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Precision medicine in Thoracic Oncology: understanding disparities to tackle inequities in access
Flávia Amaral Duarte1, Pedro Nazareth Aguiar Junior1,2, Rodrigo Dienstmann1
1Department of Clinical Oncology, Grupo Oncoclínicas, São Paulo, SP, Brazil.
Introduction:
Precision medicine is defined as personalized interventions fitted to patients' or tumors' characteristics. Patients diagnosed with different neoplasms have benefited from a personalized therapeutic approach in terms of response and survival. However, several challenges must be addressed for precision oncology to become a global reality. Access to genomic testing that allows biomarker identification is a main issue.
Areas Covered:
A nonsystematic literature review about inequities in access to molecular genetic testing, focusing on lung cancer as the prominent example, was performed by a group of expert clinical oncologists.
Expert Opinion:
Access to molecular tests and their matched treatments differ between regions of the world and even among diverse populations in the same country. Socioeconomic characteristics are often strongly correlated with this disparity. Furthermore, although the cost is a determinant factor for inequality, other issues have been recognized. Advances in the education of healthcare professionals, patient advocacy initiatives, building local laboratory workstreams, and promoting favorable regulatory environment are vital factors in promoting equal access.
Insights
Access to precision oncology genomic testing is unequal globally, particularly for lung cancer patients. Addressing disparities requires improving healthcare professional education, patient advocacy, local lab infrastructure, and regulatory policies to ensure equitable biomarker identification and treatment.
Area of Science:
- Oncology
- Genetics
- Health Services Research
Background:
- Precision medicine offers personalized cancer treatments based on individual patient or tumor characteristics.
- While beneficial for neoplasms, challenges hinder global precision oncology adoption, notably access to genomic testing for biomarker identification.
Purpose of the Study:
- To review inequities in access to molecular genetic testing.
- To highlight lung cancer as a primary example of these disparities.
Main Methods:
- A nonsystematic literature review was conducted.
- Expert clinical oncologists focused on access to molecular genetic testing.
Main Results:
- Significant disparities exist in molecular test and treatment access across regions and populations.
- Socioeconomic factors strongly correlate with these inequities.
- Cost is a major barrier, but other factors also contribute to unequal access.
Conclusions:
- Equal access to molecular testing and targeted therapies is crucial for precision oncology.
- Key strategies include enhancing healthcare professional education, empowering patient advocacy, developing local laboratory capabilities, and fostering supportive regulatory environments.
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