Credence genomics:

Welcome cure for cancer

by Dhaneshi Yatawara

In the very near future a single drop of blood or a minute tissue part of the body will be able to predict what kind of drug will suit us best. Put it into a small handy looking machine and the result will come in a microchip. Sounds more like a scene from a science fiction movie.

Well, not anymore.

The global science world is approaching step by step to this level based on our genes. Specially to treat complicated and serious illnesses such as cancer. Wrong treatment can kill a cancer patient in addition to the natural killing it does to the body.

"Many new drugs manufactured in the world reach Sri Lanka and there are new technologies emerging. But with all this each year approximately 18,000 new cancer patients are diagnosed," said Dr. Mahendra Perera, a leading oncologist in Sri Lanka.

According to him, Sri Lanka still follows the evidence-based medication which is steadily fading from the world - meaning the medicine is chosen according to clinical evidence showing the effectiveness of the drug on a disease or diseases.

Characteristics

This gets complicated with the seriousness of the cancer and heavy expenses of the drugs. One fourth of the patients treated with evidence-based treatments die and that shows there is something wrong with it.

Genes are the magical spell in our body cells that determine our many characteristics. In the same process it determines our strength and weaknesses against disease. Such a specific method can predict our levels of reaction to medication based on our genetics which helps doctors prescribe drugs to treat specific to each individual, rather swallowing or injecting a drug that can treat a broader spectrum of diseases, presuming the sickness of the patient.

Such precision treatment has become possible in today's world with the development of the gene technology field which is called Next Generation Sequencing. NGS.

Reality

Though NGS is advanced and expensive it still can bring solutions to serious and complicated illnesses that doctors struggle to cure while saving the quality of life of the patient. Genetic disorders and cancer are the best examples.

In each moment in our lives we witness numerous medical advancements which are expensive and too far from developing countries such as ours where most patients heavily depend on the public health service.

It may look as it NGS is one of those. Fortunately the technology has reached our soil. Not just theoretically among academia. But as a commercial venture at a reasonable price.

Credence Genomics, the country's first commercial and biotechnology venture was initiated a week ago making precision treatment a reality. A subject new to the world the entrepreneurs take a risk in establishing such business where precision, credibility and cost affect the growth of the business.

In developed countries where each citizen is medically insured, choosing such an expensive method is possible. Thus the businesses have a market. With all the risks the Sri Lankan medical field welcomes such a venture in our soil for many reasons.

Cancer is caused by multiple factors and patients do not react equally to treatments. It is the complicated nature of the disease. Yet, NGS can simplify this at any given level and precise medication can be prescribed.

Treatment of primary cancer will not end the illness. Cancer can escape to any side be it liver, lungs, brain. But to treat the first level its only chemotherapy.

Chemotherapy

"There are so many drugs pouring in to the country and the doctors are also using them based on evidences available. We are purchasing millions worth of drugs but we do not see much response in cancer survivals," Dr. Perera said.

The cost of these medicine for chemotherapy are very expensive. "Sri Lankan Government today gives us 1.5 million rupees for one cancer patient for a year to purchase these drugs. This is in addition to the basic cancer drugs available in Sri Lanka, he said.

"If we take a similar cancer in 10 people they react in 10 different ways. Some patients may survive only for six months, some for few years and some for 10, 15 or 20 years even. Normally, the blame will be on the doctor. It is not anyone's fault, it is the genes of the system, according to the new findings," he said.

"Most of Sri Lankan patients go for private hospitals for consultation but due to the high cost for treatment they are referred to the Government hospital," doctor Perera added.

"Doctors aim at curing cancer. Proper curing has three aspects - biological, functional and psychological," he said.

Curing biologically doctors practically destroy cancer cells somehow. "But that does not mean the patient should not be compromised of his functions. Removal of a leg in the course of the treatment is not preserving his or her ability to function close to normal level at least. That is not a functional cure for the patient. At the same time the patient should feel that with the treatment that they are given a very near normal life. That is the psychological aspect," he explained.

"Cancer starts in a very small spot and keeps on progressing. Cancer is a multi factorial event. If we diagnose sore-throat we know that it is caused by streptococcal pharyngitis and can be treated accordingly. But in a cancer there are so many factors that play such as genetics and carcinogenic substances.

This is what triggers the abnormal multiplication of a cell. Cancer spreading in to other internal organs is another level of the disease," Perera said.

The answer is personalised cancer treatment. Personalised cancer treatment is the treatment to a patient based on his molecular characteristics. In this method a drug can be matched at a laboratory to suit the molecular structure of a patient. This way the precise drug or a drug regime can be identified. This is where NGS plays a crucial role.

It is important to diagnose the abnormal cell and treat the patient accurately, which is more successful.

What we need to do is maximise the efficiency of the treatment. We can avoid the severe adverse effect of cancer drugs that literally destroy the patient, Dr. Perera said.

This will be a comprehensive cancer cure at a very lesser cost where the patient will not suffer from the financial and psychological burden.