Immunotherapy increases life expectancy in cancer patients, but does not reach SUS

Immunotherapy can increase the life expectancy and well-being of people with cancer, but it is still poorly accessible to the population.

In the SUS, doctors find it difficult to prescribe immunotherapics due to lack of funding, which compromises the democratization of treatment.

Considered an important advance in cancer medicine, the strategy “trains” the immune system to recognize and fight cancer cells.

This was one of the themes of the 7th edition of the Seminar on Cancer, held by Sheet on the 15th and 16th of August.

The event was sponsored by Bristol Myers Squibb, Hospital Sírio-Libanês and Pfizer and mediated by Vera Guimarães, former ombudsman of the Sheet.

“It’s a huge advance. They are drugs with a very targeted target and have a different toxicity from common chemotherapeutic drugs. For the vast majority of patients, the treatment is very well tolerated”, says Maria Del Pilar, director of the clinical staff of ICESP (Instituto of Cancer in the State of São Paulo).

The specialist says that there may be side effects in some cases, but that medicine has learned to deal with these situations.

“Perhaps most importantly, immunotherapy has given some diseases a life expectancy that we didn’t have before. This is particularly true of melanoma, lung cancer, and kidney cancer.”

She adds that the effect of this therapy can increase with the use of immunoconjugates, that is, drugs that combine antibody with chemotherapy to fight the disease.

Despite being an important treatment, access is uneven. According to the expert, funding in the public network is still insufficient to ensure that it is offered in a systematic way.

“We are faced with difficulties at this moment that need to be overcome so that we do not have social differences during treatment. If it is useful, brings gain and quality of life to the patient, it is important that it be offered to those who really need it.”

Marina Sahade, an oncologist and clinical deputy director at Hospital Sírio-Libanês, has a similar opinion. According to her, patients who undergo immunotherapy do not usually feel sick or need hospitalization.

“But the big challenge is access. For a disease like melanoma, in which the other options are not good, having to fight for access to immunotherapy is very serious.”

She recalls that, before this method, there was treatment for melanoma that caused serious adverse effects and had low response rates.

“Immunotherapy allows us to bring a much better quality of life to the patient. Now, we just need to show that this is happening to take the weight off that everyone thinks the patient is dying when in fact he is not.”

Medical director of Bristol Myers Squibb, Angélica Pavão says that elderly patients can make use of immunotherapy and that the minimum age to undergo treatment is usually 18 years old.

Marina Sahade says that women cannot get pregnant during treatment and that they need a break to get pregnant after the immunotherapy ends.

In addition, she states that it is not known for sure whether there is impairment of fertility. “It is essential that the patient asks the oncologist if it will affect, if he needs to freeze egg or sperm.”

Although it has benefits in combating certain types of cancer, immunotherapy has some limitations. For the treatment of sarcoma, the tests did not give satisfactory results.

See the panels from day one

“Immunotherapy for sarcoma has not done so well so far. The studies are not very encouraging, but there are plenty of chemotherapy options that work,” says Sahade.

In the case of breast cancer, the strategy can help, but it is not usually powerful enough to act alone, says Max Senna Mano, oncologist and leader in the breast cancer area of ​​the Oncoclínicas Group. “In general, we combine it with chemotherapy to have a better result.”

The specialist also explains that the approval of these drugs in Brazil occurs at an adequate pace. The problem, he reinforces, is in the distribution of medicines.

“The public sector has been having a hard time absorbing these treatments, which is understandable, because they come with absurd costs.”