Dr. Bodoky Gyorgy, founder and Honorary President of the Hungarian Society of Clinical Oncology (MKOT), explains the activities of the society, the multi-stakeholder collaborations MKOT has, the challenges of oncological treatments in Hungary, the impact of immunotherapy in oncology, and the future objectives of the society.
There needs to be more push for screening programs and diagnosis in oncology.
Can you introduce yourself and the activities of the Hungarian Society of Clinical Oncology (MKOT)?
The society was founded 20 years ago and is primarily dedicated to education. The mission of MKOT is to make oncologists aware of the newest therapies, medical devices, and practices in this field. To encapsulate as much knowledge and experience as possible, the society coordinates and organizes congresses and symposiums with national and highly recognised international speakers for Hungarian medical oncologists.
During the bi-annual national MKOT congress symposiums are catered to resident doctors, oncological nurses and pharmacists as well to provide them with the most up-to-date information that is pertinent to their field. Resident doctors can engage in competitions, and the winner is then sponsored by the society to attend international oncology conferences.
Every year a dedicated conference is organised after the Annual ASCO congress to highlight the most beneficial and important therapies and practices for oncological patients. This is a very successful annual meeting for MKOT as around 80% of the practicing medical oncologists in Hungary attend them yearly. Furthermore, a two-day thematic congress is organized bi-annually dedicated to specific topics like immuno-oncology, breast cancer, and urogenital cancer, where the selected topic is discussed and presented in detail.
The society also publishes the Hungarian review journal entitled Clinical Oncology which is published four times a year. The format of this journal is the same in each issue and it features seven of the most prominent articles to date. Three articles focus on clinical oncology while the others are about microbiology, oncological support, an opinion piece by a prominent oncology leader, and special interests which can be helpful to this medical field (e.g. AI, alternative medicine). There are 2,500 copies printed of each issue which are distributed among post-graduate students and medical doctors as we believe that continuing education is a must in the fast-evolving oncological sciences.
The society does not only focus on doctors but also on patients, through supporting an advocacy group and patient-education. It provides the group anything from clinical information to representation in health insurance discussions. Additionally, MKOT aims to educate oncology patients by providing a free printed journal which is also available online. Around 5,000 printed copies are distributed to medical centres annually, while the online version is increasingly getting more popular, with 1.5 million downloads yearly.
What do you see as the main challenge in oncology in Hungary?
There needs to be more push for screening programs and diagnosis in oncology. Hungary was one of the first countries to introduce mammography and gynaecology screening, but there is still room for improvement in attendance. Last year colorectal screenings were introduced and we hope that they will be successful in the at-risk population. Every year there are over 10,000 new colorectal cancer cases and a loss of about half the patients. The hope is that the number can be reduced to 2,500 through preventative screening mechanisms introduced by the government. We need to increase health awareness among the population and keep educating people about the importance of screenings.
Patients arrive at their physicians with cancer in later stages, partially due to a lack of medical literacy and a complex patient pathway and diagnosis. MKOT tries to improve the situation by engaging the GPs by providing courses for them about the first symptoms of malignancies and the optimal diagnosis pathway.
Oncological treatment is centralized in Hungary so patients can be treated in specialized oncology centres. Furthermore, by law, patients need to be treated by a multidisciplinary oncology team, a so-called tumor board, which allows the most efficient treatment for patients.
How do you see the treatment of cancer evolving with the integration of immune therapy?
Immune oncology is a new paradigm for some cancers like melanoma, lung cancer and kidney cancer. However, for example in the case of gastrointestinal, colorectal, or liver cancer it is too early to apply immune therapy as the results do not reveal conclusive answers. Targeted therapy is an area in oncology that is increasingly developing as well and several start-ups are growing in that field. Oncompass is one of those, which develops, manufactures, and sells genomic analysis diagnostics for solid tumors and circulating cancer cells to identify the best treatment pathways.
What is the importance of clinical trials in the fight against cancer?
Clinical trials offer a great opportunity for patients to access new therapies and for doctors to gain hands-on experience. Furthermore, these trials offer Hungarian investigators both financial assistance and scientific prestige. Hungary in general boasts a very innovative and well-organized infrastructure for clinical trials. For example, in my department we have study nurses and data managers alongside with well-trained and experienced physicians. Pharmaceutical companies acknowledge that Hungary is an attractive country for clinical trials as the data are accurate and reliable, the approval process is smooth, healthcare professionals are highly educated, trained and motivated and – unfortunately – there are many patients to be enrolled in all kinds of studies.
Hungary is well prepared for clinical trials and has a rich ecosystem. The societies, institutions, medical practitioners, and the recruitment of patients allow for Hungary to be the leading country in Europe for accessibility and availability.
Could you tell us more about multi-stakeholder collaboration in oncology?
Our connection with pharmaceutical companies is imperative, as the society depends on support from these companies. During our meetings, there are pharmaceutical symposiums organised and the society has access to research and educational grants for colleagues. They collaborate closely with the society, however pharma companies fully accept and appreciate the fact that the society is independent when it interprets clinical results; thus they do not even attempt to influence the content of our scientific congresses or publications.
With the authorities, especially with the insurance authority, the relationship is very close-knit. Judit Bidlo—Deputy Director-General of Price Support, National Health Insurance (NEAK)—attends all the meetings and provides constructive feedback on the best course of action. Furthermore, she is a keynote speaker every year at our congress, presenting the financial aspects of oncology treatments, their views on new innovative therapies and the current treatment outcomes of oncology centres and the issues that they are facing.
What are the objectives of MKOT in the next five years?
Education to have the Hungarian oncology experts at the highest level possible remains the main priority of the society. Also, we try to change the mindset around cancer within the society as it is still stigmatized. Cancer is one of the leading causes of mortality in Hungary, and despite that, there is still shame associated with this disease. Unlike in some other countries, patients in Hungary are not open to sharing their disease story with others, which would raise an open and hopeful discussion about this disease and would also raise awareness about the importance of screenings.
Access to the newest innovative treatments and drugs is also a continuous struggle, but we are quite good in this field. The list of available drugs and treatments accessible for oncology patients increases yearly thanks to the efforts of oncological societies, pharma companies and the national health insurance fund. However, the costs generated by oncology treatments are significant, which causes a certain delay until patients can get access to the newest innovations.
What is your final message?
The society has created a valuable network by connecting with the medical, industrial, and authoritative communities. Through the medium of education and discourse, the fight against cancer persists qualitatively. Additionally, changing the stigma surrounding cancer and also hospice is an important objective of the society.