Cancer is a global health challenge, accounting for one-sixth of all annual deaths globally. It is a difficult disease to understand, with potentially fatal effects.
Oncology treatments are ever-evolving, challenging the concept of one-size-fits-all and normalization. Advances in cancer care have brought hope to cancer patients over the past two decades, courtesy of the ability of scientists and oncologists to better understand cancer biology and design treatment plans based on that knowledge. Every person is unique and so is their cancer.
At a basic level, cancer is a disease characterized by uncontrolled cell proliferation caused by abnormalities in genomic makeup and mechanisms. Cancer can arise from congenital genomic abnormalities such as mutations, deletions, gene amplifications or rearrangements, the body’s immune system, or as a result of external attacks such as tobacco, alcohol, chemicals, infections, and radiation. Precision medicine is a concept that involves designing a personalized cancer treatment strategy based on a thorough understanding of the mechanisms that cause a disease. Novel treatment modalities are being explored to increase survival and reduce side effects associated with treatment to maintain quality of life.
Although standard of care guidelines are specific to the type of cancer and may include different modalities of cancer treatment such as surgery, radiation, chemotherapy, targeted therapy and immunotherapy, the unique biology of each tumor is a major component of cancer care worldwide. has become an integral part.
A comprehensive plan of care with experts discussing the specifics of each case is a reality and not the future. This is usually accompanied by the identification of a clinical pathway, in which we uncover the specific mystery of that patient’s cancer. Beyond the mandatory specific histopathologic investigations, this is also accomplished by conducting comprehensive genomic analyzes and multi-analysis tests to study DNA, RNA, proteins, metabolic functions within cancer cells, and the tumor microenvironment.
Understanding cancer biology and developing treatment options based on that knowledge has revolutionized cancer management and disease outcome.
Biomarker discovery and designing therapeutic strategies based on them are concepts largely applicable to late-stage cancers. However, the field is progressing, and with it the use of precision medicine in cancer prevention is moving to an early stage where the goal is to prevent disease recurrence.
Targeted therapy and immunotherapy are two examples of novel therapeutic applications that are being used to enhance outcomes, improve survival, and make cancer treatments less morbid. In addition to improving outcomes in advanced cancer, such drugs are now being used to prevent cancer from coming back.
Although most of these drugs are now available at reasonable prices in India, immunotherapy is prohibitively expensive, restricting its use. Bringing these new drugs into the country for clinical trials is one way to boost access.
The field of immunotherapy, which includes cancer vaccines, adaptive T cell therapy, and CAR-T cell therapy, is another major area of advancement in optimizing oncological therapies. These techniques are mostly used in blood cancers, however, these strategies are emerging in solid tumors as well.
Genomic analysis and biomarker identification are so integral to cancer care that they are going to be an essential part of clinical investigation and critical for appropriate therapeutic application. The aim and effort is to reduce the cost of such testing and make them routine, so that informed decision making becomes the rule rather than the exception!
Disclaimer
The views expressed above are those of the author.
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