The Way Forward in Cancer Treatment

The medical approach offers a way to design treatments tailored to the genetic profile of each patient's cancer

- Kavita Bajeli-Datt @New Delhi

When 69-year-old Arvind (name changed) was diagnosed with advanced small cell lung cancer (SCLC), his prognosis was grim. The disease is aggressive and long-term survival rates are low. Yet three years later, Arvind remains cancer-free, thanks to a combination of chemotherapy and immunotherapy.

"It's a remarkable turnaround," said Dr Amit Rauthan, professor and head of Medical Oncology, Manipal Hospital, Bengaluru. "We would not have expected such outcomes in advanced SCLC a few years ago. Immunotherapy has truly rewritten the survival narrative for many such patients."

He recalled another case—a young woman with an oncogene-addicted tumor who had failed multiple lines of targeted therapy and developed brain metastases. "She was emotionally and physically drained. We initiated chemo-immunotherapy combination including Atezolizumab. Not only did the treatment offer clinical benefit, it gave her renewed hope and control," said Dr Rauthan.

These stories are no longer anomalies but part of a larger trend in precision oncology, a field driven by molecular diagnostics, genomic profiling and immune checkpoint inhibitors.

According to GLOBOCAN 2022 estimates, India ranks third globally, after China and the US, with around 1.41 million new cancer cases. With over 1.5 million new cases and 800,000 deaths reported each year, precision oncology offers a way to design treatments tailored to the genetic profile of each patient's cancer.

"We are experiencing a remarkable shift, moving away from a 'one-size-fits-all' approach to highly personalized care," said Dr Prashant Bagali, Head of Scientific Affairs, MedGenome, India's only College of American Pathologists (CAP)-accredited genetic testing lab. "This is happening because of advancements in three key areas—genomic testing, artificial intelligence (AI) and immunotherapy."