NCRI cancer conference day 4: the cost of cancer care and the immune system (again)

On the final day of the conference the media picked up on two studies. The first found that across a poll of almost 1,500 people many were unaware of the full purpose of the national cancer screening programmes.

The second covered clinical trial results on radiotherapy dosing for men with prostate cancer.

And so to our final round-up of talk highlights.

The cost of care

In one of the stand out sessions from the conference, former BBC economics editor, Robert Peston, chaired a fascinating discussion about the cost of cancer care.

The panel touched on everything from the challenges of prioritizing treatment funding to the ‘dark arts’ of drug pricing and how doctors discuss data with patients.

Professor Richard Sullivan, from King’s College London, kicked off by talking about what he called an ‘unsustainable economic approach’ to funding cancer treatment.

He highlighted how there are big differences between how much different European countries spend on treatments for different types of cancer.

Some countries, like Greece, are putting massive amounts of money into treatment. But according to Sullivan, the amount of money spent on treatment doesn’t always tally with more patients surviving.

Professor Maarten IJzerman, from University of Twente, talked about where people place value in terms of treatments and how this differs from where the money is spent.

He showed some interesting survey results revealing that the public place value on drugs based on how severe the disease is, how innovative the treatment is and also whether treatment options have previously been lacking.

Dr Tito Fojo, from Columbia University Medical Centre, closed the session with an excellent talk reinforcing how doctors should carefully discuss clinical trial results with their patients.

In terms of drug approval and pricing, he said that there needs to be some careful consideration on what is deemed effective. He reinforced this point by saying that clinical trial results are often the ‘best case scenario’ for a drug, and not every patient should assume they will respond as well as those received the greatest benefit from the drug in a trial.

He ended his talk with a call to arms, stating that rather than accepting small gains from expensive new treatments we should simply be demanding better drugs that can cure more cancers.

The immune system strikes back

To reinforce just how big immunotherapy has become there were two more talks dedicated to this exciting field.

Our own Dr Sergio Quezada gave an overview of the history of immunotherapy. It’s hard to believe, but the idea of using our immune system to fight cancer has actually been around for over a century.

The reason it hasn’t been successful until recently is that we’ve only just begun to understand how immune responses are regulated.

Dr Quezada explained that the area surrounding a tumour is a balance between healthy cells that dampen down the immune response and others that are desperate to kill cancer cells. It’s only been in the last decade or so that we’ve developed more effective ways of tipping that balance towards the cancer killing cells.

He then went on to describe how we may be able to tip that balance further, and target cancer as effectively as possible. The key is to find the molecules in a patient’s tumour that are both detectable by the immune system and present on all of their cancer cells. Then we could potentially redirect cancer-killing immune cells towards the tumour’s weakest point.

The conference finished with a talk by Dr Carl June, a giant in the field of immunotherapy.

He discussed his latest research into treating patients with their own immune cells by “engineering them to be better than nature made them”.

He has had great success using this technique to treat a small number of patients with certain types of blood cancer. The challenge now is how to make these treatments more effective and for more types of cancer.