As noted by Krzysztof Jakubiak, who led the discussion, we spend about 60 million zlotys annually on molecular diagnostics, which is half a percent of all spending on cancer treatment. Meanwhile, a significant portion of new therapies that are covered by reimbursement are only available to patients with specific mutations confirmed by molecular tests - no diagnostics, no modern treatment. - Won't diagnostics block the inclusion of patients in treatment programs, he asked.
Andrzej Tysarowski, M.D., head of the Department of Genetic and Molecular Diagnostics of Tumors at the National Cancer Institute in Warsaw, coordinator of genetic diagnostic guidelines under the National Cancer Strategy, reminded that molecular diagnostics not only allows a patient to qualify for a drug program targeted for a specific mutation, but above all enables the proper diagnosis of cancer. - Today, microscopic testing is not enough," he said. But that's not all - thanks to molecular testing, it is also possible to monitor the progress of treatment, to see how the profile of a cancer cell changes. Last but not least, molecular testing also has preventive significance - when there is a genetic risk associated with cancer.
Molecular diagnostics has more than one name, as it consists of simple tests of a specific gene, complex tests involving several, a dozen or more genes, and tests of several hundred genes or even the entire genome. - We have the technology, equipment, capabilities. The quality and class of research performed in Poland is absolutely comparable with Western European countries or the US. What differentiates us is funding," Dr. Tysarowski pointed out. At the moment, the public payer finances basic gene tests and simple panels - primarily in breast, ovarian, colorectal, pancreatic or melanoma cancers. - We lack funding for advanced testing, which is necessary in some cancers," he stressed. Tests covering 6,000-8,000 genes are not reimbursed, although in sarcomas or certain ovarian and lung cancers, for example, they would make a difference to the patient. - We have the technical capacity to perform these tests, and efforts are underway to include them in funding for adults. The population up to the age of 18 already has guarantees of funding from the Medical Fund," he stressed.
A breakthrough in access to diagnostics would also be to provide funding for liquid biopsy, a test performed from the peripheral blood, which makes it possible to obtain the gene profile of a cancer cell without the need to collect material for testing. - Sometimes a simple biopsy is either impossible or very invasive for the patient, the expert recalled.
Prof. Iwona Hus, president of the Polish Society of Hematologists and Transfusiologists and head of the Hematology Department at the National Medical Institute of the Ministry of Internal Affairs and Administration, stressed that also in the field of hematology, an essential standard for patient diagnosis and treatment is the use of molecular tests. - Proper care is basically impossible without such tests," she said, while adding that it is hard not to notice the progress that has been made in recent years. - Not long ago, during such discussions, we argued for the need to provide or expand reimbursement for innovative therapies.
Because in hematooncological diseases - both chronic and acute myeloid leukemia - the traditional treatments available to date are being supplanted by targete...
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