Even as advances in lung cancer treatment have improved survival rates, the focus is now shifting
toward enhancing quality of care through more personalised approaches. A key part of this evolution
is expanding access to genomic testing, which can guide targeted therapies and significantly improve
patient outcomes. Hitesh Goswami, CEO and Co-Founder, 4baseCare, shares his perspective on the
challenges that hinder widespread adoption and the collaborative steps needed to make genomic
testing a standard part of lung cancer care in India.
A report published by the Indian Journal of Medical Research indicates that India has a growing burden of lung cancer cases with the number expected to rise from 63,708 cases in 2015 to 81,219 cases in 2025. Kolkata and Delhi recorded the highest number of cases followed by Bengaluru, Chennai and Hyderabad.
The primary reasons attributed to this is an increase in smoking and environmental factors such as air pollution. Furthermore, there are 66,279 lung cancer deaths annually reported in India. The high mortality
rate highlights the urgent need for personalised treatment approaches over the conventional one-size-fits-all methods that can lead to better patient outcomes.
In the last decade or so, the way cancer is treated has undergone significant changes. Genomic testing
has slowly emerged as a game changer in the treatment and management of lung cancer. It enables targeted and personalised therapies that are decided based on an individual’s genetic profile.
However, one of the key challenges in implementing this is creating ease of access to genomic testing.
India has a growing burden of lung cancer cases with the number expected to rise from 63,708 cases in 2015 to 81,219 cases in 2025.
Expanding access to genomic testing for lung cancer – What are the challenges?
Infrastructure gaps: Genomic testing is a niche space and not all healthcare institutions
are equipped with the right infrastructure to offer it to their patients. Only specific companies
that specialise in genomic testing can offer this at scale. In addition, most genomic testing might be
available in urban centres which might make it difficult for patients from tier II / Tier III cities to access
Limited awareness: Not many patients as well as some oncologists in Tier II / Tier III cities are aware
of genomic testing and the impact it can have on improving patient outcomes.
Financial challenges: Since this is an emerging area, the cost for some comprehensive genomic tests might be significantly higher and it may not be covered by insurance. This further makes it difficult for the masses to afford it.
How do we address the above?
Collaboration with key stakeholders
One of the best examples of collaboration between stakeholders is the LuNGS Alliance. Very recently, Cancer Research and Statistic Foundation (CRSF), has announced free Lung NGS (Next Generation Sequencing) biomarker testing for lung cancer patients across India. This initiative is backed by leading pharmaceutical companies AstraZeneca, Pfizer, and Roche, with 4baseCare serving as the official lab partner. Advanced NGS-based biomarker testing should be standard for every lung cancer patient. Initiatives like the LuNGS Alliance will bring us closer to democratising precision medicine and
making a real difference in patients’ lives.
Awareness and education drives Building more visibility about Genomic testing among oncologists as well as patients is a key step towards creating access. Avenues such as Continuous Medical Education (CMEs), oncology conferences, and physician training programmes are essential. Collaborating with hospitals, cancer societies, and digital health platforms can further ensure that both patients and doctors stay informed about advancements in precision oncology.
Build better infrastructure
One of the key issues currently is that genomic testing is mostly accessible in bigger cities. To create easy access, we need to build genomic testing centres in rural areas and smaller towns. Additionally, there have to be dedicated sample collection centres in Tier II cities so that patients from underserved locations do not have to travel to urban centres to submit their samples. Recently we partnered with the Department of Preventive Oncology, Homi Bhabha Cancer Hospital and Research Centre, Muzaffarpur, Bihar to empower precision medicine in rural India. Many more such collaborative efforts are
required.
Clarity on insurance coverage
Currently, there are no clear guidelines around reimbursement for the tests. This becomes an obstacle for patients to choose the test and for oncologists to recommend it. To standardise this and include it under insurance, we need a much more substantial policy framework that integrates genomic testing into mainstream oncology treatment.
The way forward
Targeted treatment for lung cancer can be made a standard treatment protocol if there’s widespread adoption of genomic testing. This can only happen if we can categorically remove barriers to access and
build more awareness about the need for genomic testing and the impact it can have on the quality of life of the patients. With collaboration and coordinated efforts from key stakeholders, genomic testing can be made more accessible and it can become an essential part of lung cancer care in India.
