Cancer care is undergoing a profound shift from one-size-fits-all protocols to truly personalised treatment strategies built around each patient’s tumour biology. As Head of Scientific Affairs- Oncology at MedGenome Labs Ltd., Dr Prashanth Bagali brings a clinician- scientist’s perspective to this transformation, drawing on deep experience in cancer genomics and its real-world application in patient care. Under his guidance, genomic profiling is helping clinicians uncover the hidden genetic differences between tumours, reshaping how cancers are diagnosed, treated and monitored, and offering patients more precise, effective and potentially less toxic care.
Two patients are affected by cancer. They have the same diagnosis, the same stage of tumour, and their cases look similar on paper. Yet one responds well to treatment while the other struggles to recover. This is because even when a cancer appears in the same organ, two patients can have tumours that are genetically different from one another.
Understanding genomic differences has driven much of the progress in oncology over the past two decades. For a long time, clinical decisions were based on the site of origin, such as lung, breast, or colon, tumour size, and metastases, which largely determined the protocol, and it was applied uniformly across patients. Results were unpredictable, and many patients endured treatments that were poorly suited to their specific tumour types. That is where genomic profiling of cancers started to make a real difference.
Understanding Cancer’s Genetic Blueprint
Cancer is fundamentally a disease of the genome. Genetic mutations within cells, whether inherited or acquired over a lifetime, disrupt normal cellular functions and drive uncontrolled cell growth. Identifying these mutations gives clinicians a genomic signature of tumours for early diagnosis and treatment of cancers. These genomic profiles provide a genetic basis for the tumours of individual patients. Since these mutations are unique to the tumour and are responsible for its growth and progression, they directly impact treatment response in the patient.
Genetic tests pinpoint the exact mutations within a tumour, giving oncologists a solid basis for selecting treatments that are tailored to each patient. Knowing the tumour’s molecular characteristics puts clinicians in a much stronger position to weigh up whether targeted therapies, immunotherapies, or clinical trials are the right fit. From there, oncologists can piece together a treatment regimen that is truly built around that patient, with better outcomes as the end goal.
Improving Outcomes with Genomic Insights
Genomic profiling is changing how cancer is diagnosed, understood, treated, and monitored. By pinpointing the exact mutations within a tumour, clinicians can pursue targeted therapies against specific biomarkers- EGFR, ALK, BRCA, and HER2– leading to more effective treatment and better outcomes for patients. For those with rare cancers or cancers of unknown primary origin, this has been particularly significant, filling gaps that traditional diagnostic methods could never quite address. Looking at the tumour’s molecular characteristics gives clinicians a much stronger footing when it comes to spotting treatment options that could easily have been missed.
Beyond treatment, genomic profiling plays an important role in disease monitoring, treatment response, drug efficacy and evolution of new resistance genes in patients. This helps track treatment effectiveness and detect signs of relapse, enabling clinicians to adapt novel treatment strategies as the disease progresses. It can also help predict how likely a patient is to respond to a particular therapy.
This is enabling more personalised and effective cancer care by helping clinicians match patients to the most appropriate treatments while avoiding ineffective therapies, unnecessary side effects, and consequently the emotional and financial burden associated with this journey.
An Informed Approach to Cancer Care
While scientific evidence is evolving, tumour biology remains a complex subject. Moreover, adoption and access to genomic testing are uneven across healthcare settings across the globe. The progress made so far, however, points clearly toward what is achievable. The technology is improving and becoming more accessible. Our understanding of cancer genetics is helping to understand tumour behaviour, so that novel drugs can be invented in the future. In practice, this means that clinicians can ask deeper and more effective questions, such as what is specifically causing the cancerous tumour and what is the most effective way to treat it. Ultimately, this could lead to earlier detection, faster interventions, stronger patient outcomes, and overall reduced medical, financial and emotional burden.
