Precision Oncology – the new way forward | The Financial Express

Precision Oncology – the new way forward

With the advancement in the science behind the treatment, the survival rate is relatively better without compromising quality of life significantly.

AstraZeneca, India-Sweden Healthcare Innovation centre, Lung Cancer, Lung Cancer in India, healthcare news,
The constant increase in the incidence of lung cancer highlighted the need for healthcare organisation around the world to come together, collaborate and innovate the way lung cancer was addressed. (File)

By Dr Amit Verma

Cancer has been a menace, an incurable disease for many years with dismal outcomes. Various options including surgery, chemotherapy, radiation therapy is offered to the patients but most of them fail eventually. This approach is traditional and called blanket or conventional treatment which is based on the tumor type and staging. As opposed to the traditional ‘one size fits all’ approach, personalized treatment is offered to the individuals based on the tumor molecular profiling. This contemporary science is called ‘Precision Oncology or Personalized Cancer Medicine’ approach.

This involves deep diving of the tumor genomics, transcriptomics, proteomics, phospho-proteomics, metabolomics and
epigenetics. Understanding the tumor biology gives insights of the mechanism driving the cancer and targeting them with newer drugs like target therapy and immunotherapy have shown to have better response rates, progression free survival and overall survival, and they bear fewer side effects as compared to chemotherapy.

The contemporary comprehensive treatment approach based on the newer science of precision oncology is practiced with the aim of providing the right treatment for the right patient at the right time. This approach empowers the patient and offers multiple treatment options that are tailored treatment plan based on genomics and offer a strategy for cancer prevention. With the advancement in the science behind the treatment, the survival rate is relatively better without compromising quality of life significantly.

This scientific approach is enabled by the high-end technologies to understand the genetic and epigenetic alternations in tumour cells that help to understand the underlying mechanism of cancerous transformation. These technologies are not only limited to studying the genes (at DNA level) but their effect at both, RNA and protein level. The common technologies used are Polymerase Chain Reaction (ARMS, methylation specific PCR), Sequencing (NGS and sanger), Fluorescence In Situ Hybridisation (FISH), Microarray, Karyotyping for the purpose of identification of four classes of genetic alterations i.e., Single
Nucleotide Variations (SNV), insertions and deletions, Copy Number Variations (CNV), translocations.

All this information is discussed with various oncology experts in Molecular Tumour Board to reach out on the treatment consensus depending on the results of the testing and molecular signatures identified. Few treatment options offered are beyond the conventional guidelines and are considered experimental. The patient is empowered to make the choices between the conventional and contemporary treatment options. There are various factors governing the choice of treatment and one may be the eligibility of the patient for particular targeted therapy. Sometimes, treatment offered are contemporary with single or combinatorial approach of various modalities of treatment including target therapy, immunotherapy, hormonal therapy, chemotherapy along with radiation and surgery.

Like any other treatment modality, following the path of precision medicine also comes with challenges and sometimes the financial crisis can be the biggest one. Cancer is one of the few diseases which are most expensive to treat globally as the treatment can be prolonged in some or the other way. Few factors which lead to the financial toxicity are the type of
cancer, age, income, medical insurance coverage, etc. The toxicity is likely to be more in relapsed cases, advance stage cancer, cancer with poor prognosis, or in cases where patients have other comorbidities along with cancer. All of these have to be considered and understood well while counselling the patient and the attendant. As precision oncology approach uses oral targeted therapies quite often, in addition, it is more efficacious with fewer side effects in most cases and thus, requires less hospitalisation saving money in long run and comes out of to be cost effective. The quality of life is maintained following the precision oncology way making the earning capability of the patient and family intact.

Efforts are being made throughout the country to make the cancer care and precision oncology, the new way forward for the cancer treatment, more accessible and feasible for all the patients who are needy.

(The author is a Molecular Oncologist and Cancer Geneticist, Dr AV Cancer Institute of Personalized Cancer Therapy and Research, Gurgaon. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the

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First published on: 07-02-2023 at 13:00 IST