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Genomics 3.0 has the potential to put India at forefront of precision medicine and personalised cancer treatment. Moves to see how healthcare for global Indians can be enhanced by understanding the unique genetic signature of Indians holds the key. Earlier this year, I wrote a piece on how technology and knowledge were the key to delivering rural healthcare. One of the areas in which technology and big data is going play an important part in India is in genomics, and the ability it offers to provide precision, personalised medicine with greater results in treatment of cancer. India has almost 1 million new cancer patients every year with almost 700,000 deaths estimated in 2015. In certain types of cancer, such as breast and ovarian cancer, 150,000 new cases are detected every year in India but staggeringly the 5-year survivability in India is 52 per cent compared to 89 per cent in US. According to the FDA, in 75 per cent of patients oncology drugs are not deemed to be effective. In 2015, almost $15 billion is estimated to have been spent on cancer diagnostics and treatment and this is growing rapidly. Against this severe backdrop, advances in life sciences, in particular the functional testing of tumours using either genomic or phenotypic approaches is changing the landscape and treatment options for cancer. According to Tufts University, in 2015, 73 per cent of the drugs in pipeline currently benefit from the use of genomics. Bringing genomics innovation to India Dr Jonathan Picker, faculty at Harvard Medical School and chief scientific officer of Global Gene Corp, an innovative genomics company co-founded by Harvard clinicians, is acquiring and applying genomics data in Asia. Having co-founded the company along with his Harvard colleague, Dr Saumya Jamuar (who is also clinical lead for Precision Medicine Initiative, Singapore), he says, “Given the vibrant life sciences ecosystem, I find it very interesting to note collaboration between innovative life sciences companies who are further strengthening India-UK technology collaboration. A unique opportunity exists to juxtapose the global expertise in genomics, and the British National Health Service systematic processes with the wealth of experience and talent to help solve the challenges for patients in India.” He highlights a specific example of a tie-up that is aiming to bring the latest from global research into India in order to transform the cancer treatment options - from bench to bedside. With its expertise on the Indian genome, his company is collaborating with Imagen Therapeutics, a cutting edge British oncology company that targets chemotherapy precisely against the individual patient's cancer. The partnership reflects the ethos of the latest generation biotech companies in being focused on applying the principles of precision medicine in an actionable way that actually benefits patients. Both companies however approach the challenge from very different perspectives reflecting their respective global Indian and British pedigrees. Imagen, born within the British system, based alongside the Manchester University Medical School, developed out of the integrated British system that created the 'evidence based treatment' model. From this background Imagen has developed a method for determining the optimal chemotherapy regimen for individual cancers. This stands in contrast to the current model of protocol-driven treatment whereby standardised therapies are dispensed with minimal consideration to individual variations. Understanding the unique genetic signature of Indians On the other hand, Global Gene Corp, founded by Harvard Medical faculty and alumni from prestigious Indian Institute of Technology (IIT), is embedded in the global genomics ecosystem and has deep expertise within India and Asia. With its core based in the Asian healthcare system and research presence in Mumbai, it works with a multitude of different approaches to healthcare that characterise medicine in India. Currently, the company is focused on understanding how health care for global Indians can be enhanced by understanding the unique genetic signature of Indians. Corresponding applications include its proprietary IndiaCHIP™ technology, developed to identify genetic mutations that cause disease and disorders specifically in Indians. The analysis is carried out using a state-of-the-art Illumina® system and SNP (single nucleotide polymorphism) technology. The goal is to provide precision treatment that revolutionises outcome and wellbeing for the patient. By bringing together the personalised cancer therapy born out of British rigour and the application of a pragmatic Indian approach, Global Gene Corp and Imagen are attempting to realise the opportunity to rapidly translate a precision medicine approach to cancer care in India. Dr. Picker says, “Thus, while others theorise, in acting, this pairing of new gen life-sciences companies will put India in the vanguard of personalised medicine.” He adds, “This real-life example demonstrates for me the power of the India-UK collaboration in life sciences, how exceptional people with disruptive technologies and intellectual property can combine to solve a very pressing problem for millions of cancer patients.” This use of specific patient data derived from genomics and functional testing to enable health care providers to provide precision, personalised medicine that has been demonstrated to be far more effective at treating conditions like cancer. The UK-Indian collaboration in precision medicine, enabled by technology, genomics, functional testing and big data analysis, is likely to be the future of health care. The key to making it happen though, according to Dr Picker, is to focus on affordability to bring the best of applied genomics technology not only to the elite, but to the rural and real India in an affordable manner.
