In the Asia Pacific region, precision medicine in cancer treatment has come a long way, but according to Vishal Doshi, CEO of AUM Biosciences, we still have work to do in ensuring that we translate research into tangible outcomes for patients.
The concept of precision medicine is no longer just visionary. Over the last two decades, international research and genomic profiling projects have served as a catalyst to turn this notion into a reality.
In Asia, we have come a long way in recognizing and leveraging this technology for cancer treatment. At a regional level, eight Asian countries – Japan, Korea, Taiwan, Indonesia, Malaysia, Thailand, Singapore and Vietnam – have come together to form a regional pharmacogenomics research group (SEAPharm).1 At a local level, and as early as 2004, Thailand put into place the National Biotechnology Policy Framework, where genomics and bioinformatics were identified as the key areas to help improve the health of the Thai people. Meanwhile, countries like Singapore and South Korea have embarked on translating available research and data into actionable diagnosis and treatment plans with programs like the Integrated Molecular Analysis of Cancer Program by the National University Cancer Institute Singapore (NCIS) and Korea’s Cancer Precision Medicine Diagnosis and Treatment Enterprise (K-MASTER).2
However, proliferation of precision medicine has not been the same across the region. Varying levels of infrastructural sophistication, such as the keeping of centralized records, as well as a lack of specialist talent pools have stalled the implementation of precision medicine in some countries.
Despite these challenges, precision medicine continues to gain much needed momentum in the region. Here are some areas in cancer care that have seen advancement, thanks to precision medicine, and how we can take these advancements further to improve the outcomes of cancer patients in the Asia Pacific region specifically.
The crucial role of biomarkers and artificial intelligence in precision medicine
Before exploring the possibilities to which precision medicine has opened the doors, a look at the building blocks which enable this targeted and purposeful approach is essential. The foundation that largely makes precision medicine possible is the continuous identification of specific biomarkers. So crucial is the role of biomarkers that at AUM Biosciences, we mandate biomarkers for asset selection and conducting trials in order to improve the probability of success over conventional approaches. The ability to look at the genetics of a tumour as well as tumour markers is what makes it possible to design highly effective oncology therapies.
Another element that is being sharpened in order to advance cancer care in the region is the further integration of artificial intelligence (AI) into drug discovery and clinical trial designs. AI’s potential to track patterns will enable us to identify toxicity signals, potential combinatorial treatments as well as indication expansion models, thus not only speeding up clinical trial times, but also identifying the best possible treatment and outcomes for patients.
At AUM Biosciences, we harness the best of both a biomarker approach and the application of artificial intelligence in drug discovery, subsequently leading to the following outcomes:
Therapeutic cost reduction
Globally, the costs associated with oncology care are higher than those for any other disease. In 2017, the median annual cost to patients of a new cancer drugs exceeded US$150,000, compared to US$79,000 in 2013.3
A biomarker strategy can assist in selecting out molecules likely to be ineffective, speeding up efforts in finding therapies with true potential. By increasing the success rate of clinical trials, it reduces the investment needed in research and development, subsequently lowering the costs involved in bringing a new therapy to the market. The goal is to ensure that these cost savings are translated into patient’s savings where relevant.
Accelerated treatment availability
In 2017, 55 oncology drugs were approved globally, however, less than 20 percent of these drugs are available in Asian markets.3 By focusing on Asian specific biomarkers and conducting localised trials here in Asia, we can improve the probability of success and rapidly develop affordable and relevant therapies for Asia.
Quality of life improvement
While chemotherapy is still a foundational part of cancer treatment, the advent of targeted and immunotherapies have improved toxicity profiles of cancer treatments. This in turn has sparked conversations around quality of life and what it means for cancer patients.
It is the role of biomarkers in the early detection and monitoring of cancers, as well as the development of new cancer therapies, that has given us this important paradigm shift to more precise, targeted, and less toxic treatment options. By stratifying patients into groups based on their individual variability in genes, environment, and lifestyle, we can deliver personalised medicine while minimising side effects.
In the future, the more precise and specific we can be in identifying the factors that make one’s cancer different from the other, the better the success rate of the treatment, and improved quality of life of each patient.
The path ahead
We can’t stop here. To further the ground-breaking development that is precision medicine, there are several steps that we need to take. Our first task is to expand the size of our databases to include more Asian data – at the moment, existing genetics and clinical trial databases are mainly made up of Caucasian data. However, this is by no means an easy feat. Recruiting Asian patients to participate in any studies or clinical trials involves massive recruitment efforts given the vastly dispersed geography and patient accessibility in Asia. In these instances, offline and in-person recruitment drives are the best chances of success.
Attracting talent into the Asia-Pacific region to lead these clinical trials and drug development is the other end of the spectrum that we need to consider. Companies such as AUM Biosciences can help pave the way by flying the flag of a unique, localised, and highly successful approach to pique the interest of clinicians and scientists worldwide.
Last but not least, it is imperative to partner with the relevant local authorities and stakeholders to build national frameworks around ethics, infrastructure, talent and funding, among others. This will help regulate industry standards and ensure that patients are receiving the right diagnosis and care as a result of this new approach. Although this is a relatively new area for us here in the Asia-Pacific region, it is crucial that we approach the regulation of this technology in an agile manner, guided but not bound by precedents.
There is growing awareness and interest in precision medicine in Asia, and with laser sharp focus on these core areas we can further catalyse innovation. With consistent support and investment in precision medicine, we can move closer to the goal of developing more affordable, effective and safer therapies for cancer patients in Asia.
- Chong HY, et al. (2018). Current landscape of personalised medicine adoption and implementation in Southeast Asia. BMC Medical Genomics
- La Mola F, et al. (2019). The promise of precision medicine in Asia Pacific. Retrieved from: https://www.lek.com/insights/ei/promise-precision-medicine-asia-pacific Last accessed August 2019.
- IQVIA. Global oncology trends 2018: Innovation, expansion and disruption. Retrieved from: https://www.iqvia.com/institute/reports/global-oncology-trends-2018 Last accessed August 2019.
Vishal Doshi, CEO, AUM Biosciences