Genomic tests for cancer split oncologists
MUMBAI: Some of India’s leading oncologists have raised doubts over the utility of the tests like Oncotype DX genomic test, which assesses how a cancer is likely to respond to treatment, saying it increases the cost of treatment without yielding clear benefits while others have expressed their support.
In June several oncologists at the American Society of Clinical Oncology had validated the test that many experts claim can be used by women suffering from early-stage breast cancer to forgo chemotherapy, offering relief to several patients suffering from the toxic side effects of chemotherapy.
The test is offered by the United States-based genomic firm OncotypeIQ, which conducted a study, TailoreX, and reported that women who are diagnosed early with breast cancer and with a mid-range tumour score of 21 can skip chemotherapy. It said that the study found no improvement in disease-free survival when chemotherapy was added to hormone therapy in the group of trial patients.
However Dr Sudeep Gupta, medical oncologist at Mumbai’s Tata Medical College, told ET that even without the Oncotype DX test oncologists in India did not put patients under chemotherapy. “These tests might not add much value, and they are possibly not needed when good pathologists are available in hospitals,” he said. “The bulk of the patients are not eligible for these tests. When I get 100 patients in my OPD, 10-15 patients might fall in low-risk category and those patients are anyway not put under chemotherapy by us.
Therefore, he said, while in the US such a test is conducted for $500 (about Rs 34,000) to determine whether a patient needs chemotherapy, in India a good pathologist can offer a similar service for $20 (about Rs 1,360).
In the past decade several gene testing firms have emerged in Europe and India as well that are looking at ways to improve diagnosis and treatment of cancer. Gene testing diagnosis has become a core part of personalised medicine as medical practitioners are looking at ways to prescribe treatments according to individual needs. Like the Oncotype DX test, there are several other tests such as Mammo Print, Endo Predict and PAM 50 which study the association of a specific gene with different levels of low, medium or high risk for recurrence in a breast cancer patient.