Of all the women who get breast cancer every year - about 54 thousand in Italy - only 20% of those with hormone-sensitive cancer actually benefit from post-operative chemotherapy, while for the remaining 80% this would not be necessary. .
The problem is to identify these patients with precision: today it is possible thanks to genomic tests, which would therefore avoid unnecessary chemo while also guaranteeing significant savings to Healthcare.
The 2021 Budget Law has provided for a 20 million euro fund to guarantee them free of charge throughout Italy, but there are still no implementing decrees.
To take stock of these molecular tests are the oncologists, who define them as a "revolution" in the treatment of breast cancer, asking that they be immediately free throughout the national territory.
To date, the tests are reimbursable only in Lombardy, Tuscany and the Autonomous Province of Bolzano and this, says Francesco Cognetti, the president of the Together Against Cancer Foundation, "represents an unacceptable discrimination. The fund of 20 million is a very important result but it is necessary now an implementing decree by the Ministry of Health to unlock this money. Immediately guaranteeing access to genomic tests throughout the territory is a battle of civilization ".
A request shared by patient associations such as Europa donna, which will launch a national campaign on social networks in order to urge the enactment of the implementing decree.
Maximum commitment to speed up the times, so that the decree can see the light within the year, was assured by the Deputy Minister of Health Pierpaolo Sileri who, speaking at the virtual press conference, underlined how the final goal is to ensure that the tests genomics are included in the essential levels of assistance.
In Italy there are about 10 thousand a year, explained Cognetti, women with breast cancer who could be candidates for the genomic test.
The test is in fact indicated for women with hormone-responsive breast cancer at intermediate risk.
This is about 20% of the total new annual cases of breast cancer in our country.
These tests, he notes, "can avoid unnecessary chemotherapies, but in the majority of regions the test must be carried out privately and has a cost of about 3 thousand euros. Where reimbursement is foreseen, however, the regions have closed agreements with the 4 manufacturing companies. a cost of 2 thousand euros ".
In the world, Cognetti points out, "14 clinical studies have demonstrated the validity of the tests on a total of about 800 thousand women treated following the results of the examination; of these, 40% were able to avoid chemo".
The experiments show that "the majority of patients with early stage breast cancer - explains the oncologist - can avoid chemo. In particular, a 21-gene genomic test is able to identify the proportion of women (equal to 20%) that can really benefit from chemo and that would not have been selected with traditional systems and the majority percentage (80%) that, overall, does not get benefit. We can therefore estimate about four chemotherapy treatments avoided in every five genomic tests performed ".
These tests, according to the elected president of the Italian Association of Medical Oncology Aiom Saverio Cinieri, "are used almost routinely in France, Germany, GB and the USA. We applaud the fund set up by the government but now we must guarantee the tests to all women. for which there is doubt about the usefulness of chemotherapy, which is often carried out for a prudential approach ".
Not to mention, he concludes, "the savings for the National Health Service, equal to 7 thousand euros per patient for unnecessary chemotherapy not performed".