Context: 

• As part of the U.K. ‘s ongoing ‘100000 Genome Project’, a study of over 13,800 cancer patients has been published suggesting cancer genomics could transform cancer care.
• Enhanced Customization in Cancer Therapy: The program showed how genome sequencing combined with regular clinical data could increase the level of customization in cancer therapy. 

About Cancer

• Cancer is a disease of the genome which is caused by changes in genes that cause some cells to divide in an uncontrolled way. 
• Causes: These changes can be inherited or acquired. Inherited genetic variants form the basis of many hereditary cancers, including breast and ovarian cancer. 
• Major Public Health Concern: Cancer has emerged as a major public health concern worldwide with about 20 million new patients being added every year. 
  • According to estimates from the World Health Organization, over the next ten years, the incidence of cancer will rise by about 60%, making it the second leading cause of death. 
  • According to the National Cancer Registry, there are almost 1.4 million new cancer cases in India alone each year, accounting for nearly 1 in 1,000 diagnoses among Indians.

100000 Genomes Project

• Genome Sequencing Analysis: Under this 100000 Genomes Project, researchers obtained, sequenced, and analysed the genomes of people with different types of cancers. 
  • Their analysis can be applied in clinical settings to guide treatment strategies for cancer patients.
• Identifying New Target for Treatment: The study found that a greater percentage of those with lung or bowel cancers as well as those with brain tumours had unique DNA alterations that may serve as new targets for treatment. 
• Insights into ovarian cancers and sarcomas: The study also provided insights that could reshape even the understanding of challenging conditions like ovarian cancers and sarcomas.
  • For example, approximately 10% of sarcomas (rare cancers of the bone and soft tissue) exhibited genetic changes that could impact treatment decisions. 
  • The researchers also identified a corresponding proportion of ovarian cancers as being potentially inherited.

Significance of 100000 Genomes Project

• Harnessing Genomic Medicine for Enhanced Cancer Care:  The impetus behind this study aligns with the vision of England’s public health system.
  • The National Health Service (NHS) has been keen on understanding how genomic medicine can be harnessed to enhance cancer care. 
• Realisation of Precision Medicine: The study signifies the realisation of the promise of precision medicine, envisioned with the launch of the 100000 Genomes Project.
• Under the project, patients were recruited as part of a larger genomics initiative whose focus was as much cancer as rare genetic diseases.
• Real World Applications: The lessons learned from it are finding real-world applications in some parts of the U.K. 
  • Hospital trusts in East Midlands are incorporating insights from genome-sequencing and referring individuals with certain genetic mutations to clinical trials for certain therapies.

Precision Oncology

• Precision Oncology is an innovative approach to cancer treatment that ensures  treatment is specifically designed and targeted to unique forms of cancer. 
• It’s the science of using each patient’s individual genetics – the genes that are mutated, causing their cancer to grow – to create a treatment protocol just for them, based on those genetic mutations.

Limitations of Precision Medicine in Cancer

• Requirements for Gene or Protein Alterations in Cancer Cells: Eligibility for participation in a precision medicine clinical trial requires specific gene or protein alterations in the individual’s cancer cells, aligning with the targeted therapy under investigation. 
• Accessibility Challenges: Access to precision medicine trials is frequently restricted to larger cancer centres, potentially limiting opportunities for participation among certain individuals.
• Increased Costs: Tests for gene and protein changes can be expensive, especially if many changes are being tested for, and insurance might not cover all testing costs.

Also Read: 

• Bio-Imaging Bank
• AktoCyte Tablets
• CAR T-cell Therapy

News Source: The Hindu