Challenges in Implementing Precision Medicine in Oncology

By siliconindia  |  Friday, 28 June 2024, 13:02 IST

Dr. Vishal Rao serves as the chief of head and neck surgical oncology and robotic surgery at HCG Cancer Centre in Bangalore. He possesses extensive expertise in managing both benign and malignant tumors affecting the thyroid, parotid, and salivary glands. Dr. Vishal specializes in performing intricate neck surgeries, including radical and modified neck dissections, carotid body surgery, as well as the management of vascular tumors and parapharyngeal space tumors. Furthermore, he demonstrates a strong commitment to cancer prevention and anti-tobacco initiatives.

The advancements in science, medicine and technology have been intriguing in the last decades. In this expansive CXO interview discussion, shedding light on Precision Oncology, Dr. Prof Vishal U S Rao, Head Neck Oncologist - Robotic Surgeon, HealthCare Global fills the readers with information that is exclusive. Let’s delve in the excerpts!

Given the exponential growth of data in precision oncology, what are the main challenges researchers and clinicians face effectively managing and interpreting the vast amount of molecular and clinical information to improve patient's outcome?

One of the main things that I've noticed today is the exponential growth of data. This data comes from two sources: bedside to bench data, which comes from basic scientists and researchers, and bedside to bench data, which comes from clinicians. The future of oncology and precision medicine lies in translational medicine, which involves combining data from both researchers and clinicians to create clinically relevant outcomes for patients. This requires a collective effort from both ends, as the precision medicine revolution is moving toward a clinical scientist approach. This means that clinicians must also take on the role of a scientist.

How do the cost implications and accessibility barriers affect the adoption of precision medicine in oncology especially for patients and healthcare systems with limited financial resources? Also, what strategies can be implemented to mitigate these?

There are two main aspects to improving accessibility barriers in the field of healthcare. Currently, we heavily depend on the West for new drugs, technologies, and devices. To change this, we need to shift our focus to a ‘Make in India’ approach. This means that we should aim to develop our own science, innovations, and products instead of relying on imports. This shift would involve moving from merely ‘Making in India’ (importing and assembling products) to ‘Creating in India’ (completing every step of the process within the country). By doing so, we can utilize our talent pool and expand accessibility barriers.

In order to facilitate this shift, it's vital to increase collaboration between academia and industry. This collaboration can help bridge funding gaps for research and innovation. It's important to take responsibility for solving our own issues by fostering strong collaboration between academia, industry, and the government to encourage research, innovation, and emphasize the importance of patents and intellectual property.

What specific regulatory challenges must be addressed to facilitate the broader adoption of precision medicine therapies in oncology?

In the field of precision medicine in oncology, regulatory authorities post-COVID have expedited the time to market for innovations. Hospital ethics committees play a larger role, and collaboration between academia and industry is crucial to address regulatory challenges and ensure patient safety. More extensive discussions and meetings involving academia, industry, and regulatory bodies are needed to foster an environment where regulations support and facilitate innovation, rather than acting as obstacles. Hence, open dialogues with regulatory authorities and funding support from governments can certainly lead to streamlining the regulatory process, enabling innovative treatments to reach patients more quickly.

In the context of implementing precision medicine in oncology, how can interdisciplinary collaboration between researchers, clinicians, data scientists, and other stakeholders be enhanced to overcome the inherent challenges and foster innovation?

It is crucial to have a clinical scientist approach in precision medicine, especially in oncology. This requires interdisciplinary collaboration across various domains, not just limited to researchers, clinicians, and scientists, but also involving finance, legal, and non-domain science experts. I am currently engaged in collaborative efforts with a mathematical oncology team and a quantum physics team to study biology. This kind of cross-collaboration between different disciplines is breaking boundaries and integrating domain experts with non-domain experts to advance precision oncology. Regarding novel strategies and technologies for addressing tumor heterogeneity and their impact on treatment decisions in precision oncology, the focus is on leveraging biologic advances in technology. Scientists, researchers, and innovators are working to bridge the gap using technological advancements.

What novel strategies and technologies are being developed to tackle tumor heterogeneity, and how do they impact treatment decisions in precision oncology? How can these approaches be integrated into clinical practice to optimize patient care?

When discussing a novel approach in oncology, it's essential to bridge biological and technological advances. This includes addressing unanswered questions in both tumor and patient care. The key challenge is to exchange meaningful and reliable data between technology and biology for informed decision making in precision oncology. This collaborative approach involves integrating digital pathology, genomics, microbiomics, and patient immune profilings to optimize patient care. Additionally, merging biology and technology in areas such as wearables and robotic surgery demonstrates the importance of collaboration between different fields to advance patient care.

What are the key considerations and best practices for safeguarding patient privacy and ensuring the security of sensitive data in precision oncology initiatives, particularly in the context of data sharing and collaborative research efforts?

I believe that all research conducted in clinical care settings by doctors, clinicians, and hospitals carries an inherent responsibility to be accountable to ethics committees, scientific committees, and regulations. The DCG has provided clear guidelines for this, and ICMR is holding regular training programs to ensure the standardization of best practices. Efforts are being made to ensure that ethics committees have a strong standing in the field, with regular audits, data sharing, collaborative research, and patient safety all being addressed in a structured and standardized manner. These considerations will help us achieve our goal of best practices.

What methodologies and approaches are being employed to clinically validate precision medicine strategies in oncology? Also how is it possible to accelerate the translation of promising therapies into clinical practice?

Well, to explain the methodologies broadly, it involves a conventional approach of moving from preclinical data and animal studies to phase 1, phase 2, phase 3, and phase 4 clinical trials. The traditional lengthy process of drug development has faced challenges, particularly with the emergence of COVID. To address this, there has been a shift in regulatory outlook, allowing for more innovative and accelerated approaches such as investigator-initiated clinical studies and synthetic biology. These new approaches aim to bridge the gap and speed up the translation of promising therapies into clinical practice.

ON THE DECK

siliconindia