became even higher than with a less aggressive. Breast cancer today is not only transferred from the category of deadly diseases in chronic, but in a significant number of cases can be cured permanently. People need to know this, do not be afraid of this disease and to live with hope.
The next breakthrough in the treatment of breast cancer — the emergence of new targeted therapies for metastatic cancers with a mutation of the HER2+. In Russia was already two such drug. These medications open up the Russian doctors new ways to treat patients with the most aggressive forms of breast cancer. And the state must provide such treatment possible for all patients. To make available modern medical achievements for all citizens, because it happens all over the world.
And how accessible modern treatment in Russia?
Our patients are provided with modern medicines, but, unfortunately, not all of them. And, of course, is the problem. No state in the world is able to provide the expensive treatment of cancer patients themselves. This involved insurance companies, charities and large corporations. Throughout the world there is a real medical insurance, and the best examples should be reproduced in Russia. We need to unite all the efforts — people need to effective drugs that they pin hope for a cure.
On the other hand, the huge progress that is observed today in Oncology involves and methods of rational therapy. So, patients for whom expensive targeted therapy effective, not so much. The one she shows these drugs can save lives, but they should be used wisely. Assign them all in a row, overloading patients with useless treatment, is impossible. And if earlier for lung cancer, I would prescribe the same medicine to all 100 patients, today I will conduct a genetic analysis, which will show that it only need five. And geting another feature of targeted therapy.
What are some other ways to solve the problem of expensive medicines?
— The basic is the use of generic anticancer drugs. They are widely used in our center and in other leading clinics of Russia, and serious claims to such drugs no. We must not be afraid, generics are used worldwide. In America 40% of all drugs are generics, in Europe, with special emphasis on their own production to 60%. In Russia 77% of anticancer drugs are reproduced.
Another thing is the quality of these drugs, that’s where we have the weakest link. Generic should be evaluated according to the criteria, allowing to determine its compliance with the original drug. Laws should be effective and not convenient for pharmaceutical companies. I say all the time about the leadership of the Ministry of health. In countries with a high level of development of medicine have established a very strict control of non-original drugs, there are strict standards for biosimilars and generics. In Russia control over the quality of generics should not differ from the European, and then patients will not doubt to use them or not.
But there are medications that have closed the patents, and do not yet have generics at all. Here they need to purchase. Modern medicines that save the lives of patients, should be available under strict indications for their use, and must be paid by the state.
But something is happening in the country the framework of import substitution? The fsbu”. N. N. Blokhin” takes part in the development of products of Russian companies?
— About import substitution speech does not go yet. As for drugs, in Russia, this is a problem inherited from the Soviet era when the pharmaceutical industry in the country is not developed. But our scientists, doctors, not only doctors, but also representatives of the fundamental science involved in the development of fundamentally new drugs. This affiliate participation in national and international projects, international cooperation, exchange of experience is very important to understand the situation, to understand the modern possibilities of medicine to which we all should strive for.