Thousands of patients missing out on targeted cancer drugs

THOUSANDS of cancer patients are missing out on personalised treatments each year in England because they are not being given a test to see if they might benefit from them, according to a new report from Cancer Research UK published today (Thursday).

The report looked at the NHS’s molecular diagnostic testing service for cancer patients in England. These are tests that can identify the genetic faults underpinning a patient’s cancer, some of which can be hit with targeted therapies. The report focused on patients with skin, lung and bowel cancer, where targeted drugs are already available on the NHS.
In 2014, it is estimated that more than 24,000 molecular diagnostic tests were not carried out in hospitals across England. In lung and bowel cancers alone, around 16,000 eligible patients weren’t offered these tests*. And about a quarter of these patients could have been given targeted treatments, meaning an estimated 3,500 lung and bowel cancer patients missed out on medicines that could have changed the course of their disease.

The main reasons for missed tests are the cost – there is no dedicated funding available for them – and doctors’ poor awareness of targeted treatments and testing. But molecular diagnostic tests have been available since 2008, are routinely available in many other countries and the Government made a commitment in its 2011 cancer strategy to develop a national commissioning structure for the tests. This has still not been introduced and so features again in the new cancer strategy for England, announced earlier in the summer.

The report – commissioned by Cancer Research UK and produced by health consultancy Concentra – estimates that at least a further £13million is needed to meet the demand for tests and make sure the services keep up to date, as new treatments become available and new biomarkers are found that can be added to the tests.

Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation, said: “I have no doubt that the over-riding emotions of patients and their loved ones upon hearing this news will be one of anger and also confusion.

“Quite rightly, they will want to know whether they were eligible for these tests and, if so, why it did not happen.

“I will do everything in my power to make sure that all eligible patients receive access to these tests.”

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “It’s lamentable that routine molecular diagnostic testing still hasn’t been established, more than 2 years after Cancer Research UK showed how it can be done with our Stratified Medicine Programme. Despite much talk about innovation in care, the NHS is once again lagging behind, and patients aren’t getting tested to see if they might benefit from new types of treatment.

“Molecular diagnostic tests can help doctors to choose more tailored treatments that may improve survival for their patients, allow patients to take part in clinical trials and potentially reduce side effects from less effective treatments: they are not an optional extra.”

Emma Greenwood, Cancer Research UK’s head of policy, said: “We need to see greater investment and leadership from NHS England to organise national commissioning of molecular diagnostic testing. And, if action isn’t taken, England will fall behind as these tests are now routine in many other countries.

“In some cases, patients have missed out on treatments that could have given them priceless extra months with their friends and families. In order to make sure thousands of patients don’t continue to miss out, it’s essential that the Government acts on the recommendations in the new cancer strategy, which calls for NHS England to properly commission these tests.”

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