Lung cancer has been the most deadly cancer in Taiwan, as Dr Chen Shih-Chung, the MOHW Minister, put it: “Lung cancer is a national pain.” To achieve the target of 25% reduction in premature mortality from cancer, the MOHW has formulated an array of measures, including providing low-dose computed tomography (LDCT) scan for lung cancer, expanding the availability of companion-diagnostic tests and increasing new drug accessibility.
Use bio data to improve treatment efficiency
Dr Chen Shih-Chung expressed that the NHI has already felt the financial impact of lung cancer treatments as the treatment costs grew 15% annually in the past 7 years and new drugs are very expensive. So far, the NHI can still deal with the stress. However, financial preparations have to be done immediately. Dr Chen pointed out that the ratio of healthcare expenditure to GDP should reach 7% so as to ensure the quality of healthcare.
As for companion-diagnostic tests, Dr Chen said that the MOHW will collaborate with the National Health Research Institute (NHRI), the Ministry of Science and Technology (MOST) and drug companies on genetic tests so as to make cancer treatments more efficient and more accurate. The NHIA will soon make the next generation sequencing (NGS) tests available under the NHI Benefit Scheme.
Dr Chen Shih-Chung also mentioned the health hazards posed by e-cigarettes and heated tobacco products. There should be more studies on these new products to evaluate their impact on health. The MOHW will continue communicating with the society on law amendments.
LDCT plays a key role
Early detection is the best strategy to reduce the mortality of lung cancer. Dr Yang Pan-Chyr, the host of the Asia Pacific Consensus Conference of the IASLC Lung Cancer Staging Project, said that the Staging Project’s target is to double the 5-year survival rate for lung cancer by 2025. This target can be achieved if the number of early-stage cases increases by 50% and the late-stage cases reduces by 50%; therefore, the implementation of LDCT scan is of great urgency.
Innovative new drugs provide patients with new hope
Dr Yang Chi-Hsin expressed that as lung cancer treatments advance, it is possible to double the 5-year survival rate for stage IV lung cancer. In the past, the median survival time was only nine to ten months, and now it is over one year. The world average 5-year survival rate for stage IV lung cancer is 6%, while it is 8-9% in Taiwan. By bringing the drug reimbursement regulations into line with international standards, we can certainly further increase the survival rate, said Dr Yang.
The R&D of lung cancer drugs keeps advancing. Precision medicine provides breakthrough treatment options. Target therapies are now moving towards the 4th generation. All these help to improve the survival rate for late stage lung cancer.
Immunotherapy increases 5-year survival rate
Immunotherapy is also a new treatment trend. Dr Lai Jun-Liang said that immunotherapy contributes to a higher 5-year survival rate. Immunotherapy is most effective for patients with PD-L1 expression ≥ 50. For them, the survival rate can increase form 16% to 33%, said Dr Lai.
Dr Chang Wen-Cheng pointed out that clinical trials provide an opportunity for patients to access new drugs. He suggested improving the clinical trial platform to make clinical trials more accessible for patients.
【2021-12-28 / United Daily】
