A box of medicine is equivalent to a used car!
Ms. Shou’s husband suffered from kidney cancer in 2016. After surgical resection, the doctor suggested taking targeted drugs for control because of lung metastasis and insensitivity to chemotherapy. This is a new imported drug , a 500 yuan, Ms. Shou’s husband eats 4 a day, and a box costs 23,000, which is equivalent to the price of a used car.
In order to treat their husband’s illness, their family was in debt, and the hardships of the process could not be explained in a thousand words, so they persisted for three years, but unfortunately Ms. Shou’s husband died. Leaving a few boxes of medicines, Ms. Shou, in addition to her grief, also experienced the pain and helplessness of cancer patients, so she decided to donate the medicines to cancer patients in need.
Ms. Shou’s righteous deeds are respected. The medicine that Ms. Shou’s husband takes has already entered the medical insurance, but the sky-high anti-cancer drugs are emerging one after another. Recently, 1.2 million yuan of anti-cancer drugs and 2.9 million yuan of anti-cancer drugs have caused heated discussions. The sky-high price of anti-cancer drugs is the pain of all cancer patients. Today we are going to talk about expensive targeted drugs.
1. What is a targeted drug?
When you are sick, you need medication. After ordinary drugs enter the human body, only a very small part can actually act on the diseased part. This is also the root cause of the low efficacy of common drugs and the toxic side effects.
If there is such a drug, which has the precise targeting ability like a missile, can effectively hit cancer cells and protect our healthy cells to the greatest extent, it will play a very important role in the treatment of patients with cancer. big improvement. Based on this concept, drug research and development began to develop towards targeted drugs.
Targeted drugs refer to drugs or their preparations endowed with targeting ability. The purpose is to enable the drug or its carrier to target specific lesions and accumulate or release the active ingredient at the target site.
Two. Are targeted drugs a life-saving drug or a scam that wastes money and manpower
target To treat cancer can be precisely targeted to kill cancer cells through drugs, which greatly reduces the toxic and side effects of common drugs. It should be noted, however, that not all patients are suitable for targeted therapy.
Before determining targeted therapy, genetic testing must be performed to confirm that it meets the conditions for targeted therapy before implementation. For example, patients with lung cancer have positive genes such as EGFR and HER2; patients with breast cancer have positive HR and HER2; patients with liver cancer are inoperable or have distant metastatic hepatocellular carcinoma. Otherwise, even if targeted therapy is used, it will not be able to target the target, and the effect will be greatly reduced.
How effective are targeted drugs?
1. Kidney cancer
Professor Zhou Fangjian from the Department of Urology, Sun Yat-sen University Cancer Hospital said that in targeting Before the era of drugs, there was basically no good treatment for advanced metastatic renal cancer, and 90% of patients with advanced stage had a survival time of only about 1 year. After entering the era of targeted therapy, the survival time of patients with advanced renal cell carcinoma has been improved by 1-2 years.
2. Lung cancer
Lin Lizhu Associate Hospital of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine Long also gave the affirmation of targeted therapy. She said that before targeted therapy, patients with advanced lung cancer were usually only able to choose chemotherapy and local radiotherapy, and the median overall survival was only about 10 months. After the introduction of targeted therapy, advanced lung cancer patients can survive for 3-5 years with reasonable drug treatment, and some patients can even live for 10 years.
3. Gastric cancer
Professor Bi Feng from Department of Abdominal Oncology, West China Hospital, Sichuan University also presented at the 2015 Chinese Society of Clinical Oncology It is pointed out that the current survival time of advanced gastric cancer patients is about 3-5 months, and after receiving chemotherapy, the survival time is only extended by 6-10 months. However, through precise treatment of gastric cancer, the survival time of HER2-positive patients was significantly prolonged by 16 months, and if the HER2 gene was amplified by 4 times, the survival time could be doubled.
It can be seen that after targeted drug treatment, the median survival time of most patients can be extended to 3-4 years. Depending on the patient’s condition and the degree of onset of the drug, it can be extended up to more than ten years. Unfortunately, the effect of targeted drugs is limited, and unlimited mutations of cancer cells will eventually defeat the limited targeted drugs, resulting in drug resistance. Targeted drugs still face challenges in maintenance therapy.
Third, targeted drugs are so expensive, why can’t they be reduced in price?
Targeted drugs may be the last “life-saving straw” for some cancer patients. Although many drugs have been included in medical insurance in China, the prices of targeted drugs are still high. What makes targeted drugs so expensive?
1. R&D costs
From drug conception, to discovery, screening, optimized synthesis, pre-clinical research and clinical research, and finally to drug approval After a 10-15 year process. This process requires a lot of human and material resources, and costs a lot of money, generally at least 1 billion US dollars.
2. Circulation costs
If drugs are imported, import duties are also required, which is about 5%-8%, and consumers need to pay for this part . In addition, there are also drug transportation, promotion, and price increases by distributors at all levels… These will undoubtedly fall on consumers.
3. Approval costs
For imported drugs, even if they are approved abroad, they still need to re-complete clinical trials after entering my country to be approved. Costs will undoubtedly be superimposed on drug prices.
The cost makes it difficult to reduce the price of targeted drugs in a short period of time, which also causes many cancer patients to be reluctant to receive treatment.
4. How do I know if taking targeted drugs is effective?
What many patients are more concerned about is: I have spent so much money on targeted therapy, how can I judge whether it is effective?
Clinically, the efficacy of targeted drugs is mainly determined by observing tumor regression. Before treatment, the imaging data of tumor baseline should be obtained, and after 2 cycles of treatment, imaging examination and evaluation should be performed again.
Response Evaluation Criteria in Solid Tumors (RECIST Criteria):
a. Complete remission (CR): All targets disappeared completely; p>
b. Partial remission (PR): Baseline tumor length and diameter reduced by more than 30%;
c. Stable disease (SD): The sum of the length and diameter of the line lesions decreased but did not reach PR or the lesions increased but did not reach PD;
d. Disease progression (PD): The sum of the length and diameter of the lesions increased at baseline More than 20% or new lesions appear.
If the disease is in remission (CR/PR) or the disease is stable (SD), the current drug treatment program should be continued.
Targeted drugs have changed the treatment mode of tumors in the past, and more and more tumor patients have prolonged their survival and improved their quality of life. However, targeted drugs are not a cure for cancer after all. According to individual differences, each person may have different side effects and curative effects. We still need to look at targeted drugs objectively.
References:
[1] “These tumor patients can use targeted drugs, covering more than 20 types of carcinoids”. Shenzhen Anticancer Network. 2018-01-08
[2] “No pain or itching, the physical examination actually found out kidney cancer? Standardized targeted therapy can lead to long-term survival”. Jinyang.com. 2019-02-28
[3] “Rumors | No vomiting and diarrhea, rash all over the body, indicating that tumor-targeted drugs are not effective? 》. Guangming.2020-09-22