Earlier today, Munich Re published the latest chapter in its Life Science Report series, delving into ‘Improving Cancer Outcomes’ and how inroads into the prevention and treatment of cancer is supporting its evolution from a deadly disease into a chronic – but treatable – one.
Exploring the chapter in further detail in an interview with ReInsurance Business, Dr. Brad Heltemes (pictured), VP & medical director of R&D at Munich Re underscored the message it delivers to the reinsurance market. “There is an important shift underway in how we understand what drives the source and evolution of cancers. This will impact how cancers are diagnosed and treated, and lead to overall improvements in cancer survival. The insurance industry needs to be prepared for these improvements, as well as for changes in how cancers are classified.”
Outlining some of the key progressions being made with cancer genetics, Heltemes noted that this primarily involves the identification of various gene alterations that drive the development and growth of a cancer, and yet can differ significantly between two cancers that otherwise appear to be the same in location and appearance.
“An old example is how it was recognized that breast cancers expressing the HER2 gene had a worse prognosis than those not expressing it until a treatment targeting HER2 (trastuzumab) became available,” he said. “It has now been found that a number of other tumors outside of the breast also express HER2 and often respond to trastuzumab, whereas similar tumors in the same organ that do not express it will not respond.
“They are effectively different cancers, even though they would be considered the same by current criteria. Another example is the multiple different gene signatures seen with non-small cell lung cancers, each which responds to a different targeted treatment and each having a different prognosis.”
Long established patterns take time to change, he said, but there is definitely a movement toward the classification of cancers based more on their genetic/molecular profile in order to better align with the best treatment options and to make it easier to conduct relevant clinical trials.
Alongside these classification evolutions, new diagnostic tests and innovative treatments are also moving the dial on improving cancer outcomes. Heltemes highlighted that further improvements are projected, as well as an acceleration of cancer mortality improvement as more treatment targets are found and better treatments are developed. “This is an area of strong potential and pharmaceutical interest.
“Numerous drugs are being studied and many will likely make it to market in the next decade. As a result, many kinds of cancer are no longer a death sentence. Recent studies have demonstrated how a number of previously terminal cancers can now be managed similarly to other chronic diseases.”
Touching on what these improving cancer outcomes may mean for the life insurance sector, Heltemes noted with cancer diagnosis and treatments improving, patients will suffer less and lead longer and better lives. “This is good news for life insurance payouts and yet it poses a challenge for existing longevity models at the same time,” he said. “We will have to question our existing models in life and health insurance: life insurance payouts, longevity and costs of modern treatments will have to be considered in more detail.”
Since cancer is a leading cause of death, he said, these changes are expected to increase life expectancy for most groups of people and thus impact longevity markets unfavourably for insurers. Yet, with the help of this, knowledge people will hopefully not only be living longer but also in better health.
For the team at Munich Re, he said, reports such as this reflect the work being done behind the scenes to push the boundaries of insurance. Because of the expected impact of the changes addressed above, and the speed of change, it is deemed crucial that insurers keep attuned to the trends and the science.
“And since this is challenging and can be resource intensive, it can help to partner with companies that have that kind of expertise,” he said. “With these kinds of reports we can send out decent signals to the market about which topics we consider relevant for the years to come and even for the next decade.”
