June 2015 822

Towards Personalised Medicine & Targeted Therapy

Diagnosis today is more widely used for identifying the right course of treatment says, Dr Kirti Chadha, Divisional Head Oncology Group and Surgical Pathology, Metropolis Healthcare Limited

Today we have better diagnostic technology and facility compared to a decade back when it comes to cancer treatment. Cancer diagnosis attains significance as it is an extremely specialised area of diagnosis and needs to be validated by oncologists. Cancer testing is of different types and a combination of technologies is applied to arrive at conclusive diagnosis.

Dr Kirti Chadha, Divisional Head Oncology Group and Surgical Pathology, Metropolis Healthcare Limited

Dr Kirti Chadha, Divisional Head Oncology Group and Surgical Pathology, Metropolis Healthcare Limited

Histopathology: Surgical pathology allows for definitive diagnosis of disease (or lack thereof) in any case where tissue is surgically removed from a patient.

Cytogenetics: The cytogenetics lab offers karyotype analysis and SNP-microarray analysis to detect balanced, unbalanced, and copy number neutral chromosome abnormalities at the whole genome level. The lab also performs fluorescence in-situ hybridization (FISH) analysis to detect targeted chromosome abnormalities. The results from these studies play important roles in cytogenetic diagnosis, prognosis, and guide treatment of specific types of hematologic malignancies and solid tumours.

Molecular Pathology: The molecular diagnostic lab offers DNA or RNA based assays. Tests range from simple, routine PCR amplifications to complex tests translated from cutting-edge research findings to clinical utility.

Moving towards a new era in Cancer Testing

Cancer treatment has shifted in recent years to the use of biologic therapeutics that target genomic alterations in cancers, creating demand for more advanced and sensitive genomic testing to identify these alterations. It is important to provide diagnostically more significant information and correctly identify mutations present in smaller samples. Today diagnosis is more widely used for identifying the right course of treatment. One size fits all is no more the approach and below is an example of one such extensive study conducted by us.

Example for personalized treatment

Surgery, radiotherapy, chemotherapy and hormone therapy are the four modalities of treatment of breast cancer. Breast cancer patients needs to be treated individually and pathology reports play a significant part. One of the areas where data based analysis has been minimal is in the arena of hormone therapy. We carried out a retrospective analysis of 3500 breast cancer patients for ER, PR, CerbB2 receptor expression for the last three years i.e. 2012, 2013 and till September 2014. Our study proved that with accurate diagnosis, more breast cancer patients in India can opt for hormone therapy rather than chemotherapy as a choice of treatment. Hormone therapy in these patients has better prognosis and is less painful with a lesser degree of recurrence when compared to chemotherapy.

What is most important to address in case of cancer is “can I have a report that is conclusive and one that will help me design my treatment?’’

Single point, effective, cost effective and conclusive diagnosis is a void in India and Metropolis is at the forefront in bringing about this change. Through our Oncomet division, we provide conclusive and cost effective cancer testing by correlating all techniques and technology with morphology, which refers to the histological classification of the cancer tissue.

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