Dataciencia

Colección SciELO Chile

Implementing precision oncology in Latin America to improve patient outcomes: the status quo and a call to action for key stakeholders and decision-makers

Indexado

WoS	WOS:001145363200001
Scopus	SCOPUS_ID:85183972205

DOI

10.3332/ECANCER.2024.1653

Año

2024

Tipo

artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras

Abstract

Background: The advent of precision oncology (PO) has revolutionised diagnostic follow up strategies and improved clinical outcomes for cancer patients. However, socioeconomic inequalities in the level of implementation of PO in different countries is a vailing issue. To improve this situation, the Latin America Patients Academy has gathered the recommendations of healthcare professionals and social civil members experienced in cancer management from Mexico, Guatemala, Costa Rica, Dominican Republic, ama, Colombia, Chile, Ecuador, Peru and Argentina regarding the areas that need to prioritised to improve the access to PO in Latin American (LATAM) countries. Methods: This manuscript is the culmination of a series of educational campaigns panel discussion aimed at improving the implementations of PO in LATAM that place from June 2021 to January 2022. The status of PO in Latin America: the level of PO implementation is generally low some exceptions. The number of clinical trials and articles published with keywords related to PO from LATAM countries is drastically lower than in Europe and the United States. Despite sharing many complex challenges, progress is taking place in some countries in the region. Focus areas defined by the expert panel: The expert panel determined the areas of that should be improved by LATAM countries to improve its implementation through cancer care plans, educational programs and collaborative strategies. These initiatives should increase awareness about PO in the region and eventually improve cancer control in the region.

Revista

Revista	ISSN
Ecancermedicalscience	1754-6605

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Disciplinas de Investigación

WOS
Oncology

Scopus
Oncology
Cancer Research

SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional

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Autores - Afiliación

Ord.	Autor	Género	Institución - País
1	Castilla, Eva Maria Ruiz de	-	Latin Amer Patients Acad - Estados Unidos
1	De Castilla, Eva Maria Ruiz	Mujer	Latin America Patients Academy - Estados Unidos
2	Mayrides, Maurice	-	Latin Amer Patients Acad - Estados Unidos Latin America Patients Academy - Estados Unidos
3	Gonzalez, Haydee	-	Linfomas Argentinas - Argentina
4	Vidangossy, Francisco	-	Fdn Canc Vida - Chile Fundación Cancer Vida - Chile
5	Corbeaux, Tatiana	Mujer	Oncoloop - Chile
6	Ortiz, Nancy	Mujer	Foro Nacl Canc Chile - Chile Foro Nacional de Cancer Chile - Chile
7	Amaya, Claudia	-	Fdn SENOSama Bucaramanga - Colombia Fundacion SENOSama Bucaramanga - Colombia
8	Nunez, Alexandra	-	Asociac Unidos Canc - Costa Rica Asociación Unidos Contra el Cáncer - Costa Rica
9	Jimbo, Diego Fernando Jimbo	-	Familias Unidas Enfermedades Catastrof - Ecuador Familias Unidas por las Enfermedades Catastróficas - Ecuador
10	Ayensa, Adela	-	Salvati - México
11	Galindo, Mayra	-	Latin Amer Patients Acad - Estados Unidos Asociac Mexicana Lucha Canc - México Asociación Mexicana de Lucha contra el Cáncer - México Latin America Patients Academy - Estados Unidos
12	Ruiz, Karla	-	Latin Amer Patients Acad - Estados Unidos Latin America Patients Academy - Estados Unidos
13	Perez, Juan Manuel	-	Latin Amer Patients Acad - Estados Unidos Linfomas Argentinas - Argentina Fdn Amigo Como Tu - República Dominicana Fundación Un Amigo como Tu - República Dominicana Latin America Patients Academy - Estados Unidos

Muestra la afiliación y género (detectado) para los co-autores de la publicación.

Financiamiento

Fuente
AstraZeneca

Muestra la fuente de financiamiento declarada en la publicación.

Agradecimientos

Agradecimiento
Funding support for this initiative was provided by AstraZeneca.
Funding to facilitate access to PO treatments is another issue that LATAM countries face [10]. The cost and affordability of oncologic drugs compounds this problem because costs tend to be higher in LMICS than in high income countries (HICs), and there is often no relationship between drug prices in LMICs and their gross domestic products [12,13]. As reported recently by Moye-Holz and Vogler [14] in their study comparing the prices and affordability of oncology drugs (bevacizumab, cetuximab, dasatinib, everolimus, imatinib, mercaptopurine, nilotinib, panitimumab, pazopanib, rituximab, sorafenib, sunitinib, trastuzumab) in 16 countries in Europe (Austria, France, Germany, Greece, Hungary, the Netherlands, Poland, Romania, Spain, Sweden and the UK) and LATAM (Brazil, Chile, Colombia, Mexico and Peru): upper-HICs (UHICs) in Europe had lower adjusted prices for PO drugs than LATAM and LHICs in Europe. The cost of the drugs were also less variable in UHICs than in LHICs and LATAM. Accordingly, the affordability assessment the authors performed showed that PO drugs were more affordable in HICs than in LATAM and other middle income European countries. Some of the reasons they propose for the higher and variable PO prices in LATAM include lack of pricing and reimbursement regulations and the lack of bargaining power of these countries [14]. As minuciously described in the supplementary tables of their manuscript, mercaptopurine 50 mg, trastuzumab 150 mg, imatinib 100 mg, and imatinib 400 mg were the most affordable drugs in all countries. The drugs bevacizumab 100 mg, bevacizumab 400 mg, cetuximab 100 mg, dasatinib 50 mg, everolimus 5 mg, panitumumab 100 mg, sunitinib 12.5 mg, and trastuzumab 440 mg were the least affordable [14]. In terms of costs per country, for most drugs, Sweden and the UK had the lowest prices, and drug cost in Poland and Romania were some of the highest. Peru and Brazil had the highest prices for some drugs [14]. Another notable reason for increased PO drug costs in LATAM’s countries are frequent economic crises with out-of-control inflation as highlighted recently in The Lancet Oncology [15]. Research funding is another problem: as a review by members of the Latin American (LATAM) Cooperative Oncology Group and other LATAM institutions explained, governmental grants in LATAM are insufficient to maintain competitive research initiatives. Investigator-initiated research is funded mostly by pharmaceutical companies,

Agradecimiento

Funding support for this initiative was provided by AstraZeneca.

Funding to facilitate access to PO treatments is another issue that LATAM countries face [10]. The cost and affordability of oncologic drugs compounds this problem because costs tend to be higher in LMICS than in high income countries (HICs), and there is often no relationship between drug prices in LMICs and their gross domestic products [12,13]. As reported recently by Moye-Holz and Vogler [14] in their study comparing the prices and affordability of oncology drugs (bevacizumab, cetuximab, dasatinib, everolimus, imatinib, mercaptopurine, nilotinib, panitimumab, pazopanib, rituximab, sorafenib, sunitinib, trastuzumab) in 16 countries in Europe (Austria, France, Germany, Greece, Hungary, the Netherlands, Poland, Romania, Spain, Sweden and the UK) and LATAM (Brazil, Chile, Colombia, Mexico and Peru): upper-HICs (UHICs) in Europe had lower adjusted prices for PO drugs than LATAM and LHICs in Europe. The cost of the drugs were also less variable in UHICs than in LHICs and LATAM. Accordingly, the affordability assessment the authors performed showed that PO drugs were more affordable in HICs than in LATAM and other middle income European countries. Some of the reasons they propose for the higher and variable PO prices in LATAM include lack of pricing and reimbursement regulations and the lack of bargaining power of these countries [14]. As minuciously described in the supplementary tables of their manuscript, mercaptopurine 50 mg, trastuzumab 150 mg, imatinib 100 mg, and imatinib 400 mg were the most affordable drugs in all countries. The drugs bevacizumab 100 mg, bevacizumab 400 mg, cetuximab 100 mg, dasatinib 50 mg, everolimus 5 mg, panitumumab 100 mg, sunitinib 12.5 mg, and trastuzumab 440 mg were the least affordable [14]. In terms of costs per country, for most drugs, Sweden and the UK had the lowest prices, and drug cost in Poland and Romania were some of the highest. Peru and Brazil had the highest prices for some drugs [14]. Another notable reason for increased PO drug costs in LATAM’s countries are frequent economic crises with out-of-control inflation as highlighted recently in The Lancet Oncology [15]. Research funding is another problem: as a review by members of the Latin American (LATAM) Cooperative Oncology Group and other LATAM institutions explained, governmental grants in LATAM are insufficient to maintain competitive research initiatives. Investigator-initiated research is funded mostly by pharmaceutical companies,