Lawrence N Shulman1, Claire M Wagner2, Ronald Barr2, Gilberto Lopes2, Giuseppe Longo2, Jane Robertson2, Gilles Forte2, Julie Torode2, Nicola Magrini2. 1. Lawrence N. Shulman and Claire M. Wagner, Dana-Farber Cancer Institute; Lawrence N. Shulman, Partners In Health, Boston, MA; Claire M. Wagner and Julie Torode, Union for International Cancer Control; Jane Robertson, Gilles Forte, and Nicola Magrini, World Health Organization, Geneva, Switzerland; Ronald Barr, McMaster University, Hamilton, Ontario, Canada; Gilberto Lopes, Centro Paulista de Oncologia e Hcor Onco, São Paulo, Brazil; Gilberto Lopes, Johns Hopkins University, Baltimore, MD; and Giuseppe Longo, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy. lawrence.shulman@uphs.upenn.edu. 2. Lawrence N. Shulman and Claire M. Wagner, Dana-Farber Cancer Institute; Lawrence N. Shulman, Partners In Health, Boston, MA; Claire M. Wagner and Julie Torode, Union for International Cancer Control; Jane Robertson, Gilles Forte, and Nicola Magrini, World Health Organization, Geneva, Switzerland; Ronald Barr, McMaster University, Hamilton, Ontario, Canada; Gilberto Lopes, Centro Paulista de Oncologia e Hcor Onco, São Paulo, Brazil; Gilberto Lopes, Johns Hopkins University, Baltimore, MD; and Giuseppe Longo, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.
Abstract
PURPOSE: A great proportion of the world's cancer burden resides in low- and middle-income countries where cancer care infrastructure is often weak or absent. Although treatment of cancer is multidisciplinary, involving surgery, radiation, systemic therapies, pathology, radiology, and other specialties, selection of medicines that have impact and are affordable has been particularly challenging in resource-constrained settings. In 2014, at the invitation of the WHO, the Union for International Cancer Control convened experts to develop an approach to propose essential cancer medicines to be included in the WHO Model Essential Medicines Lists (EML) for Adults and for Children, as well as a resulting new list of cancer medicines. METHODS: Experts identified 29 cancer types with potential for maximal treatment impact, on the basis of incidence and benefit of systemic therapies. More than 90 oncology experts from all continents drafted and reviewed disease-based documents outlining epidemiology, diagnostic needs, treatment options, and benefits and toxicities. RESULTS: Briefing documents were created for each disease, along with associated standard treatment regimens, resulting in a list of 52 cancer medicines. A comprehensive application was submitted as a revision to the existing cancer medicines on the WHO Model Lists. In May 2015, the WHO announced the addition of 16 medicines to the Adult EML and nine medicines to the Children's EML. CONCLUSION: The list of medications proposed, and the ability to link each recommended medicine to specific diseases, should allow public officials to apply resources most effectively in developing and supporting nascent or growing cancer treatment programs.
PURPOSE: A great proportion of the world's cancer burden resides in low- and middle-income countries where cancer care infrastructure is often weak or absent. Although treatment of cancer is multidisciplinary, involving surgery, radiation, systemic therapies, pathology, radiology, and other specialties, selection of medicines that have impact and are affordable has been particularly challenging in resource-constrained settings. In 2014, at the invitation of the WHO, the Union for International Cancer Control convened experts to develop an approach to propose essential cancer medicines to be included in the WHO Model Essential Medicines Lists (EML) for Adults and for Children, as well as a resulting new list of cancer medicines. METHODS: Experts identified 29 cancer types with potential for maximal treatment impact, on the basis of incidence and benefit of systemic therapies. More than 90 oncology experts from all continents drafted and reviewed disease-based documents outlining epidemiology, diagnostic needs, treatment options, and benefits and toxicities. RESULTS: Briefing documents were created for each disease, along with associated standard treatment regimens, resulting in a list of 52 cancer medicines. A comprehensive application was submitted as a revision to the existing cancer medicines on the WHO Model Lists. In May 2015, the WHO announced the addition of 16 medicines to the Adult EML and nine medicines to the Children's EML. CONCLUSION: The list of medications proposed, and the ability to link each recommended medicine to specific diseases, should allow public officials to apply resources most effectively in developing and supporting nascent or growing cancer treatment programs.
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