Cancer treatment in India, just like world over, is undergoing a paradigm shift with genetic markers of the tumour increasingly driving the treatment plan for every patient, leading oncologists said on October 28 during an event to discuss newer and advanced therapies for breast cancer.
Every year in India, over two lakh new cases of breast cancer are diagnosed, and it is ranked number one cancer among Indian females with a mortality rate of 12.7 per one lakh women.
Around 20 percent of all breast cancers are HER2+ve, meaning that the tumour in such patients is positive for a protein called epidermal growth factor receptor 2 that promotes the growth of cancer cells. This type of breast cancer is considered more aggressive.
"This is an era of precision oncology with molecular signature of the tumour deciding the treatment modality for every patient," said Dr Meenu Walia, medical oncologist with Max Hospital in Noida.
She added that newer targeted therapies are also resulting in better prognosis of the disease in a higher number of patients, even though the problem of late detection of cancers in India persists.
All the research for cancer treatments, was aimed at turning the disease into a chronic, manageable one, just like diabetes and hypertension, Walia said.
Dr Sajjan Rajpurohit, Director, Medical Oncology with BLK-Max Super Speciality Hospital highlighted that advancements in cancer treatment had made it possible for even late-stage cancer patients to live longer and have a better quality of life as compared to earlier.
Dr Shyam Agarwal, oncologist with Sir Gangaram Hospital in Delhi, stressed that a large number of breast cancer cases may be preventable with lifestyle changes such as diet and exercise.
Stress on newer drugs
Oncologists stressed that targeted therapies such as Phesgo, a dual Innovator fixed-dose combination that provides the best standard of care for HER2+ breast cancer patients have resulted in better patient experience and cost benefits.
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Phesgo, a fixed-dose subcutaneous formulation that combines Perjeta (pertuzumab) and Herceptin (trastuzumab) to be administered under the skin in one injection, is the world's first fixed-dose combination of two monoclonal antibodies in oncology.
This drug by Roche Pharma was first approved by the US Food and Drug Administration in June, 2020, and by the European Medicines Agency (EMA) in December 2020, and has been recognised in the National Comprehensive Cancer Network (NCCN) treatment guidelines.
In India, Phesgo, which costs Rs 2.8 lakh per dose, was approved by the Central Drugs Standard Control Organisation (CDSCO) in October last year and import license granted in January 2022. As of now, the drug is being used in about 400 patients.
Dr Pragya Shukla, a senior oncologist with Delhi State Cancer Institute, said that despite the high cost of the medicine, it had come to be a preferred treatment choice for both clinicians and patients due to ease of administration and was being procured by the government and made available to poor patients free of cost.
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