By Dr Nitesh Rohatgi
The year 2021 will be remembered in the history of mankind when healthcare failed as well as succeeded, both at the same time.
While the Covid-19 pandemic was at the epicentre, it’s actually how individual teams reacted to treat patients that are the stories that will be long told.
Oncology, the art of cancer medicine, was no different. But 2021 also saw some big leaps in technology and science of oncology despite everything and these are my top picks.
Cancer disparities are affecting outcomes in a big way including diagnosis, treatment and research. In August 2020, ASCO published its Cancer Disparities and Health Equity Policy Statement that highlighted this and gave direction that can help solve this crisis.
Molecular profiling in gastro-intestinal cancers including esophageal, stomach pancreas, gallbladder and colo-rectal cancers set a new standard of care in early and advanced diseases where the role of both Immunotherapy and targeted therapy was consolidated and benchmark set for future research.
Aspirin usage was linked to long-term reduction in cancer risk in patients with hereditary cancer predisposition.
Immunotherapy before surgery in early stage triple negative breast cancer, the most virulent type, was established for the first time.
Similarly the role of a new class of drugs the CDK 4/6 and PARPi was established in reducing the risk of recurrence in high risk post-operative breast cancer patients.
Patients with lung cancer also saw benefits of post-surgical administration of targeted therapy with Osimertinib. Hepatocellular carcinoma saw new treatment options after almost a decade with a combination of immunotherapy using atezolizumab and targeted therapy with bevacizumab.
“CAR T” cell treatment improved survival for the majority of patients with relapsed or refractory mantle cell lymphomas.
We also saw huge developments in integration of Artificial Intelligence (AI) and Deep Learning in cancer research.
The fact of the matter is that obesity reduction is probably the most important action to reduce incidence of cancer.
Covid-19 will be a catalyst in research with a positive impact on oncology outcomes. This is the result of decentralisation and global acceptance of virtual collaborations.
Going forward, new trail designs focusing on timeliness and optimisation will be the key.
(Dr Nitesh Rohatgi is Senior Director, Medical Oncology, at Fortis Cancer Institute in Gurugram. The views expressed here are personal)