Precision medicine in Thoracic Oncology: understanding disparities to tackle inequities in access

ABSTRACT

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.

KEYWORDS:

• Precision medicine
• inequities
• access
• oncology
• lung cancer
• target therapy

Article highlights

• Countless genetic alterations have been recognized as tumor drivers and potential targets for precision therapies.

• Lung cancer is a successful example of precision medicine application in Oncology.

• The costs of innovative therapies against cancer are rising together with the costs of broad genomic testing, such as Next-Generation Sequencing (NGS).

• Geographic population distribution and ethnic inequalities are also access barriers for precision medicine in oncology.

• Global strategies must be defined to improve access to precision oncology.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.