Research: breast cancer treatment can be easier for patients and much cheaper

• Sander Zurhake

  healthcare editor

Dutch oncologists from Amsterdam and Rotterdam have proven that patients with metastatic breast cancer can be treated just as well by prescribing new medications with fewer side effects for a shorter period of time.

This is good for patients as they have far fewer side effects and hospital visits. But society also benefits. Due to the reduced use of expensive medicines, this method of treatment saves around 45 million euros per year.

This is evident today from the publication of the research results in the scientific community Nature magazine.

In women with hormone-sensitive metastatic breast cancer, combined treatment with hormone therapy and a so-called CDK4/6 inhibitor is prescribed at the same time. The aim of this treatment is to stop cancer cells from multiplying.

This has extended the lives of many patients. At the same time, they were limited in daily life by the side effects of CDK4 / 6 inhibitors. The study, in which 1,050 patients participated, now shows that these inhibitors do not have to be are used immediately. Hormone therapy alone can control the cancer at first as well as the treatment method that uses CDK4/6 inhibitors from the beginning.

In fact, if the inhibitors are only started after the hormone therapy has lost its effectiveness, this will make no difference in terms of life extension. But the side effects are much less. Patients have almost no complaints during treatment and have the option to choose to continue working, for example.

The patients in the study who belonged to the group where CDK4/6 inhibitors were prescribed from the beginning experienced up to 74 percent more side effects such as fatigue and reduced blood production. They also had to go to hospital more often compared to patients who started taking the inhibitors later.

In the Netherlands, the treatment guidelines have therefore already been changed and CDK4/6 inhibitors are no longer used from the start of treatment.

This research, which was established by oncologists from Erasmus MC, Amsterdam UMC and Antoni van Leeuwenhoek Hospital, is also seen with international interest. Not only does the quality of life increase, costs also decrease because less medication is used.

The researchers estimate that this saves 45 million euros per year in the Netherlands. In a large country like the United States, this even includes savings of up to 5 billion euros.

At times when the demand for care and costs increase significantly, such effectiveness studies become necessary, according to research leader Gabe Sonke, who is also a medical oncologist at Antoni van Leeuwenhoek and a professor at the University Amsterdam.

But pharmaceutical companies, which are crucial to funding scientific research, are standing their ground not all jumps for these studies. “Of course, they also want their medicines to be inserted into the patient as precisely as possible. But there is also a financial interest. And with a more efficient use of medicines, less is sold and earned.”

As a result of the Integrated Care Agreement, there is money for effectiveness studies for the next four years and health insurers will be funded on an ad hoc basis through the Treatmeds foundation.

But according to Sonke, this is not enough given the huge costs to society. It advocates structurally investing a small percentage of the money saved through more targeted use of medicines into a research fund.

“We are already saving 45 million euros per year on this one treatment and making the treatments easier for patients.