Two societies this week urged the government to allow the National Health Insurance (NHI) to cover immunotherapy for people with late-stage lung cancer without requiring them to undergo chemotherapy first.
Immunotherapy, a treatment that uses the body’s natural defenses to fight cancer, offers “a slim chance of survival” to late-stage lung cancer patients, Taiwan Clinical Oncology Society president Kao Shang-jyh (高尚志) said at a news conference.
Each year, more than 13,000 people in Taiwan are diagnosed with lung cancer, Kao said.
As lung cancer cannot be easily diagnosed in the early stages, but spreads quickly, the disease has already progressed to an advanced stage in more than 70 percent of people when diagnosed and such cases can no longer be treated surgically, he said.
Moreover, nearly 40 percent of people with lung cancer cannot be treated with targeted therapy, because the tumors do not have special gene characteristics, Kao said, adding that many people die within a year after chemotherapy, the only treatment covered by the national health insurance.
By contrast, the median survival rate after immunotherapy is 30 months among people who receive the revolutionary treatment for non-small cell lung cancer, he said.
Immunotherapy works by stimulating the immune system to combat cancer cells, Kao said.
The immune system’s T-cells are like police patrolling the body, he said.
Research has found that a protein called PD-L1 in cancer cells integrates with PD-1 in T-cells, leading T-cells to treat tumor cells as allies, so they will not attack them.
Immunotherapy uses checkpoints of the immune system to stop PD-1 and PD-L1 from integrating, so T cells identify tumor cells and attack them, Kao said.
Immunotherapy has so far proven efficient in treating melanoma, urothelial carcinoma and lung cancer, he said.
The National Health Insurance Administration (NHIA) in August said that people with late-stage melanoma that cannot be removed through surgery and shows no improvement after front-line therapy will have immunotherapy covered by the National Health Insurance.
The new measure is to go into effect in December at the earliest, Kao said.
Taiwan Lung Cancer Society president Chen Yu-min (陳育民) said it has been about three years since immunotherapy became available.
“For people with lung cancer, three years is a threshold of survival they cannot cross,” Chen said.
Many patients have died while waiting for the national health insurance to cover immunotherapy because they could not afford the high cost of private treatment, he said.
Thirty-three countries are taking steps to include immunotherapy in their public health coverage, including the UK, Canada, Australia and Japan, Chen said, adding that he hopes the government would speed up the process to review their proposal for immunotherapy coverage for lung cancer.
NHIA official Tai Hsueh-yung (戴雪詠) on Tuesday said that the agency is reviewing the clinical evidence related to immunotherapy and evaluating whether national health insurance resources can cover payments for the treatment.
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