All about precision therapy, and how it can help reduce cancer-related mortality by up to 98%

What is precision medicine?

Precision medicine, also called personalised medicine, traditionally used in advanced stages of cancer, now plays a key role even in early stages.“Early-stage cancers often have a better prognosis when detected and treated promptly. Precision therapy involves identifying specific genetic mutations in tumours, allowing doctors to choose targeted treatments that may be more effective than standard therapies. This approach can improve outcomes and reduce unnecessary side effects,” said Dr Mukesh Patekar, unit head, medical oncology at Artemis Hospitals.

From infectious diseases to once-pathology, hematology, medical geneticists, and medical oncology, Dr Biswal listed some of the branches where its role is “tremendous,” considering India has been named the cancer capital of the world. “The research in the field of oncology has led to a boost in ongoing research, and it’s also being translated into patient care,” said Dr Biswal.

What is the procedure?

The process begins with diagnostic tests, such as biopsies, where a tumour sample is analysed for genetic markers. A pathologist reviews the sample, determines its nature and adequacy, and prepares it for molecular analysis. “With new, advanced testing, even smaller samples are sufficient for analysis. Next-Generation Sequencing (NGS) helps identify molecular targets. Based on the results, a molecular tumour board recommends treatments, including off-label options and genetic counseling,” Dr Biswal said. These targeted therapies can complement traditional treatments like surgery and chemotherapy, said Dr Patekar.

Genetic screening is crucial in precision medicine, especially for those with a family history of cancer. Such individuals may undergo genetic testing to identify “abnormal genetic pathways”. “For instance, in women with a family history of breast or ovarian cancer, BRCA1 or BRCA2 mutations are often detected,” said Dr Mandeep Singh Malhotra, director of surgical oncology at CK Birla Hospital (R), Delhi. “In these cases, “preventive interventions can be considered, such as risk-reducing mastectomy, prophylactic oophorectomy after menopause, or the use of chemoprevention through hormone therapy,” he said.
The core principle of precision medicine is tailoring treatment to the individual, ensuring the right patients receive the right care. “This helps avoid overtreatment, which leads to unnecessary side effects, and prevents undertreatment, which leaves the patient vulnerable to cancer progression,” says Dr Malhotra.

Benefits

Helps identify issue

Precision therapy serves as a key tool to identify patients requiring intensive treatments like surgery or chemoradiation and those who can be treated with less invasive methods such as radiation alone. “One key application is identifying high-risk individuals more likely to develop certain cancers, allowing for preemptive interventions. For example, women with BRCA (breast cancer gene) mutations, who are at high risk for breast and ovarian cancers, can be identified early and receive preventive treatments at the right time,” said Dr Malhotra.

Make treatment decisions

Precision medicine is guiding treatment decisions, such as escalating or de-escalating therapy. For example, in throat cancer, specifically oropharyngeal cancer, precision medicine helps determine if the cancer is HPV-related, which may only require radiation, or smoking-related, necessitating more aggressive treatment.

Helps make lifestyle changes

Precision therapy also aids in making lifestyle adjustments. By analysing a patient’s genetic profile and environment, doctors can recommend intensive screening or lifestyle changes, potentially reducing cancer risk by up to 98 per cent, said Dr Malhotra.

According to Dr Atul Narayankar, consultant medical oncologist, Wockhardt Hospitals, Mira Road, precision therapy is a “game-changer” as it involves analysing the patient’s data, examining genetic profiles, understanding the patient’s lifestyle and environment, and then identifying the risk of any cancer. “This therapy is known to provide accurate diagnosis and make decisions when it comes to inculcating healthy habits and slashing down the chances of various types of cancer such as kidney and lung,” said Dr Narayankar.

Here’s what to consider (Source: Getty Images/Thinkstock)

Challenges

Although precision medicine is advancing rapidly, “it is not universally applicable to all cancers or accessible to everyone,” said Dr. Patekar. “Some cancers, like breast, lung, and melanoma, have well-established targeted treatments, while others may have limited options,” he said.

Affordability 

According to Dr Patekar, “The cost of precision medicine can vary significantly, often depending on insurance coverage and the specific treatments involved.”

Dr Biswal concurred and shared that affordability remains an issue. “Hopefully with more research, the drugs can be made affordable for the benefit of the patients battling with cancer,” he said.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.