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EDITORIAL
Year : 2017  |  Volume : 8  |  Issue : 2  |  Page : 91-92

Cancer research: Challenges and promise for individualized treatment


Department of Radiation Oncology, Apollo Hospitals, Belapur, Mumbai, Maharashtra, India

Date of Web Publication14-Jun-2017

Correspondence Address:
Shyam Kishore Shrivastava
Department of Radiation Oncology, Apollo Hospitals, Belapur, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_26_17

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How to cite this article:
Shrivastava SK. Cancer research: Challenges and promise for individualized treatment. J Radiat Cancer Res 2017;8:91-2

How to cite this URL:
Shrivastava SK. Cancer research: Challenges and promise for individualized treatment. J Radiat Cancer Res [serial online] 2017 [cited 2017 Aug 20];8:91-2. Available from: http://www.journalrcr.org/text.asp?2017/8/2/91/208031

Over the past two decades' phenomenal efforts from International Cancer Genome Project, Cancer Genome  Atlas More Details and Cancer Genome Consortium have presented data on genomics alterations in various cancers. This has provided clues for changing the classification of cancer to the molecular rather only on histological based.[1] It resulted in reclassification of common cancers, based on molecular and genomic markers, which is getting increasingly common in oncology.[2] However, with the evolving understanding of cancer biology and molecular pathology the outcome of cancer has not changed as expected. It is known that some issues such as delay in diagnosis, limited access of clinical expertise, less effective standard treatments, inadequate funding for clinical research programs are also contributing for poor outcome of cancers.

The clinical research is essential not only for developing medicines but also finding the safer and cost-effective treatment strategies for diseases such as cancer. Particularly in India, having large patient population, unmet health needs, and limited resources, there is a need for developing newer and better options available in quick, economical, and dependable methods. For this, the research needs to be promoted to assume leadership role globally. We need to ensure that the research in our country is carried out as per global scientific standard satisfying the ethical institutions.

The clinical research has grown in India in the past several years because of cost advantage, qualified doctors, and treatment-naïve patient. However, recent past has witnessed a decline in number of trials in India. Slow accrual of subjects is major problem, despite there are examples of active support from industry for potential effective collaboration between industry, academia, and patient advocacy groups.[3] It is necessary to relook on the strategy to optimize clinical research. It is required to develop training resources to educate more researchers for carrying the research activities to the international standards than presently available. The dynamic training modules should be developed according to the national needs. It is required that the training infrastructure be flexible enough to accommodate ever-changing regulatory aspects.

The majority of international trials focus on the problems faced in developed countries and have been successfully addressed to overcome the issues. However, there are several issues associated with challenges that are commonly faced in developing countries. This includes important issues such as developing consensus on research priorities for cancer. The active support from research and funding organization is needed to overcome these challenges and reducing barriers in collaborative research. It is important to have collaboration between investigators, research consortia, industry, regulatory bodies, patient advocacy group, and funding agency.[4]

The understanding of cancer biology, gene expression, proteomics, sophisticated tumor profiling, and rapidly increasing numbers of targeted and immunological drugs is bringing closure the promise of precision oncology and truly individualized care. This may further be associated with novel treatment for specific subtypes and further clinical trial design. The success has been achieved in some cancers and further research will enhance the successful development of therapies for patients possibly for all malignancies.

Clearly, the development of a strong research base substantially improves patient outcomes,[5] and research systems need to cover both modern medicine and alternate/traditional medicine. Cancer research is also essential to deliver an affordable cancer care system in India, therefore, connecting the research and policy agendas is crucial to create effective decision-making institutions for health,[6] India has the opportunity and capability, with the right support, to be a world leader in cancer research that delivers radical cost-effective solutions to deliver affordable cancer care. The awareness among the treating physicians, researchers, and policy makers will make it successful and meaningful.

 
  References Top

1.
Greenlee RT, Goodman MT, Lynch CF, Platz CE, Havener LA, Howe HL. The occurrence of rare cancers in U.S. adults, 1995-2004. Public Health Rep 2010;125:28-43.  Back to cited text no. 1
    
2.
Cancer Genome Atlas Network. Genomic classification of cutaneous melanoma. Cell 2015;161:1681-96.  Back to cited text no. 2
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3.
Carvajal RD, Schwartz GK, Mann H, Piperno NS, Smith I, Nathan PD, et al. Study design and rationale for a randomised, placebo-controlled, double-blind study to assess the efficacy of selumetinib (AZD6244; ARRY-142886) in combination with dacarbazine in 88 patients with metastatic uveal melanoma (SUMIT). BMC Cancer 2015;15:467.  Back to cited text no. 3
    
4.
Blay JY, Coindre JM, Ducimetière F, Ray-Coquard I. The value of research collaborations and consortia in rare cancers. Lancet Oncol 2016;17:e62-9.  Back to cited text no. 4
    
5.
Krzyzanowska MK, Kaplan R, Sullivan R. How may clinical research improve healthcare outcomes? Ann Oncol 2011;22 Suppl 7:vii10-5.  Back to cited text no. 5
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6.
Chalkidou K, Marquez P, Dhillon PK, Teerawattananon Y, Anothaisintawee T, Gadelha CA, et al. Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries. Lancet Oncol 2014;15:e119-31.  Back to cited text no. 6
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