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Research continues in this field of precision oncology and there has been an explosion of novel drugs in this field
Various tests have been developed to try and detect genetic abnormalities within Cancer cells.
Cancer is nothing but an uncontrolled growth of abnormal cells, which can affect any organ. This growth is the result of mutations developing in genes involved in growth regulation and/or DNA repair of the cells. Mutations that are acquired during one’s lifetime are called sporadic mutations and are present only in the tumour cells. Some mutations are inherited from parents leading to increased susceptibility to a particular Cancer; such cancers are called ‘hereditary cancers’. These mutations are present in parental germ line cells and hence are detected in all cells of the individual. Dr Uma Dangi, Consultant-Medical Oncology, Fortis Hospital Mulund & Fortis Hiranandani Hospital, Vashi shares all you need to know:
Various tests have been developed to try and detect genetic abnormalities within Cancer cells. This has not only helped in a better understanding of the biology of Cancer, but also led to newer drug development targeting these mutations. Treatment that is based on targeting these mutations has been shown to improve responses and outcomes in cancers driven by them and forms the basis of Precision Oncology. In addition, it is possible to identify individuals who are at an increased risk of developing Cancer by doing genetic testing in people with a strong family history of Cancer. These people can then be offered prophylactic measures for prevention and/or stronger screening methods for early detection of Cancer. For example, Prophylactic Mastectomies or Oophorectomies for patients with a positive BRCA mutation.
Tests to detect such mutations are complex and involve isolating the Deoxyribonucleic Acid (DNA) and Ribonucleic acid (RNA) of the tumour tissue followed by amplifying and reading the genome to detect any abnormality. This requires special technology and expertise and can only be done in laboratories which have adequate infra structure for it. Due to the complex nature of the tests, the results may take two-to-three weeks or more. Sometimes, the test may fail if the DNA quality is poor, especially in old tissues.
If any mutation is detected, targeted therapy may be offered to such patients depending on availability of drugs. Patients may also be considered for clinical trials which study newer drugs directed towards these mutations. Many times, no mutation can be identified, and it may not be possible to prescribe targeted therapy to such patients.
The benefit of precision Oncology is personalized treatment based on the Cancer type. The goal is “to treat the right patient with the right treatment at the right time”. Currently it is mainly used for patients with advanced malignancy and those with limited options of treatment like certain rare cancers. While biopsy tissue is necessary for detecting many of these mutations, newer advances allow for detecting the same anomalies in the blood so that biopsy can be avoided. However, this is currently limited to a few cancers like lung, colon and breast.
Research continues in this field of precision oncology and there has been an explosion of novel drugs in this field. However, treatment with targeted drugs can result in tumour acquiring newer mutations leading to drug resistance. And repeated biopsies and testing as disease advances may be necessary. It holds great promise for revolutionizing future cancer treatments, offering more targeted and effective therapies. Advances in this field could significantly improve survival rates and quality of life for patients.
