All patients with metastatic breast cancer (mBC) should have equal access to the best treatments and outcomes wherever they live in Europe and regardless of prognosis, according to a manifesto to be agreed on the last day of EBCC14.

The manifesto identifies innovations in breast cancer treatment that bring the greatest benefit to patients but are not equally accessible, highlights barriers to accessing these advances, and proposes steps towards improving access.

It has been developed by cancer experts led by the co-chairs of EBCC14, Professor Michail Ignatiadis and Dr Fiorita Poulakaki, who will chair the session on Friday afternoon. The session will be addressed by Stella Kyriakides, the Commissioner of Health and Food safety for the EU.

Dr Poulakaki, Vice President of Europa Donna, the European Breast Cancer Coalition, as well as Head of the Breast Surgery Department, Athens Medical Center, Greece, said: “Patients with metastatic breast cancer face various challenges not only because of their disease but also because of the stigma they encounter in society and in the workplace, which unfortunately still persists. There are disparities not only across Europe but within countries regarding access to multidisciplinary quality care, information and innovative new treatments. In order to bridge the gap between patients who get the best care and those who do not we have been working on this manifesto for the implementation of effective health policies for patients with metastatic breast cancer.”

The manifesto is divided into four categories: stigma, registries and real-world data, multidisciplinary care, and quality indicators. It will make seven recommendations:

1. Address the stigma experienced by patients with mBC by increasing the visibility of the disease to society, and facilitating patients’ involvement in trials, the workplace and everyday life.
2. Implement a national cancer registry recording stage at diagnosis and relapses in every European country in order to understand how many people are living with mBC. Currently, prevalence is unknown.
3. Real-world and registry data should be used to improve access to treatment, trials and services, and to evaluate outcomes.
4. Ensure all European patients with mBC have equal access to high-quality, multidisciplinary information and care.
5. Ensure implementation of newly-established quality indicators across Europe to help monitor, implement or adapt policies to ensure equitable access.
6. Rate the importance of interventions beyond anti-cancer drugs by developing and introducing a tool similar to the ESMO Magnitude of Clinical Benefit Scale (MCBS).
7. Re-allocate European funding to level up care. This will help to improve access to care for the elderly, those living in rural areas, those with lower educational or socioeconomic status, and those with reduced financial means.

Prof. Ignatiadis, Director of the Breast Medical Oncology Clinic at the Jules Bordet Institut, Université Libre de Bruxelles, Belgium, and Chair of the Breast Cancer Group of the EORTC, said: “The above seven recommendations summarise our view on the key priorities for addressing inequalities across Europe in access to innovation for patients with metastatic breast cancer.”

Manifesto session: Addressing disparities in access to innovation for patients with metastatic breast cancer across Europe.
Silver room at 14.00 hrs CET, Friday 22 March