Evolving assessment pathways for precision oncology medicines to improve patient access: a tumor-agnostic lens.

life-cycle assessment personalized medicine precision oncology tumor-agnostic

Journal

The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837

Informations de publication

Date de publication:
17 Apr 2024
Historique:
received: 03 11 2023
accepted: 07 03 2024
medline: 17 4 2024
pubmed: 17 4 2024
entrez: 17 4 2024
Statut: aheadofprint

Résumé

Genomic and molecular alterations are increasingly important in cancer diagnosis, and scientific advances are opening new treatment avenues. Precision oncology (PO) uses a patient's genomic profile to determine optimal treatment, promising fewer side effects and higher success rates. Within PO, tumor-agnostic (TA) therapies target genomic alterations irrespective of tumor location. However, traditional value frameworks and approval pathways pose challenges which may limit patient access to PO therapies. This study describes challenges in assessing PO and TA medicines, explores possible solutions, and provides actionable recommendations to facilitate an iterative life-cycle assessment of these medicines. After reviewing the published literature, we obtained insights from key stakeholders and European experts across a range of disciplines, through individual interviews and an industry workshop. The research was guided and refined by an international expert committee through 2 sounding board meetings. The current challenges faced by PO and TA medicines are multiple and can be demonstrated through real-world examples of the current barriers and opportunities. A life-cycle approach to assessment should be taken, including key actions at the early stages of evidence generation, regulatory and reimbursement stage, as well as payment and adoption solutions that make use of the evolving evidence base. Working toward these solutions to maximize PO medicine value is a shared responsibility and stands to benefit all stakeholders. Our call to action is to expand access to comprehensive genomic testing, foster a learning health care system, enable fast and equitable access to cost-effective treatments, and ultimately improve health outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Genomic and molecular alterations are increasingly important in cancer diagnosis, and scientific advances are opening new treatment avenues. Precision oncology (PO) uses a patient's genomic profile to determine optimal treatment, promising fewer side effects and higher success rates. Within PO, tumor-agnostic (TA) therapies target genomic alterations irrespective of tumor location. However, traditional value frameworks and approval pathways pose challenges which may limit patient access to PO therapies.
OBJECTIVES OBJECTIVE
This study describes challenges in assessing PO and TA medicines, explores possible solutions, and provides actionable recommendations to facilitate an iterative life-cycle assessment of these medicines.
METHODS METHODS
After reviewing the published literature, we obtained insights from key stakeholders and European experts across a range of disciplines, through individual interviews and an industry workshop. The research was guided and refined by an international expert committee through 2 sounding board meetings.
RESULTS RESULTS
The current challenges faced by PO and TA medicines are multiple and can be demonstrated through real-world examples of the current barriers and opportunities. A life-cycle approach to assessment should be taken, including key actions at the early stages of evidence generation, regulatory and reimbursement stage, as well as payment and adoption solutions that make use of the evolving evidence base. Working toward these solutions to maximize PO medicine value is a shared responsibility and stands to benefit all stakeholders.
CONCLUSIONS CONCLUSIONS
Our call to action is to expand access to comprehensive genomic testing, foster a learning health care system, enable fast and equitable access to cost-effective treatments, and ultimately improve health outcomes.

Identifiants

pubmed: 38630538
pii: 7648248
doi: 10.1093/oncolo/oyae060
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press.

Auteurs

Priscila Radu (P)

Office of Health Economics, London, United Kingdom.

Gayathri Kumar (G)

Office of Health Economics, London, United Kingdom.

Amanda Cole (A)

Office of Health Economics, London, United Kingdom.

Aikaterini Fameli (A)

Global Oncology Policy, GSK, London, United Kingdom.

Mark Guthrie (M)

Global Access Strategy Oncology, Roche, San Francisco, CA, United States.

Lieven Annemans (L)

Department of Health Economics, Ghent University, Ghent, Belgium.

Jan Geissler (J)

Patvocates, Munich, Germany.

Antoine Italiano (A)

Early Phase Trials and Sarcoma Units, Institut Bergonié, Bordeaux, France.

Brian O'Rourke (B)

ISPOR, Ottawa, Canada.

Entela Xoxi (E)

Faculty of Economics, ALTEMS Università Cattolica del Sacro Cuore, Rome, Italy.

Lotte Steuten (L)

Office of Health Economics, London, United Kingdom.

Classifications MeSH