Cancer-fighting drugs included in UN list of essential medicines

The UN health agency, WHO, has announced that dozens of new drugs have been added to the list of essential medicines that every country should have, including new cancer treatments that can be swallowed rather than injected.

More than 150 countries use the UN’s Essential Medicines List, which contains around 460 drugs deemed critical to treat public health needs. This latest update adds 28 products for adults and 23 for children, and specifies new uses for 26 already-listed products, based on value for money, evidence and health impact.

WHO said on Tuesday that the five cancer therapies added to the list are regarded as “the best in terms of survival rates” to treat melanoma, lung, blood and prostate cancers.

They include two recently developed immunotherapies - nivolumab and pembrolizumab - that have delivered up to 50 per cent survival rates for advanced melanoma, a skin cancer that, until recently, was incurable.

“The inclusion in this list of some of the newest and most advanced cancer drugs is a strong statement that everyone deserves access to these life-saving medicines, not just those who can afford them,” said WHO Director-General.

Other updates to the list include new oral anticoagulants to prevent stroke, as an alternative to warfarin treatment of deep vein thrombosis. These are “particularly advantageous” for low-income countries, according to WHO, because, unlike warfarin, they do not require regular monitoring.

In addition, the agency’s committee also advised that countries supply new products to treat chronic inflammatory conditions such as rheumatoid arthritis and inflammatory bowel diseases.

Life-threatening bleeding after childbirth was also addressed in this year’s Essential Medicines List update, with the proposal to use carbetocin rather than the currently used therapy, oxytocin.

“This new formulation has similar effects to oxytocin?but offers advantages for tropical countries as it does not require refrigeration,” WHO said in a statement.

UPDATES ON CRITICAL DIAGNOSES TOO

In a related development, the UN health agency also updated its Essential Diagnostics List, in recognition of the critical, life-saving importance of finding out what is wrong with patients before it is too late.

The first list, issued last year, concentrated on a limited number of priority diseases, such as HIV, malaria, tuberculosis, and hepatitis. This year’s list includes more non-communicable and communicable diseases. In all, WHO added 12 tests to the Essential Diagnostics List to detect a wide range of solid tumours such as colorectal, liver, cervical, prostate, breast and germ cell cancers, as well as leukemia and lymphomas.

The list focuses on additional infectious diseases prevalent in low- and middle-income countries such as cholera, and neglected diseases like leishmaniasis, schistosomiasis, dengue, and zika.

The list was also expanded to include additional general tests which address a range of different diseases and conditions, such as iron tests for anemia and tests to diagnose thyroid malfunction and sickle cell anaemia, which is very widely present in Sub-Saharan Africa.

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Pill on a string can detect cancer without need for biopsy

A ‘pill on a string’ has been developed by the University of Cambridge to detect the early signs of gullet cancer without the need for a biopsy.

The pill is swallowed and when the outer case dissolves it reveals a sponge which can then be pulled up the throat lining, collecting cells.

Researchers say the tiny sponge is more effective at picking up cancer because it takes a swab of the whole throat and not just a small area that a biopsy would examine.

Oesophageal cancer is often preceded by Barrett’s oesophagus, a condition in which cells within the lining of the esophagus begin to change shape and can grow abnormally.

Between one and five people in every 100 with Barrett's oesophagus go on to develop esophageal cancer in their life-time, a form of cancer that can be difficult to treat, particularly if not caught early enough.

The new test can pick up the earlier condition which means treatment can start sooner.
“The trouble with Barrett’s esophagus is that it looks bland and might span over 10cm,” said Professor Rebecca Fitzgerald, at the Medical Research Council Cancer Research Unit at the University of Cambridge.

“There is a great deal of variation amongst cells. Some might carry an important mutation, but many will not. If you’re taking a biopsy, this relies on your hitting the right spot.

“Using the sponge appears to remove some of this game of chance.”

The team has taken samples from 73 cancer patients over three years so that they know exactly which mutations indicate that the disease is present.

They found patterns of changes where one letter of DNA had been switched for another to provide a ‘fingerprint’ of cancer.

The researchers also discovered that there appeared to be a tipping point, where a patient would go from having lots of individual mutations, but no cancer, to a situation where large pieces of genetic information were being transferred between chromosomes.

Co-author Dr Caryn Ross-Innes adds: “We know very little about how you go from pre-cancer to cancer – and this is particularly the case in esophageal cancer.

“Barrett’s oesophagus and the cancer share many mutations, but we are now a step closer to understanding which are the important mutations that tip the condition over into a potentially deadly form of cancer.”

The research was funded by the Medical Research Council and Cancer Research UK.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.






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