Over the last six months, several major studies have laid bare the threat posed by antimicrobial resistance (AMR) to cancer patients.
In the past 20 years, cancer medicine has been revolutionized by an array of new treatments, ranging from monoclonal antibodies to novel immunotherapies like CAR T-cell therapy, and targeted therapies like tyrosine kinase inhibitors. Some have played such a major role in improving survival rates that they have now been added to the WHO Model List of Essential Medicines.
But in parallel, a silent crisis has been brewing, one which threatens to reverse much of the progress that has been achieved. Over the last six months, a couple of major studies have laid bare the threat posed by antimicrobial resistance (AMR) to cancer patients.
Published by the Cancer AMR Consortium – a new partnership between the AMR Action Fund, the Union for International Cancer Control (UICC) and medtech company Becton Dickinson – these studies have revealed that infections are the second leading cause of death in cancer patients, often driven by drug-resistant bacteria. In particular, hospitalized cancer patients are also 1.5-2 times more likely to have infections caused by various gram-negative or gram-positive bacteria, which are resistant to multiple antibiotics, than hospitalized patients without cancer. (Full disclosure, I sit on the board of the AMR Action Fund, a global initiative that aims to bring two to four new antibiotics to patients by 2030.)
In the past 20 years, cancer medicine has been revolutionized by an array of new treatments, ranging from monoclonal antibodies to novel immunotherapies like CAR T-cell therapy, and targeted therapies like tyrosine kinase inhibitors. Some have played such a major role in improving survival rates that they have now been added to the WHO Model List of Essential Medicines.
But in parallel, a silent crisis has been brewing, one which threatens to reverse much of the progress that has been achieved. Over the last six months, a couple of major studies have laid bare the threat posed by antimicrobial resistance (AMR) to cancer patients.
Published by the Cancer AMR Consortium – a new partnership between the AMR Action Fund, the Union for International Cancer Control (UICC) and medtech company Becton Dickinson – these studies have revealed that infections are the second leading cause of death in cancer patients, often driven by drug-resistant bacteria. In particular, hospitalized cancer patients are also 1.5-2 times more likely to have infections caused by various gram-negative or gram-positive bacteria, which are resistant to multiple antibiotics, than hospitalized patients without cancer. (Full disclosure, I sit on the board of the AMR Action Fund, a global initiative that aims to bring two to four new antibiotics to patients by 2030.)
Chemotherapy, for example, can destroy the protective lining of the gut wall, making it more likely that drug-resistant pathogens will end up circulating in the blood, while patients are often fitted with a peripherally inserted central catheter (PICC line) to deliver drugs or nutrition, something which also comes with a raised infection risk.
“Antimicrobial resistance disproportionately impacts patients with cancer, because many have weakened immune systems that make them completely reliant on effective antibiotics,” says Satlin.
According to Shalini Jayasekar Zürn, Senior Advocacy Manager at the UICC, the growing burden of resistant infections is also making it harder to treat many people with cancer. For example, when patients undergo surgery to remove a tumour, they are often given prophylactic antibiotics to prevent post-operative infections. But if those drugs do not work so well, this can greatly delay recovery.
“You can also have people living with cancer, on treatment with chemotherapy, but if they develop a multi drug-resistant infection and require an extended hospital stay, their treatment is delayed, giving the cancer time to progress,” she says. “Sometimes you get patients who actually die of the infection before the cancer.”
By: Juergen Eckhardt, Forbes