Doctors unhappy with tailored drugs

Hyderabad: Is precision medicine required for everyone suffering from cancer? This is a tricky question for the vast and varied population of India, where cost plays a major role in treatment protocols.

Precision medicine is a model treatment module customised in terms of medicine, an oncologist’s approach, and the utilisation of special drugs. 

However, it is a costly affair, as it is a tailor made medical regimen to suit a particular patient, and not accessible to all.

In India, there have been 5,000 documented and published cases of precision medicine which have been used for lung, breast and liver cancers and disorders.

Apollo Cancer Institute director Vijay Anand Reddy said, “The experience with precision medicine has not been very happy. It was found to work in 25 to 30 per cent of cases only, and just 10 per cent of all patients opt for this treatment. The costs are very high, too, and it is not for everyone.”

Some doctors say the use of precision medicine requires a lot of detailing and understanding of the disease aetiology and genetic profiling to optimise the care. Given the huge pool of patients and the increasing burden of cancer, to get such a regimen working for a large number of patients is not a workable solution, as it adds to the cost factor. At the same time, it can create disparities in treatment regimes.

Consultant surgical oncologist Praveen K. Dadireddy said, “For small tumours, a patient will be put on chemotherapy. But with challenging tumours, solid tumours for instance, liquid biopsies are used for most. In case of blood cancers, genotyping is done to understand the type of cancer. Similarly in breast, colon, lung and liver cancers, the treatment requires molecular and gene profiling, which is precision medicine. Eventually, there will be a large number of patients who will opt for it and the costs will come down as more and more facilities become available. At present, the cost of hospitalisation, side-effects, and loss of working hours are not being counted in case of traditional treatment, while it will probably be done away with in precision medicine.”

Experts state that this treatment requires better understanding and appropriate usage. But cost is still the biggest constraint and until it becomes affordable, it seems unlikely that many cancer patients will risk this treatment.