‘Despite promise, personalized medicine for head and neck cancers facing hurdles’

Head and neck cancers are a significant public health concern in India. Traditional treatment approaches, often involving surgery, radiation therapy, and chemotherapy are effective but can come with side-effects. Personalized medicine provides hope for patients by offering treatments that are more targeted and effective, with fewer side-effects. Personalized medicine takes into account finer aspects of the cancer’s behaviour as well as the patient’s body to optimize outcomes. April is head and neck cancer awareness month.

Interview with Dr. Deepak Sarin, Vice Chairman, Head and Neck Cancer Thyroid and Parathyroid Surgery, Cancer Care, Medanta Hospital. 

What are the various kinds of head and neck cancers? 

Head and neck cancers are not uniform. These varied tumours originate from different sites, show differences in molecular composition, and react differently to treatment.

What are the benefits of personalized treatment?

Improved efficacy: By identifying specific mutations driving tumour growth, personalized medicine allows for targeted therapies that have a higher success rate compared to ‘one-size-fits-all’ approaches. This can lead to better tumour shrinkage, improved survival rates, and potentially higher cure rates.

Reduced side-effects: Traditional treatments often cause a range of side-effects due to their broad impact on healthy cells. Personalized treatments, by focusing on cancer-specific targets, minimize collateral damage to healthy tissues, leading to a better quality of life during treatment.

Predicting treatment response: Personalized medicine allows doctors to predict a patient’s response to specific therapies before treatment begins. Knowing this information upfront helps in selecting the most effective treatment and avoiding those with a low chance of success, sparing patients from unnecessary side-effects.

Identifying new treatment options: As research delves deeper into the landscape of head and neck cancers, it unveils new targets for therapy. Personalized medicine facilitates the exploration of these new potential treatments through clinical trials designed for patients with specific mutations.

What are the tools of personalized medicine for head and neck cancers?

Genetic testing: Analyzing the tumour’s DNA reveals specific mutations that can be targeted by existing therapies or it is used to identify patients who might benefit from clinical trials involving novel targeted drugs.

Immunotherapy: This approach leverages the body’s immune system to recognize and attack cancer cells. Personalized medicine helps identify patients whose tumours are more susceptible to immunotherapy by analyzing factors like the presence of specific proteins in the tumour cells.

Liquid biopsy: This minimally invasive technique analyzes circulating tumour DNA (ctDNA) shed by the cancer cells in the bloodstream. By analyzing ctDNA, doctors can track mutations over time, monitor treatment response, and detect potential recurrences earlier.

What are the challenges and the road ahead? 

Despite its promise, personalized medicine for head and neck cancers face hurdles. The high cost of genetic testing and targeted therapies can be a barrier for some patients in India, where healthcare costs can be a significant burden. Additionally, continuous research is needed to identify more actionable mutations and develop targeted therapies for a broader spectrum of head and neck cancers specific to the Indian population, as there might be genetic variations compared to other regions.

What about the question of ethics in genetic testing? 

It is essential to consider ethics when it comes to genetic testing and personalized medicine. Strict measures are needed to protect patient privacy and data security. Although there is potential for using artificial intelligence (AI) in analyzing data and choosing treatments for personalized medicine, this technology is still early in its development in India’s healthcare system.

What is the future of personalized treatment? 

Personalized treatment for head and neck cancers is a transformative approach that offers a brighter future for patients in India. By harnessing the power of genetic and molecular analysis, this strategy paves the way for more effective, patient-centric treatment with minimized side-effects. As research progresses, costs decrease, and access to testing improves, personalized medicine holds immense potential to improve the lives of head and neck cancer patients in India significantly.