Accelerating equitable cancer genomics and precision oncology in health care and research: A Lancet Oncology Commission
Casolino R, Mateo J, de Vries E, Johns A, Courtot M, Lawlor RT, Perdomo S, Gray SW, Perez Lopez R, Turnbull C, Torrents D, Vokinger KN, Akhoundova D, Bourque JM, Cardona AF, Chakravarty D, Chicherova I, Cranston KA, Davi M, Frisell O, Manzano Garcia R, Grossman RL, Hamdi Y, Hediger S, Hofmarcher T, Hofmann O, Kather JN, Kato K, Knoppers BM, Lehmann KV, Lokuhetty D, Mascalzoni D, Mulder N, Osterman T, Parikh AR, Rotimi S, Rous B, Sirohi B, Sondka Z, Staunton C, Taskén K, Wagner A, Westphalen CB, Wu J, Yann J, Zawati MH, Biankin AV, Yoshino T, Stein L, Lawler M
Thomas Hofmarcher and Oskar Frisell at IHE are co-authors of Accelerating equitable cancer genomics and precision oncology in health care and research: A Lancet Oncology Commission, an international expert report on precision oncology published in The Lancet Oncology. The report presents recommendations for how precision oncology can be implemented in a more evidence-based, equitable, and sustainable way.
Precision oncology creates new opportunities to diagnose and treat cancer by using detailed information about, among other things, the genetic and molecular characteristics of tumours. However, the benefits vary across cancer types, biomarkers, and treatments. For precision oncology to deliver real benefits to patients, a well-integrated care pathway is therefore required – from sampling and analysis to clinical interpretation and access to targeted treatment.
This is particularly relevant to the Swedish health care system, where different interventions are often evaluated separately. To ensure that resources are used efficiently, the entire patient journey increasingly needs to be assessed as a whole. At the same time, precision oncology is still in a phase of development, where today’s investments in diagnostics, data collection, and infrastructure can contribute to new knowledge and better treatments for future cancer patients.
An important question is therefore how the necessary infrastructure should be financed and organised. Greater government responsibility could contribute to equitable access and create better conditions for data to be used responsibly in research and development. This is not about accepting higher prices for medicines and diagnostics, but about building infrastructure that makes it possible to realise the value that precision oncology can create.
Several initiatives are already underway in Sweden. PROMISE aims to combine large-scale multi-omics data from research with health care data to advance precision medicine. The Swedish National Board of Health and Welfare has also received several government assignments aimed at strengthening the equitable implementation of precision health through, among other measures, national coordination, skills development, and strengthened infrastructure.
At the same time, the report highlights major global disparities in access to biomarker testing and targeted treatments. A key challenge going forward will therefore be to develop precision oncology in a way that both realises its medical potential and contributes to more equitable and sustainable cancer care.
