Need to accelerate cancer research in India-Amit Chopra, Managing Director & VP/GM, India and Middle East, Thermo Fisher Scientific
Cancer Research in India
There is a dramatic increase in cancer incidence and mortality in the country over the past several decades. Nearly a million new cases of cancer are diagnosed annually in India. The increase is primarily due to increased usage of tobacco, limited access to proven screening methods, and poor treatment outcome. On an average, approximately 15 percent of the diagnosed cancer patients opt for treatment, while the notable majority cases remain untreated.
But over the last decade, India has made giant strides in cancer research. Research institutes have been collaborating with healthcare providers to plan and coordinate activities related to epidemiological research, as well as partner in activities involving cancer registries. India has also improved surgery and radiotherapy facilities in the healthcare infrastructure today. Clinicians, scientists, and government and state policy makers in India have championed cancer research, from studies to achieve low-tech, large-scale health outcomes to some of the most advanced areas of fundamental cancer science. However, despite these important contributions, India still does not have developed public health policies to guide implementation of early detection strategies.
Cancer Research Challenges in India
Cancer research in India is a complex environment and is different from many developed countries. India has a tradition of practicing alternative forms of medicine like homeopathy, Ayurveda, Siddha, Unani and Yoga, among others. These forms of alternate medicine do not believe in surgery. Second, the life-threatening cancers in India are different from what one finds in the U.S. Cervical cancer, breast cancer and oral cancer are three of the most dangerous forms of cancer in India, whereas in the U.S. lung cancer is the most life-threatening
Technology and Solutions
Studies of cancer genetics and medical oncology are the dominant work in the Indian cancer research community and receive more than 30 percent of total research output. Research for surgical oncology, the main method of control and cure of cancer, makes up 9 percent of the total, and the proportion dedicated to radiotherapy research is even lower. Several other crucial areas of research such as palliative care and health services and outcomes research don’t receive adequate attention. The key to achieving this lies in transforming cancer care. This includes early detection, accurate diagnosis and effective approach to disease management and therapy.
Early Detection: Early detection of cancer directly impacts the rate of mortality. Statistics show that the introduction of the Pap smear test reduced the deaths due to cervical cancer in women in the U.S. Similarly, timely screening for colorectal and breast cancer has resulted in a decline in the mortality rates of these cancers.
Diagnosis: Technologies and solutions aimed at targeting Next-Generation Sequencing (NGS) and Assays can empower researchers as they seek to develop new ways to diagnose and manage cancer.
With appropriate technology and support, cancer researchers can:
Examine multiple genes in a single run with a fast turnaround time
Efficiently and quickly identify biomarkers
Ensure preservation of samples by deploying as little as 1 ng per reaction and is compatible with formalin-fixed, paraffin-embedded (FFPE) samples.
In addition, advance solutions for research in the areas of liquid biopsy, hematology and immuno-oncology are also being carried out globally. Liquid biopsies aimed to isolate biologically more relevant cells in a tumor (using cell-free DNA (cfDNA)) than concentrating on the entire tumor composition require only one tube of blood to conduct comprehensive testing, using Ion Torrent technology in combination with targeted NGS.
Oncomine assays are designed to offer reliable performance with limited FFPE and fine-needle aspirate (FNA) samples. The Oncomine assays are multi-biomarker NGS assays, which allow concurrent analysis of DNA and RNA to simultaneously detect multiple variants such as hotspot mutations, single nucleotide variants (SNVs), copy number variants (CNVs) and gene fusions in a single workflow. These assays are designed to detect mutations that have clinical utility in diagnosis, prognosis or therapeutic intervention for certain solid tumors including those present in the lungs, colon, skin, breasts and bladder.
The Path Forward
Cancer research has reached advanced levels with available technologies such as targeted NGS, liquid biopsy and diagnostic assays. These technologies are designed to help doctors detect the presence of cancer without having to examine the tumor tissues alone. Future advancements will continue to provide more information about a patient’s molecular profile, which is critical to better diagnosis and outcomes.