Adopting Cancer Genomics: The Road Ahead

Molecular science continues to offer enormous potential in transforming the current strategies undertaken to prevent, diagnose and treat cancer. Genetic research over the past few years has rapidly increased the incorporation of such solutions in clinical practice. With the benefits of genetic testing getting increasingly established, efforts must be made to increase access to genomic services for all who can benefit. India is at the cusp of a revolution in biotech innovation, and genetic tests offer diverse purposes, including screening and diagnosis of genetic disorders, prediction of drug responses and identifying therapies that provide personalized cancer care.

The focus for genetic tests is not just confined to the identification of targeted therapy' for specific cancers. Genetic testing is commonly utilized for hereditary screening beyond the BRCA gene mutation testing for breast cancer. Newer evidence and data points, along with available screening tools, are now available with healthcare professionals that identify individuals who can benefit from such tests. Greater access to credible and reliable information, along with consumer involvement in healthcare decision-making, is accelerating the pace of this change. Genomics also allows clinicians to prevent serious adverse drug reactions to certain medicines, and eliminate unintended patient harm. The science is aiding better understanding of genetic change in tumours, and new, highly personalized medications are being used that target the genetically different subtypes of cancers. Genetic counselling is advised to help understand and manage the result and impact of such tests.

The wide range of genetic testing, the variance in the approach to sequencing and the technologies used, along with the regular entrance of new solutions impact and influence physician adoption. However, the incorporation of precision medicine into clinical practice is not driven by genetic information alone. A number of lifestyle behaviours and habits can significantly hamper or potential experts risk mitigation strategies being adopted by healthcare experts in managing disease risks. Genomic risk assessments need to encourage positive behavioural change that is complementary to existing health promotion activities. The ability of genetic testing to demonstrate a reduction in healthcare costs can positively influence insurance coverage decisions, leading to more patients undergoing such tests, provided they demonstrate better clinical outcomes, offering actionable solutions for clinicians and patients.

To state that there is room for improvement for bringing the latest biotechnology to the care pathway to the cancer patient reflects a genuine understatement. The current drug development cycle needs to be redesigned taking into account the entire costs involved, and genomics has the potential to enhance our understanding of how this can translate into more effective and affordable care. Patients and caregivers need to be informed about the latest scientific advances, and improved treatment access is required not just to connect them to trained clinical experts, but also drug therapies that are available and financially accessible. The lack is trained genetic counsellors reflects a serious limitation in creating a bridge between the clinician and the science. The availability of unsupervised genetic tests raises ethical and social concerns, and as society becomes more digitized, protecting the privacy of genetic data becomes even more imperative.

The cancer burden will continue to increase over the next 15-20 years, with much of this increase seen in parts of the world where the health systems are already struggling. New generations of cancer treatments often promise only an extended remission from disease and not cure, in addition to placing an important financial burden on health services. We will find alterations in operating models, which will need to focus on better and sustained health outcomes, not just cost containment. The proportion of patients receiving genetic tests will only increase as more data points enumerate the benefits of such solutions. Increasingly, data capture related to clinical treatment, molecular, and imaging records needs to be constantly gathered and combined with predictive analytics to deliver best-practice care. However, additional factors like regular cancer screening, healthy eating, vaccination, and avoiding tobacco and alcohol consumption remain critical strategies to not just preventing cancer, but also reducing the detrimental effects of cancer.

It remains critical to invest in one’s own health; to go get a regular and personalized health check! No investment is sounder than one in your own health.

Dr Vineet Datta

Guest Author The author is Executive Director at Datar Cancer Genetics.