Will ‘precision’ be the name of cancer care?

As precision medicine reforms the landscape of healthcare and medical treatment around the world, experts hope to find in it what could be the finest therapeutic solution to cancer till date. This revolutionary cancer care model, while still primarily active only in research labs, offers exciting new possibilities of techno-
logy and innovation and might advance to clinical care soon.

Cancer has continued to baffle major research organisations, healthcare practitioners, and government bodies for decades. Estimates indicate approximately 9.6 million cancer-related deaths in 2018, amounting to 1 out of every 6 deaths globally. In India, the number of people suffering from cancer is reported to be at around 2.5 million, with over 7 lakh new cases and 56 thousand deaths yearly.

Despite conventional treatment options like surgery, radiotherapy and chemotherapy, there seems to be a dearth of effective options for patients and healthcare practitioners to choose from. Concerns such as widely experienced side-effects of cytotoxic chemotherapy and challenges in making early-stage diagnoses and predicting treatment response only add to the fear of this seemingly untreatable disease.

Inefficiency of the existing medical equipment to gain adequate information about the body’s response to drug treatment, genomic alterations of tumours and tumour recurrence
patterns press the need to intertwine data processing with customised cancer treatment plan-
ning. With precision or personalised medicine possibly coming to the clinical table in a few years, this seems conceivable.

What sits at the core of precision medicine science is devising a tailor-made treatment process for each patient with detailed specifics for the right drugs, doses, medication timing and course duration, by capturing data about his or her genetic coding, environment and lifestyle. Laying the groundwork for a participatory, predictive and preventive healthcare service delivery system, it offers an effective and scalable solution to today’s healthcare problems.

Within the realm of cancer treatment, precision medicine applies the best of micro-physiological systems and gene chip technology, to garner in-depth genomic data on growth status, metastatic potential, and environmental catalysts relating to tumours. Leveraging key insights from this data, it can predict treatment outcomes, provide prognostic information and indicate predisposition, fundamentally changing the approach to cancer treatment.

The concept of personalised medicine has been brought to mass-attention by Barack Obama’s 2015 Precision Medicine Initiative. Having been under wraps till a few years ago, the concept is being explored for the treatment of various chronic and life-threatening diseases. Recent evolvement in bioinformatics such as next-generation sequencing (NGS) has also revitalised its efficacy in studying genetic alterations accurately, thus making it ideal for targetting therapy for molecular cancerous tumours.

Oncologists admit that they have been subjected to some bit of ‘guesswork’ with regard to treating cancerous tumours, which have highly complex and heterogeneous gene structure. But the capacity of NGS technology to achieve low-abundance mutations and low-level mosaicism detection will possibly facilitate them to guide more effective treatment plans.

Clinical trials directed at helping patients with rare cancer to meet the right drug have shown an initial success. However, it would take genomic probe technologies to extract furthermore data on tumour behavior, and healthcare providers to process all the information so acquired into knowledge for precision medicine to entice clinicians.

Personalised, targeted

Contrary to the ‘one-size-fits-all’ approach, expecting all patients to get similar results for similar medication, precision medicine focuses on specific treatments by getting to the root of the illness. With digitisation and Internet of Things (IoT) coming together with healthcare systems, and costs of genomic sequencing dropping, personalised healthcare may soon be put out in the clinical practice space too.

This field of study cannot be pursued and mastered by one organisation — the entire medical research community must collaborate to explore a more dynamic approach to fighting cancer. Patients, research participants should be willing to share their gene and/or lifestyle data and healthcare experts must be roped in to draw useful insights from such data.

Both private and public-sector innovators can contribute to counter the technological, financial, infrastructural and process hassles. Academic institutions, medical centres, research organisations, governments must also come together to combine their experience and expertise and invest more time, money and efforts to support new research models that promise more prognostic than diagnostic results.

(The writer is Chairman & CEO, HealthCare Global Enterprises Ltd)