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March 3, 2017

Universal cancer care needs both technology and human touch

With Joe Bidens Moonshot Initiative, president John Kennedy’s moonshot mission in the 1960s – that landed a man on the moon – has become an inspiration for conquering cancer. Cancer is one of the leading causes of death worldwide, with more than 14 million new cases and 8 million deaths each year.

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The urgent challenge for universal cancer care is that many patients are not able to access or afford adequate treatments. To adress these problems, Joe Biden’s cancer moonshot to personalize cancer therapies and Barack Obama’s precision medicine proposals have initiated the mobilization of scientists, physicians, and healthcare stakeholders.

  • Precision medicine focuses on assessing and using genomic and other medical data to better characterize and manage diseases.
  • Personalized medicine aims to optimize treatments at the individual patient level.

Both initiatives derive from complementary technological and scientific achievements that advance medicine, but lack emphasis on the everyday struggles of cancer patients. To achieve universal cancer care requires both precision and personalized medicine, as well as integrated care, a multi-dimensional approach to ensure patients in need are aware of and have access to life-saving treatments. That at least is what Oscar Segurado, MD, PhD, Director of Medic Affairs Consulting LLC, believes.

Accelerated pace of breakthroughs

New technology helps to accelerate the pace of scientific breakthroughs in medical science, bioinformatics, and digital healthcare. Next-generation gene sequencing capabilities have transformed our approach to cancer and inherited diseases. Publishing the first human genome sequence in 2003 took the Human Genome Project 13 years and 3 billion dollars to achieve. Soon it will take hours and less than 100 dollars to obtain the same data.

Next-generation gene sequencing is especially relevant for cancer genomics, the study of gene defects that turn healthy, normal cells cancerous. These defects can be found in either germline genes (inherited and present in all cells) or in somatic genes (only expressed in certain cell types). Both defects are present in tumor cells. Their identification is essential to profiling, monitoring, and identifying therapeutic targets.

Cancer is a host of diseases that comprise many different tumor types and genetic subtypes, driven by individual genetics, lifestyle, and dynamic cellular processes. Accurate, high-speed, and low-cost ways of identifying genomic data is already revolutionizing cancer treatment. Also, the explosion of cancer genomic data is encouraging academic, clinical centers and the biopharma industry to collaborate and consolidate information.

Hurdles remain

Many hurdles remain. Some institutions are not ready or willing to share data and information. Then there is the incompatibility of databases that impair the free flow of genomic and clinical data. Many clinics are collecting doctors’ notes and pathology reports electronically, but most of information is unstructured and can’t be stored in conventional databases.

That is were borth the cancer moonshot and precision medicine initiatives come in. They address the standardization of data collection and how data sets are stored, which will potentially make them much more accessible. This is not just about data gathering, but about creating a 21st century infrastructure. The ability to search, analyze, and immediately act on genomic and clinical data will facilitate matching patients with existing therapies or cutting-edge clinical trials.

Collaboration needed

The original, lofty moonshot was achieved through unprecedented collaboration between US government agencies and scientific teams. Collaboration is essential because a true personalized approach to prevent, diagnose, and treat cancer goes beyond genomics.

While the relevance of nutrition and lifestyle for cancer is well-established, the immune system and the microbiome have recently emerged as game-changers for cancer management. Personalized medicine for cancer combines an individualized guidance to systemic treatments, surgery, and radiotherapy with interventions in nutrition, lifestyle, and other cancer-promoting drivers.

Integrating technology and human touch

Precision and personalized medicine, driven by big data analytics and artificial intelligence, cannot completely replace human interactions, especially the relationship between patients and caregivers.
To achieve truly personalized care, our healthcare system should integrate technology with the human touch, Segurado writes.

‘Patients should understand the basics of precision and personalized medicine and feel empowered to make decisions regarding how their data will be used for themselves and to save the lives of others. Only through joining forces and ensuring patient-centric healthcare can we become masters of the cancer universe.’

 

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