Is Latin America ready to overcome the challenges of implementing Precision Medicine?

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Published: 23 Nov 2022
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Dr Daniel Campos - Latin American & Caribbean Society of Medical Oncology, Buenos Aires, Argentina

Dr Daniel Campos speaks to ecancer at the 2022 World Cancer Congress in Geneva about whether Latin America is ready to overcome the challenges of implementing Precision Medicine.

He discusses the challenges of implementing precision medicine in Latin America.

Solutions as to how these challenges can be overcome and what has been done so far are mentioned by Dr Daniel Campos.

Finally, he finishes by offering the opportunity to help with the work of SLACOM.

Precision medicine arrived long ago, more than ten years within the clinic, the usual clinic. In Latin America we’re looking at it from a far place. We just can use the benefits of precision medicine in very few patients, those that could pay, and this is not a response in the region where we have more than one million people with cancer every year, new patients, and more than half a million deaths due to cancer. So we must look for an answer. The first thing we must do on that is to know where we’re standing. So we have a project, this consortium made with members of RINC for National Cancer Institute of every Latin American country, and SLACOM. 

RINC SLACOM has been working for a while with a draft of a project that stands in four columns. There are two columns first - it’s an exploratory stage and then a collection, data collection, stage. First stage means to know which centres for genetic molecular study are we having? How are they categorised, classified? Have they been publishing anything in first line papers? Are their directors affiliated to Latin American institutions? Are these centres private, public, or mixed institutions? What about the biobanks do we have in the region? How many do they have? Which is the type of specimen they work with? Which region is covered by these biobanks? Because there, in the paraffin specimen, we have the orientation, the key to treat our patients. Is the genetic configuration of our Latin American population the same like in North America or Central Europe or Europe in general? We do not know. 

Our statistics are scarce about incidents and death of populations. So we must have an exploratory stage looking not only for what we have, but what does the community think about this, not only the oncological professional community, but the general public? How many mass media interviews like this have been made asking for what do you think about precision medicine? Because we know that’s the path; we do not know if that’s the complete solution of the cancer problem but it’s absolutely that path where we can go ahead in the treatment of cancer. Cancer, as you know, is a genetic problem, so let us study it.

The second stage consisting of about three or four pathologies to be studied in sixty, seventy, pre-selected centres with 500 patients for every pathology. In every centre, we’ll have two teams, one working prospectively, and the other retrospectively, both studying the clinical evolution of the patient, and the genomic profile of each patient. Everything will be concentrated in an e-case report form so we can have a lot of information. Information about this recruitment and information about what do we have in the region in terms of centres working with it. 

So we’ll have a large amount of data and we’ll need a third column to give sense to all this data. To that, we’ll need artificial intelligence to manage all the information and bring us reliable data. After that will be the conclusions. Of course it is too premature to speak about the conclusion of a project that at most will need two years to be worked. The conclusion could be what about comparing the classic treatment, the proposed treatment by classic media, against guided treatments. Or economics, of course. Is this reasonable, to jump in this pool, to afford the cost of all this? Well, it happens to have sense. You know the NICE of Great Britain studied it and two or three years ago accepted use in the quali-economic way of studying, comparing days of quality of life against the expenses given for that treatment. Well in this study multiplatform genetic profiling surpassed by large the threshold that NICE, which is a very strict body, asks for.

So, perhaps that could be a way to interpret our results. So let me use this interview to ask all my colleagues to contact us, SLACOM, RINC SLACOM, because we have plenty of work, if you are working in an oncological centre. We need your help in terms of following clinically the patients, and we’ll be able to study the pathology, the specimen, to know the genetics, and to cross those data. The only requisite is to be fluent in Spanish.