How Precision Oncology is Transforming Patient Care by Professor David Thomas

Every person is unique, and so is every cancer. As a fundamentally genetic disease, the genomic profile of each cancer tumour is unique and determines the specific mutations that drive the cancer’s growth.

Rapid advancements in the field of precision oncology over the past decade have given us the ability to use genome sequencing to predict how a patient’s cancer will respond to existing treatments, such as surgery or drug therapy. Meanwhile, innovative digital health technologies that provide us with new ways to collect and analyse patient data using AI-driven algorithms have also emerged.     

The effects of these are transformative.

Patients no longer have to suffer treatment that is unlikely to work, and it takes the guesswork out of clinical decisions which means effective treatment, reduced healthcare costs and better clinical outcomes.

Optimising Treatment Through Genomic Medicine

Genomic medicine is the future for all cancer treatment, but will have its most significant impact on rare, high-mortality cancers like sarcomas and cancers of unknown primary.¹ In this arena, it is a complete game changer. Few therapeutic options currently exist for such patients due to the difficulty in diagnosis, the ineffectiveness of standard treatments and limited access to new therapies.

Previously, lung cancer was a disease with a very low treatment response rate. Now, up to half of all patients with lung cancer have the possibility of receiving treatment, which will make a massive difference to their survival.

Another example: identifying the KIT proto-oncogene target in gastrointestinal stromal tumours and discovering targeted therapeutics that work against that molecule has transformed survival rates for that disease. What’s more, it has opened up treatment options which have never existed before.

Equalising Access to Genomic Medicine

Precision oncology can improve efficiency of care and cut the number of ineffective treatments prescribed — particularly for billions of people in Asia Pacific. Asia Pacific is a large and complex region that has undergone rapid change over the past half-century. In addition, it contains a diversity of ethnicities, governments and health systems. Taking all of that into account, Asia Pacific will be an enormously vital influence in global health.

For that to happen, the regional healthcare ecosystem needs to be tailored to clinical challenges faced by cancer patients in Asia Pacific as well as to the various national healthcare systems involved. For instance, cancer is a significant cause of mortality in Australia, Singapore and South Korea — as it is in most higher-income countries. But you also have countries like Papua New Guinea, where communicable illnesses, neonatal mortality and infectious diseases are the major causes of death instead of cancer. Over the next 20 or 30 years, we will likely see enormous demand for genomics in the region, as the implementation of precision medicine rises in tandem with affluence.

As cancer risk is often genetically determined by genomic profiling of the germline, wider population-level screening availability in Asia Pacific may result in increased personalised risk management. My prediction is that genomics and precision medicine will increasingly spread out across the entire cancer journey in the pre-diagnostics space — where we might be able to identify people at differential risk and screen for them.

Prevention, early detection, curative therapy and personalised treatment of advanced cancers will all be affected by genomics and targeted therapies. I cannot think of an area of cancer care which will not be relevant for optimal treatment of patients going forward, in Asia Pacific or elsewhere.

Read more about healthcare’s challenges in the shadow of COVID-19 in our in-depth issue.