In Italy, every year 4,800 new cases of ovarian cancer are diagnosed at an advanced stage, a neoplasm for which making an early diagnosis is very difficult given the non-specificity of the symptoms.
Thanks to innovative treatments and new molecular tests, however, survival improves significantly.
In particular, according to the Ovarian Cancer Commitment (a coalition that brings together clinicians, institutions and patient associations) it is necessary to encourage the execution of the HRD test, which allows the selection of effective therapies.
However, only a few laboratories carry out these complex analyses, which are not yet foreseen throughout the national territory pending the entry into force of the new LEAs.
To highlight the importance of the new test and the need for greater knowledge of this neoplasm, the experts gathered today for a meeting on this topic, also an opportunity to present the new information campaign 'Do you have two minutes?'.
Ovarian cancer "is characterized by significant genetic deficits that alter the mechanisms for repairing DNA damage - explains Sandro Pignata, director of Medical Oncology, Department of Uro-Gynaecology of the Pascale National Cancer Institute of Naples -. However, there is a test, the HRD test, which is able to measure the genomic instability of ovarian cancer, one of the main biological characteristics of this tumor. Performing the HRD test thus allows treatment to be adapted to each individual patient. It represents an evolution of the test for identify the mutation of the Brca genes in this type of tumor and is relevant in the choice of therapy with Parp inhibitors, the new class of drugs capable of combating tumors that present a defect in these molecular processes".
The execution of the HRD test, he continues, "requires technological platforms and software currently present only in a few highly specialized centers. Furthermore, at the moment, the pricing and reimbursement process for the test is not always clear and homogeneous for all Regions. It is It is desirable to centralize the governance of the laboratories that carry out these very complex analyses, based on Ngs (Next Generation Sequencing) technology".
Only in this way, concludes the expert, "is it possible to guarantee the highest quality of exam provision and the containment of execution costs".
In Italy up to 80% of ovarian cancer cases are diagnosed late
In fact, over 4,800 new diagnoses per year are identified with the disease already in an advanced stage.
It is therefore necessary to increase awareness among women, through appropriate information campaigns, on a pathology that is still little talked about.
It is also important to promote and speed up, for all patients, access to tests for predictive biomarkers and to innovative treatments against the gynecological neoplasm which has the highest mortality rate.
This is the double appeal launched today during a round table of the Ovarian Cancer Commitment (OCC).
This is a European initiative promoted by AstraZeneca together with the European Society of Gynecological Oncology (ESGO) and the European Network of Gynecological Cancer Advocacy Groups (ENGAGe).
"The pathology causes more than 3,200 deaths every year - underlines Nicoletta Colombo, Director of Medical Oncology Gynecology at the IEO and Associate Professor of Obstetrics and Gynecology at the University of Milan-Bicocca -. This is due to a non-specific and late symptomatology, and by the total lack of screening programs. Despite the difficulties in obtaining early diagnoses, there has been no lack of important therapeutic innovations in recent years. In particular, precision oncology is bringing great benefits in terms of survival."
"All patients have the right to be assisted in oncology centers specialized in treating a very complex disease - adds Anna Fagotti, Professor of Obstetrics and Gynecology at the Catholic University of the Sacred Heart, Director of the Operational Unit of the Gemelli University Polyclinic Foundation and President of ESGO - In a short time it is necessary to adopt the selection criteria and standards of the reference centers within the regional oncology networks. Homogeneous guidelines are needed throughout the national territory that respect some essential criteria and standards, 10 in total, which have been recently established by the European Society of Gynecological Oncology and require, among others, the presence of a specialized surgeon, a threshold volume of at least 30-20 operations per year, and the presence of multidisciplinary teams".
Today, highlights Nicoletta Cerana, President of Acto Italia - Alliance against Ovarian Cancer, "87% of patients access the Brca test", to detect the mutation of the Brca genes, which predispose to ovarian and breast cancer and knowledge of which is also important for the purposes of prevention in the family unit. However, he warns, "no more than 40% of patients are able to access the HRD test. Therefore it is essential to include these predictive molecular tests in the essential levels of care".
Much remains to be done also on the specialized centers front: there are currently 5 specialized centers for ovarian cancer in the country, which follow the Esgo criteria, but it is estimated that only 27% of patients are referred there.
Precisely to increase awareness of this neoplasm (difficult to diagnose due to the non-specificity of the symptoms, from the appearance of cysts to abdominal swelling) the new communication campaign 'Do you have two minutes?' is launched: a specialized information site and an app with a virtual assistant, Olivia, who will provide general information and information on the centers in Italy.
Meetings and podcasts will also be promoted.
Oncologists, an ad hoc fund is needed for molecular tests for ovarian cancer
"In the new tariff relating to the updated essential levels of care, items are foreseen to also authorize molecular tests for various neoplasms, including ovarian cancer. Unfortunately, the entry into force of the tariff has been postponed and this leaves us in a condition of great unfairness and this is unacceptable: in fact, many hospitals and Reguinis for example in the return plan cannot guarantee these tests to patients, while other Regions and hospitals also make them available with their own procedures", underlines Sandro Pignata.
For this reason, he concludes, "we believe that the establishment of a specific fund is necessary to guarantee molecular tests for all patients with ovarian cancer".
Reproduction reserved © Copyright ANSA