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CANCER

Norway researchers in cancer breakthrough

Researchers at the University of Oslo have invented a new technique which potentially massively broadens the range of cancers which can be treated with cutting edge immunotherapy.

Norway researchers in cancer breakthrough
Johanna Olweus (center) and Shraddha Kumari (right), the last and first authors of the study, respectively - Oslo University Hospital
"We certainly think that this is a breakthrough," said Johanna Olweus, Director of the KG Jebsen Center for Cancer Immunotherapy at the University of Oslo. "I'm optimistic that this can be used on patients in not that many years."
 
In a research paper published in the Proceedings of the National Academy of Sciences on Wednesday, Olweus's team detail a new technique for identifying markers on various kinds of cancers to which the body's own immune system can be targeted by genetic modification of immune cells called T cells. 
 
Olweus's research comes in a year when researchers at two US cancer centres used genetically engineered T-cells to cure more than 40 patients suffering from leukaemia.
 
"The reason that this is extremely promising is that it's now been shown that immunotherapy works and that you can cure cancers that had previously been regarded as incurable," Olweus said. "The sensational thing about the immunotherapy is that the T-cells can find the cancer cells wherever they are in the body without killing the surrounding cells." 
 
However, the treatment pioneered at The University of Pennsylvania and at the Memorial Sloan-Kettering Cancer Center in New York worked because CD19, a surface protein expressed on the immune cells affected by acute lymphoblastic leukaemia, was an easily identifiable target, which the T-cells could be modified to attack. 
 
"One of the most important limitations for immunotherapy is that it's difficult to find good targets on the cancer cells," Olweus explained. "If you have a target which is also expressed in a a lot of normal cells, then you will get side effects." 
 
The new technique demonstrated in her study makes it easier to find good targets on difficult-to-treat cancers. 
 
Her researchers found 36 potential new targets for T cells in different kinds of cancers over the course of one study, opening the way for much wider use of immunotherapy techniques. 
 
The research was performed in Olweus's group in collaboration with two other groups in the newly started KG Jebsen Center for Cancer Immunotherapy at the University of Oslo. 
 
The article was published today here
 
 

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HEALTH

Why cancer patients in Spain are changing address to stay alive

Almost half of all oncologists in Spain are reporting huge disparities between different regions in terms of patient access to the latest life-saving cancer treatments, spurring many patients to pack up and move (at least on paper).

Why cancer patients in Spain are changing address to stay alive
Photos: AFP

Time is of the essence when it comes to cancer and stopping it in its tracks.

But in Spain, a country where bureaucratic holdups are part and parcel of daily life, the repercussions attached to slow public service delivery in the health sector can prove lethal for some.

Spain’s Society of Oncology (SEOM) has just released a study that highlights the huge disparity in waiting times for newly approved cancer medications between the country’s different autonomous communities.

The timeframe from which a groundbreaking treatment is green lighted by Spain’s Ministry of Health to the moment it reaches a cancer patient in hospital varies between 5 to 17 months on average.

The wait is influenced by factors such as where the hospital is located in Spain, whether or not the regional health department has decided to incorporate the new medication into its cancer treatment and even the individual hospital’s modus operandi.

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With a one and half-year wait obviously not an option for anyone with the disease, especially those which are particularly aggressive, patients are preferring to pack their bags and move to an address where the holdups are far less.

For this they need to be registered (empadronados) at a municipality that falls within the catchment area of the hospital that can get them the drugs faster.

Technically their names will have to be on a rental contract or title deeds in the desired location to be able to do so, although this can also be achieved in many regions if a person living at said address authorises that they be included in the ‘padrón’.

A total of 84 public hospitals from all of Spain’s 17 autonomous communities (as well as the autonomous city of Ceuta) took part in the study, with 11 new cancer medications and 5 cancer biomarkers (a substance or process that helps to diagnose cancer) used as the basis of the research.

A total of 43 percent of oncologists surveyed told SEOM they had patients who were having to wait excessively long to receive the most cutting-edge treatment and diagnosis methods theoretically available to them through the public system, with some practitioners citing three-year-long holdups for prescriptions that have already been approved by medical authorities.

In fact, the study initially encompassed 146 hospitals across Spain, but 42 percent of them failed to get back to SEOM with the relevant information.

The same confusion that envelops many bureaucratic processes in Spain has seeped into the country’s health system, the research reveals.

In this case, there’s no homogenous nationwide policy or body to call on or complain to. Sometimes it’s the hospital that decides, in other cases it’s the region’s health department, making it unclear for people who can’t afford the wait.

Perhaps for this reason SEOM hasn’t revealed where exactly cancer patients can get the latest treatment fast and easy, as it can vary enormously even within the same city or town.

Even though Spain’s public health system is highly regarded worldwide (9th best internationally in 2015, 19th in 2018 according to The Lancet), the evidence suggests these cancer treatment holdups are nothing new.

Cancer sufferers have been ‘fudging’ their address for years as the only solution available to them for the currently inefficient system, other than actually moving to another part of Spain to sidestep the bureaucratic wait.

Begoña Barragán, president of the Spanish Group of Cancer Patients (GEPAC) told online daily Público she had at one point had 17 patients registered at her home address in order for them to gain access to her local hospital, which offered far shorter waiting periods than on average in Spain.

Her organization encompasses 70 associations across the country which have helped other cancer patients do the same.

“I remember one local minister once warning me ‘I don’t want to find out that you’ve been doing this in our region’, to which I replied ‘don’t worry, you won’t find out,” Barragán told Público.

“None of this has anything to do with medical reasons, it’s all due to administrational and financial causes. Doctors themselves will always offer up the best treatment if it’s up to them.

“This is a post code lottery, a game of chance”.

With this strand of unequal health service delivery increasingly under scrutiny, Spain’s Ministry of Health has shifted responsibility to the country’s autonomous communities, saying it’s up to them to find a solution.

But cancer groups and Spain’s health patient ombudsman are calling instead for a system that is as systematic as paying taxes.

“The rights to health service access, to be cured, to save lives cannot be determined by the place where you live, says the president of Defensor del Paciente Carmen Flores.

“That’s serious discrimination.

“Therefore, Spain’s Ministry of Health must create some order among the autonomous communities, that’s why they’re given funds from the national budget after all”.
 

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