Genomics

The traditional paradigm of tumor profiling for a single gene mutation in cancer involves multiple tests, each targeting a single gene and revealing only a portion of what is happening within the tumor, and can lead to a "one size fits all view of possible therapies. This is effective in some cases but can lead to increased cost and a longer time to get the answer. This strategy is successful when it leads to innovation and improves standard of care but fails when it becomes trial and error.

A time has come when there is a need of complete paradigm shift for comprehensive cancer care by adopting 'Next Generation Sequencing Technologies' to add a differentiation in cancer classification and patient stratification and understand an individual patient's response to targeted therapies .This will enable physicians to go beyond the one-size-fits-all model of medicine to make the most effective clinical decisions for each patient.

The mission of this 'Cancer Genomics' centre is to support multiple physicians, and their patients with the most accurate and advanced tumor profiling of multi gene "actionable" mutations, specifically designed to identify targeted therapies. These cost effective tests using next generation sequencing will be offered throughout India and other geographies including Africa and South East Asia, to aggregate additional information on emerging cancer biomarkers in recent clinical studies for more personalized therapy decisions.

The benefits

  • This new paradigm of personalized medicine will break the cycle of 'trial and error medicine, and link the test to patient tailored action and evidence based therapy/ treatment plan. Multiple gene testing will be more cost effective in terms of changing therapy regimen, stratifying responders vs. non responders to drugs etc.

  • Using genomic markers for chemo-sensitivity/ chemo-resistance may dramatically improve response rates to chemotherapy, significantly impacting the risk-benefit ratio for these patients.

  • The tests will also help to detect the hereditary cancer: examples include testing for mutations in BRCA1or BRCA2 in unaffected women to identify those at significantly elevated risk for developing breast and ovarian cancers, colon, thyroid and other cancers. A potential tool for screening patients with newly diagnosed cancers and their family members for risk predisposition to reduce morbidity and mortality.

  • Sr. No. Test Description Benefits of NGS Based Cancer Mutation Panel Testing
    1 Germline Mutation Panel [Single or multiple cancer type or total 86 genes] Predict risk, risk estimation, institute early surveillance measures
    2 Somatic Mutation Panel [48 genes hot spot panel] Selection of therapy, indicate responsiveness to chemotherapy, sensitivity to a particular therapy
    3 Colorectal Cancer Panel [APC, BRAF, EGFR, KRAS, MET, NRAS, PIK3CA, PTEN, SMAD4] Indicates appropriate FDA approved/NCCN recommanded therapy (Cetuximab, Panitumumab, Bevacizumab, 5-FU, Oxaliplatin)
    4 NSCLC Panel [Alk (by FISH), BRAF, EGFR, ERBB2 (Her2), KRAS, MET, PIK3CA, VHL] Indicates appropriate FDA approved/NCCN recommanded therapy (Erlotinib, Afatinib, Trastuzumab, Bevacizumab, Crizotinib, Ceritinib, Vemurafenib, Dabrafenib)
    5 Breast Cancer Panel [ERBB2 (Her2), EGFR, PTEN, PIK3CA, SMAD4, VHL] Indicates appropriate FDA approved/NCCN recommanded therapy (Trastuzumab, Pertuzumab, Lapatinib, Evrolimus, Tamoxifen, 5-FU, Bevacizumab)