Global Inequities in Precision Medicine and Molecular Cancer Research

Abstract

Precision medicine based upon molecular testing is heralded as a revolution in how cancer is prevented, diagnosed, and treated. Large efforts across the world aim to conduct comprehensive molecular profiling of disease to inform preclinical models, translational research studies and clinical trials. However, most studies have only been performed in patients from high-income countries. As the burden on non-communicable diseases increases, cancer will become a pressing burden across the world, disproportionately affecting low-middle income settings. There is emerging evidence that the molecular landscape of disease differs geographically and by genetic ancestry, which cannot be explained by environmental factors alone. There is a lack of good quality evidence that characterises the molecular landscape of cancers found in low-middle income countries. As cancer medicine becomes increasingly driven by molecular alterations in high-income settings, low-income settings may become left behind. Further efforts on an international scale must be made by researchers, funders, and policymakers to ensure cancer research addresses disease across the world, so models are not limited to subtypes of disease found in high-income countries. In this review, we discuss differences found in the molecular profiles of tumours worldwide and the implication this has for the future of global cancer care. Finally, we identify several barriers currently limiting progress in this field and innovative solutions, which may address these shortcomings.

Prospects and Challenges of Precision Medicine in Lower- and Middle-Income Countries: A Brief Overview

“…The PM offers ample benefits for patients and current stratagems to describe the genetic relations of cancers by utilizing newer equipment and expertise. Nevertheless, a "lack of evidence, data, and a clear strategy on how this will be used to benefit patients across the world, particularly in LMICs" 97 . The high cost of new diagnostics aids and medication for precision medicine often aggravates health disparities.…”

“…Currently, most facts banked regarding human genomes are principally from rich countries 97 . Moreover, presently PM in LMICs is principally concentrating on infectious disorders than NCDs.…”

“…Moreover, presently PM in LMICs is principally concentrating on infectious disorders than NCDs. Although NCDs are equally public health threats as communicable diseases in LMICs 97 . Though PM provides enormous benefits for cancer and other patients of chronic NCDs.…”

“…Yet, Nonetheless, there is not much proof that the obtained information and method of treatment develop will achieve equally effective around the globe, especially in LMICs 97 . As because there is evidence that lot variances exist in molecular findings in cancer genome among patients of LMICs and rich countries 97 . Another study concluded that PM able to show a new way of treatment options for those diseases previously were not treatable.…”

Global surgery in an ecosystem for worldwide health

“…These challenges are tangible and pressing, with dire need for long‐lasting solutions through stepwise implementation and sustainable improvements recently discussed in BJS . The Editors are mindful that global surgery also pertains to an ageing population worldwide, the challenges of delivering surgery for an increasing disease burden of cancer, an ever‐increasing prevalence of obesity, and overwhelming issues relating to antimicrobial stewardship, multidrug‐resistant bacteria and surgical‐site infections.…”