- 90%: the 5-year survival rate among female patients diagnosed in the United States. This rate drops to 82% after 10 years
- 1 out of 8 women (12%) will develop an invasive form of cancer in their lifetime
- 2 million new cases were diagnosed worldwide in 2018
- Breast cancer is the No. 1 cancer among women, and the second most deadly, after lung cancer
- 21% of patients are under the age of 49 and 43% over the age of 65
Source - World Cancer Research Fund International
In honour of Breast Cancer Awareness Month this October, Rudi Van Den Eynde, Head of Thematic Global Equity, gives us an overview of the disease. He is pleased to see that pharmaceutical innovation is still going strong, driven by better understanding of the disease.
What is the most promising scientific work being done?
Research now offers a better understanding of the genetic signature of different types of cancer, opening the door to personalised medicine and the development of highly specialised drugs. Roche’s Herceptin® was the first step in this revolution, transforming the prognosis for HER2-positive breast cancer, one of the most aggressive forms of this cancer. On the downside, it is effective only on 20% of patients bearing this gene mutation. For others, however, new alternatives are gradually replacing, or supplementing, chemotherapy treatment. Last year, the FDA (US Food & Drug Administration) approved a new drug for “triple negative” cancer, one of the most complex forms of breast cancer to treat. Hereditary BRCA cancer treatments have also improved, as have treatments for cancers that have advanced to the metastatic phase or are no longer responding to standard treatment. Promising research is also being done in immunotherapy, with the goal of stimulating the immune system to better address tumours.
The cost of such innovative treatments is climbing fast, however, and is even skyrocketing for some, with the risk of making them harder to access...
That’s the cost of targeted medicine. Until the early 1990s, new treatments primarily addressed large patient populations. Cancers were treated as effectively as was possible with chemotherapy. Since then, however, research has shown that there is not just one type of breast cancer. There are actually many types that can, and should, be treated with different drugs. Generally speaking, in oncology, some very rare cancers only affect a few tens of thousands of patients around the world, and sometimes just hundreds... Biotechnology has given us weapons to fight them, but that also means that each drug that is developed can only be prescribed to a limited number of patients. Meanwhile, R&D costs have risen incessantly, forcing prices up in an increasingly fragmented market. Of course, we can’t be naive, and negotiations between healthcare authorities and labs are critical to regulating prices, as is the intense competition waged between labs. What’s more, we must not forget that putting drugs on the market creates funding for the innovation of tomorrow. And, when patents expire 10 to 12 years after they are approved for market, competition from generic and biosimilar drugs becomes very strong and prices drop. Ultimately, I find the system fairly efficient and think it stimulates the investments needed to meet future challenges.
Private-sector investors also have a role to play in this system, by funding the most promising projects. Are they still showing interest?
If we look to the past, in venture capital, there were certain voids not being filled, and companies had to engage in fierce competition to attract investors, especially in Europe. When coronavirus came along, it seemed like venture capital might get “crowded-out” towards other treatment areas. That wasn’t the case, however, which just goes to show how expansive research is today and how promising are innovations for the future. Lastly, I would say that venture capital in the healthcare industry is not only gaining ground in most European countries, but also improving. As a general rule, companies have the necessary funds to do their work. Those with the right innovation have no trouble in that department. I would almost venture to say that, in some countries, there is more capital than big ideas. Which is why is it also important for investors to conduct an in-depth analysis of the projects they plan to invest in, no matter what the type of company (publicly traded or private), by relying on renowned experts. That’s what we at Candriam offer, with our team of investment-savvy scientists and our exclusive valuation models, which have proved their worth for nearly 20 years now, even in an environment as complex as that created by the coronavirus.