Future in Oncology

Cancer is a transformed cell having altered physiology modulating host resources for it’s growth and survival. Interruption of signal transduction in the form of ligand binding, receptor binding or inhibition of key intracellular pathways with small molecules has revolutionized cancer therapies. Some of the success stories include Rituximab in lymphomas, Trastuzumab in breast cancer, imatinib in chronic myeloid leukemia, bevacizumab, VEGF TKls in number of cancers, EGFR inhibition lung, head neck cancers etc.

Preventing cancer cell from escaping immune system is emerging as revolution in cancer therapeutics Blocking CTLA4, blocking PD L1 and PD 1 with antibodies has already achieved success in melanoma, lung, kidney and head neck cancers and being tried in almost every cancer. CAR modified T cell is another leap forward in immune-oncology. Preventing viral induced cancer with vaccine especially HPV related cancers will bring down the burden of some of the common cancers like cervix and oropharynx significantly.

On the diagnostic side, functional imaging, contrast free imaging, molecular imaging, fused structural and molecular imaging is changing the way we stage and assess cancers. The sciences of ‘omics’ will provide critical information about how the cancer cell is thriving. Liquid biopsies, assessment of circulating tumor cell will provide the opportunity to assess in vivo cancer in real time.

Cancer genome atlas and compilation of BIG DATA is taking cancer informatics forward and will identify new targets for cancer therapies. Next generation sequencing and other advanced lab techniques are already available to provide critical inputs to the clinician.

Finally improving access to cancer treatment to the poor and needy will help us meet the ever increasing cancer burden in our country.

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