我们的全球肿瘤趋势2019报告已正式发布，并详细介绍了塑造全球癌症治疗的发展和交付的趋势。
I’d like to share with you five key insights from the report. For all of the detailed, data-driven insights,下载the full report and explore the trends influencing clinical development in oncology treatments today and through 2023.
- 免疫疗法迅速被采用为一线治疗
- 精密医学和生物标志物增加了试验的复杂性
- 支出增长持续两位数
- 批准的时间正在减少，但交货仍然是一个障碍
- Trial productivity is key in this high risk, high reward therapy area
Cancer patients today have more and better treatment options than ever, with improvements in progression-free survival and new options for relapsed or refractory cancers. Immuno-oncology therapies account for many of the new options and have in just 2-3 years become first-line oncology treatments (see exhibit).
这些治疗方法现在占转移性黑色素瘤中所有治疗方案的四分之三以上。
Similarly, treatment for breast cancer, the most prevalent cancer among women, has been transformed with the introduction and rapid uptake of new options, particularly CDK4/6 inhibitors. The number of patients treated with these drugs nearly tripled in the top five European countries in the past year, now matching similar rates of use in the U.S.
Precision medicines stratify patients according to their biomarkers into those most likely to respond to therapy, for both trials and treatment. Predictive biomarkers were associated with 60% of new treatments, and three were approved with a companion diagnostic.
Biomarker testing for trials is becoming easier and more widely available, improving the selection of trial participants. Nonetheless, trial complexity may increase as novel trial designs are enabled (i.e. large basket trials with multiple arms) and as sponsors become reliant on molecular profiling companies for data.
Driving the increase in health-system spending is not only the use of new treatments, but also the use of available treatments in more patients and for longer treatment durations. Spending levels and growth rates are higher across most parts of the world, and this is expected to continue for at least the next five years. New and protected brands account for nearly all the growth in spending.
自2013年以来，美国在癌症药物上的支出增加了一倍以上，并在2018年达到了近570亿美元。在美国以外，2018年肿瘤学成本超过了660亿美元，这是由新产品推出和增加现有品牌的数量使用的增加。
2018年推出的新肿瘤学药物从专利申请开始到批准四年比2017年推出的药物快四年了。但是，只有一半以上的新癌症治疗只能在精选的9个国家 /地区提供，而诸如CAR-T之类的新型疗法则需要能力，以便能够使能力能够以此能力即使在美国也很少
For example, CAR-T cancer treatments require that centers be competent to collect T cells and reintroduce them to the patient. Few cancer centers have achieved accreditation, and these centers can be thousands of miles away from a patient. In France, a 2016 study found that only eight hospitals, treating 11% of patients, met the criteria (see exhibit).
获得这些新疗法的困难可能会给家庭和看护人带来后勤负担。但是，由于治疗时间可能较短，因此总负担不一定会增加，而是在较短的时间内承受。
自2000年以来，肿瘤学试验的总体生产率提高了22％，但仍远低于其他治疗领域的试验。研究人员通过确定预先筛选患者的参与者的参与者来提高试验的生产率，到2023年，这可能会提高生产率104％。预计使用生物标志物测试将提高71％。
以下展览显示了未来五年前八种肿瘤学趋势对试验生产率的可能影响。每种趋势的可能影响在full report.
A closer look at oncology trends
The full report –全球肿瘤趋势2019– is rich with data and exhibits illuminating the trends influencing clinical development in oncology treatments today and through 2023, including scientific advances in therapeutics, shifts in therapy use, trial productivity and success rates, as well as changes in spending patterns. I invite you to下载it today, along with the full set of exhibits you can reference in your own work.