ASCO insight: Dr. Sara Tolaney, breast medical oncologist

My name is Sara Tolaney. I’m a breast medical oncologist at Dana-Farber Cancer Institute in Boston.

What is one innovation in oncology that is failing to reach patients?

Well, we’re really lucky to be at a time where we’ve seen such innovation in oncology with so many new drugs that have really… Honestly, we’ve seen such a fast pace of drug approval. It’s truly remarkable. But I think one of the challenges is that some of these drugs just are not accessible, particularly on a global scale to all of our patients. There’s some real-world series that have suggested that adjuvant CDK46 inhibitors are only being used by somewhere around 30-40% of all eligible patients.

We’ve seen data now, including data from Monarchy, showing that abemaciclib actually improves overall survival. And so to not have these drugs being utilized in a broader population is really so unfortunate. And we need to move towards making sure these new drugs that are changing survival outcomes are accessible to the general population.

What barriers are preventing patients from being able to access these innovations?

I think reasons for not having access across the globe are numerous. Some of the reasons are that in some countries, some drugs have not been yet approved, and so that is a challenge with getting drugs accessed. Sometimes these drugs may have approvals but don’t have reimbursement, and that is another major roadblock to getting access to drugs.

Then there are regions of the world where there is neither an approval nor any reimbursement and that is highly problematic. And so, I think on a global scale this continues to be a challenge in many parts of the world, and it is really critical that we start to address making sure drugs are more accessible and affordable to patients.

I think one thing that I’ve seen that has been really nice is when trials are opened in regions where there’s not drug access, it is a tremendous opportunity for patients to get access to drugs. It’s really critical though that when drug companies do this, they provide some infrastructure support so that these parts of the world that aren’t used to being able to run trials and get access to drugs start setting that up, and that actually reaps so many downstream effects for them by having the personnel and the staff to run trials to get access to drugs.

That is really such a critical piece. And then I think my hope is that once these trials are done, these patients can get the return where they start getting access to the broader country. And so, I think that’s really what we’d love to see in the long run.