Can medical oncologists keep up with the pace of innovation in precision medicine? (first part)

by doctor Svetlana NikicPhD, Founder, Precision Oncology Consulting.

precision oncology medicine It is a concept within oncology, where genomic and genetic information from affected patients is used to personalize medical care to the unique characteristics of the same patient and their tumor. With the rapid and continuous advancements in the field of oncology, medical oncologists, oncology nurses and support staff have to stay updated with the latest advancements and innovations while managing their clinical responsibilities.

The discovery of new molecular biomarkers and the development of targeted therapies have significantly improved patient outcomes in some settings. These advances in diagnostic tools have led to more accurate detection and biological characterization of malignant tissues, resulting in more effective therapeutic decisions and patient access to the most innovative treatments. At the same time, these scientific innovations are advancing cancer research and clinical trials, generating valuable and essential evidence for adopting innovations in precision oncology into clinical practice.

However, even with these scientific and medical advances, many countries are facing a shortage of health workers. In Europe, the shortage of health care personnel, particularly in cancer care, has increased due to an aging population, rising cancer rates, and a lack of investment in training and retaining professionals. Furthermore, uneven distribution and migration of professionals adds to the problem. In the Dominican Republic, similar challenges are faced, such as limited access to services and financial barriers, making cancer diagnosis and treatment difficult. However, there are opportunities for improvement through screening programmes, strengthening infrastructure, multidisciplinary approaches and promotion of research.

That said, inequities in access to biomarker testing and more innovative treatments is a concern that affects many people around the world, so it’s important to think of innovation as a tool that addresses these inequities rather than exacerbating them. Will reduce.

It is undeniable that the field of precision oncology is undergoing a revolution, and we are fortunate to be a part of it. However, the question arises: how can cancer care professionals maintain this pace of innovation while fulfilling their clinical duties? New molecular methods used for molecular assessment based on next generation sequencing (NGS), along with more established methods such as artificial intelligence (AI), immunohistochemistry (IHC) in digital pathology and imaging technologies, are some of the new Tools that allow the evaluation of relevant biomarkers that discriminate between cancerous and benign lesions. Together, these data inform medical oncologists about cancer aggressiveness, patient prognosis, and help determine specific treatments for each patient.

Importantly, most of these instruments are available through a variety of commercial vendors and laboratories, primarily through non-standardized solutions using various commercial kits. Even the use of well-established IHC has shown worrying discrepancies, highlighting the urgent need to define a standard by establishing limits and procedures for these tests.

As an example, IHC is used to measure the expression levels of certain proteins, one of them is HER2, which is now emerging as a new pan-cancer biomarker. Cancer patients who have overexpression of the HER2 gene benefit from anti-HER2 therapy. It is important to be able to differentiate between negative patients and even patients with low HER2 expression, as this differentiation can have a significant impact on patient outcomes and the selection of appropriate therapeutic strategies. The American Society of Clinical Oncology (ASCO) together with the College of American Pathologists (CAP) have developed a set of recommendations for HER2 testing, aimed at guaranteeing accuracy and reproducibility in different laboratories, as in the European Done by the expert group. Society of Medical Oncology (ESMO).

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