Personalized Medicine Coalition, Washington, District of Columbia.
American Association for Cancer Research, Philadelphia, Pennsylvania.
Clin Cancer Res. 2015 May 15;21(10):2263-7. doi: 10.1158/1078-0432.CCR-15-0827. Epub 2015 Apr 21.
Significant progress has been made in the past 50 years across the field of oncology, and, as a result, the number of cancer survivors in the United States is more than 14.5 million. In fact, the number of cancer survivors continues to grow on an annual basis, which is due in part to improved treatments that help people with cancer live longer, and improvements in early detection that allow doctors to find cancer earlier when the disease is easier to treat. However, in spite of this progress, innovation in cancer research and care is at risk as the rise in health care spending is leading to significant pressure to contain costs. As the oncology community seeks to ensure that innovation in cancer research and care continues, it is imperative that stakeholders focus their attention on the value that the research and care continuum provides. Over the past several years, the Turning the Tide Against Cancer initiative has worked with the cancer community to accelerate the delivery of patient-centered, high-quality cancer research and care, while addressing value and cost. This article highlights policy recommendations that resulted from the convening of an expert working group comprising leaders from across the oncology field. Of the recommendations, the co-conveners have identified several issue areas that merit particular focus in 2015: Support FDA's efforts to modernize its framework for bringing new medicines to patients, through facilitating and implementing innovative approaches to drug development and regulatory review. Ensure that cancer clinical pathways or similar decision-support tools are transparent; developed through a physician-driven process that includes patient input; and meet minimum standards for clinical appropriateness, timeliness, and patient centeredness. Support oncology decision-support tools that are timely, clinically appropriate, and patient centered. Build on existing efforts to convene a multistakeholder committee and develop a report on ways to define and measure value in oncology care, taking into account many of the complex dynamics associated with measuring value, including the interests and needs of patients, as well as the importance of committed and ongoing support for innovative research.These policy options are intended to further the national dialogue and represent meaningful and actionable steps toward supporting cancer research and care that is innovative, efficient, and focused on the patient.
过去 50 年来，肿瘤学领域取得了重大进展，因此，美国的癌症幸存者人数超过 1450 万。事实上，癌症幸存者的人数每年都在持续增长，这部分是由于治疗方法的改善，帮助癌症患者活得更久，以及早期检测的改进，使医生能够在疾病更容易治疗时更早地发现癌症。然而，尽管取得了这些进展，但由于医疗保健支出的增加导致控制成本的压力很大，癌症研究和护理的创新仍面临风险。随着肿瘤学界寻求确保癌症研究和护理的创新继续下去，利益相关者必须将注意力集中在研究和护理连续体提供的价值上。在过去的几年中，扭转癌症潮流倡议与癌症社区合作，加速提供以患者为中心、高质量的癌症研究和护理，同时解决价值和成本问题。本文重点介绍了由肿瘤学领域的领导者组成的专家工作组召集会议所产生的政策建议。在这些建议中，共同召集人确定了 2015 年需要特别关注的几个问题领域：支持 FDA 努力通过促进和实施创新的药物开发和监管审查方法，使新药物更快地惠及患者，对其框架进行现代化改造。确保癌症临床路径或类似的决策支持工具具有透明性；通过包括患者输入在内的医生驱动的流程进行开发；并满足临床适宜性、及时性和以患者为中心的最低标准。支持及时、临床适宜和以患者为中心的肿瘤学决策支持工具。在现有的召集多方利益相关者委员会并制定报告的努力基础上，努力寻找定义和衡量肿瘤学护理价值的方法，考虑到与衡量价值相关的许多复杂动态，包括患者的利益和需求，以及对创新研究的持续支持的重要性。这些政策选择旨在推进全国性对话，代表着支持创新、高效和以患者为中心的癌症研究和护理的有意义和可操作的步骤。
