SECOND MELANOMA MIB CONFERENCE 2014
October 27-28 on
INNOVATION AND SUSTAINABILITY
The second edition of the Melanoma Independent Board will discuss two main aspects between the melanoma scientific issues which are actual and of new definition. Firstly the concept of innovation of the various developments of cure of this disease, of how the new single drugs and integrated therapeutic approaches available may in future develop in combination modalities and how we may improve the ability in selecting the best treatment proposals to obtain the highest chances to cure the specific disease entity of a single melanoma patient and secondly the concept of sustainability will discuss on organizational aspects with specific attention to the regulatory pathways, the budget applications, the interaction with payers and the point of view of patients not only in the situation of requiring the best available treatment when discovered, but also in terms of managing their lives once cured from a melanoma. Innovation The vast majority of research is conducted by pharma and from a pipeline of thousands of drugs, only few reach the market: this is a crucial aspect in the definition of the difficulty from one side to develop new drugs and explains why this kind of research is in the hands of big companies, while from the other side justifies only in part the increase in prices shown during the last 10 years by new drugs. The total pharmacological expenditure for oncological drugs is anyway a real minority of the global balance of sanitary costs in Italy, where a large amount of spending review can be obtained by rationalizing several inefficient costs like the those linked to the excessive number of little hospitals distributed in the national territory and the unexplainable difference of costs of similar devices in different Italian regions. Molecular medicine is developing a concept of individualizing the best treatment to be offered to cure the cancer of a single person: it is more than clear that a single drug will not be effective on all patients affected by a specific disease and the most important task will be the selection of the drug to be offered to cure a single patient. Moreover it is becoming more and more clear that the molecular pathways involved in the development and progression of cancer cannot be controlled by a single drug, so the association of different compounds will be a strategic task for the next 10 years of cancer research. This aspect brings the discussion to a very delicate but fundamental aspect which is the necessity that different companies will have to play a common job and activate strategies of cooperation within specific collaborative clinical trials. The proposal to create cooperation within different companies on the target to accelerate the projectuality on new drugs and improve the quality on conduction of clinical trials is of great interest: “Transcelerate” has been proposed to reach ambitious results. Immunology and molecular medicine will represent the future of cancer cure when we shall be able to predict the response and we shall make the investment behind a cure proposal really beneficial, making the treatment proposal to a patient unavoidable: if you are proposing a cure to a cancer patient with a probability of success as high as it is now the cure rate of an antibiotic towards a bacterial infection, no price limitations will ever be present, firstly because you select the patient to whom a certain therapy is most probable to be effective, secondly because the selection of the patients will limit the number of patients to whom a certain therapy will be offered. Targets of immune response and pharmacological interaction pathways of molecular medicine drugs are the milestones of cancer cure and require all our efforts to be efficiently discussed and finalized.