How is CGP being currently used in Oncology Clinics?

Gone are the days when oncologists would treat their patients with the same kind of treatment approach and therapy for the same malignancies. With generic treatment- Some showed favourable response to the treatment whereas some showed no response at all and in some cases, the tumour used to become aggressive despite the treatment. Research has shown that carcinogenesis is the process of multiple genomic events and multiple genetic alterations. Quite a few genomic parameters have become standard of care for the successful treatment of cancer nowadays like ras-raf pathways, EFGR / ALK /ROS etc. But we need more information in a consolidated manner to customise or personalise treatment.In reality we are entering a world of bioinformatics , where there is unlimited data to assess. This includes Genomics/ epigenetics/ microbiomics/ transcriptomics/ metabolomics and proteomics to name a few …and so “MULTI-OMICS” is the key word.As we are getting more into the era of Precision and personalised oncology- Next-generation sequencing is becoming an indispensable tool in the clinical practice for the assessment of biomarkers with less tissue and in a short time. Here comes the concept of Comprehensive Genomic Profiling or CGP or CMP (Comprehensive Molecular Profiling).How is CGP implementation changing our Clinical practice?One gets all the results from a single assay and in less time, whether it is:1) Driver mutations or the mutational landscape of a cancer.2) passenger/bystander mutations3) actionable mutations or even un-druggable mutations4) pathways of resistance 5)Genomic signatures like TMB and MSI- largely known as ‘pan tumour markers’ for immunotherapy etc.6)CGP-informed targeted therapies and immunotherapy also helps to lessen the drug-related toxicity and add value in improving the quality of life of our patients.We should adopt the change in terms of clinical practice, for optimal treatment outcomes. The CGP derived insights will also be an indispensable tool in the battle against cancer, and in the coming age, oncologists will have more and more genomically informed data for the comprehensive management of cancer.(Article Courtesy: Dr. Niti Krishna Raizada, Senior Director, Medical Oncology & Hemato-Oncology, Fortis Hospitals, Richmond Road, Bangalore)