The inclusion of three oral chemotherapy options in the list of health acts and events of the National Complementary Health Agency (ANS) brings advantages in terms of survival to patients and allows the prescription, by the doctor, for patients who have health insurance, assessed on Monday, May 16, the oncologist Andreia Melo, of the Oncoclínicas group, also head of the clinical research division of the National Cancer Institute (Inca).
Published on the 6th in the Federal Official Gazette, the decision included the substances trifluridine + tipiracil hydrochloride, for colorectal and metastatic gastric cancer; Brigatinib, for locally advanced or metastatic non-small cell lung cancer (NSCLC), positive for anaplastic lymphoma kinase (ALK); and venetoclax, combined with obinutuzumab, for adult patients treated as first-line chronic lymphocytic leukemia (CLL).
According to Inca, the estimate is that each year of the 2020-2022 triennium, Brazil will have around 41,000 new cases of colorectal cancer, 21,000 cases of gastric cancer and 30,000 lung cancers, in addition to 11,000 cases. leukemia, of which chronic lymphocytic leukemia will account for about a quarter. In total, Inca estimates the appearance of 650,000 new cases of cancer in the country each year of the triennium.
Therefore, in the assessment of the oncologist, the meaning that treatment incorporations can bring to patients is great.
“They bring new therapeutic options. These are new lines of treatment for patients with these neoplasms (colorectal and gastric) in the metastatic scenario. In the case of lung cancer, you have the selection of a biomarker and you have a very good objective response with the use of treatment and a survival gain”.
Mandatory coverage of these three new oral chemotherapy options by health insurance plans is essential for oncologists to achieve the best in the literature in terms of standards of care in their clinical practice.
“It is essential to prioritize these oral treatment options in the coverage of patients with these neoplasms. This is what happens with the role of the ANS”, indicated the oncologist.
Colorectal cancer is the name given to the type of tumor that affects the large intestine (colon), the rectum (end of the intestine, before the anus) and the anus. In 2019 alone, the disease caused more than 20,000 deaths in the country. It is, according to Inca, the third most common type of cancer in Brazil, with an estimated risk of around 19 new cases per 100,000 people. Metastatic colorectal cancer is the advanced stage of the disease.
Treatment should be continuous and aimed at prolonging survival, reducing tumor-related symptoms, delaying disease progression, and maintaining quality of life. Even considering that the disease is at a more advanced stage, patients can still receive treatment.
The Inca warns that almost 30% of all colorectal cancers could be prevented through healthy diet, physical activity and reduced consumption of alcoholic beverages. The institute, linked to the Ministry of Health, estimates that in 2030, the expenditure of the Unified Health System (SUS) with patients who will develop this type of cancer, due to exposure to avoidable risk factors, will be 88% higher than the amount spent in 2018, which reached 545 million reais.
Andreia Melo warned that the cost of oncology care is rising every year, not just because of the increase in the number of cases. “It is a disease which has become more frequent and which has also increased its mortality. Of course, along with that, you walk with the development of new therapeutic options, new technologies, new interventions that usually come at a high cost.”
Stomach cancer, also known as gastric cancer, is the third most common type in men and fifth in women, with an estimated risk of 12.81 cases per 100,000 men and 7. 34 cases per 100,000 women. Worldwide, 684,000 new cases have been estimated in men, the fourth most common among all cancers. The most common type is adenocarcinoma, responsible for 95% of cases, Helicobacter Pylori infection being the main risk factor.
Chronic lymphocytic leukemia (CLL) is characterized by an increase in the number of lymphocytes, which are one of the main cell types of leukocytes, or white blood cells. It is a slowly progressive disease that mainly affects people over the age of 55. The average age at diagnosis is around 70 years old. Extremely rare in children, the risk of developing CLL is 0.57%, slightly higher in men than in women.
According to Inca, lung cancer is the second most common in Brazil and the first in the world, both in terms of incidence and mortality. It is responsible for approximately 13% of all new cancer cases, with a worldwide incidence of 1.8 million new cases. This type of cancer is considered today as one of the main causes of preventable death, since in approximately 85% of cases its appearance is directly linked to the consumption of tobacco derivatives. Smoking is the most important risk factor.
In the same decision, the ANS approved inclusion in the List of health acts and events of the substance Risankizumab, for the treatment of moderate to severe psoriasis.
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