Singh Anshul, Velu Umesh, Lewis Shirley, Nittala Roselin, Yang Johnny, Vijayakumar Srinivasan
Radiotherapy and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, IND.
Radiation Oncology, University of Mississippi Medical Center, Jackson, USA.
Cureus. 2024 Oct 5;16(10):e70892. doi: 10.7759/cureus.70892. eCollection 2024 Oct.
This paper comprehensively analyzes India's potential to become a leader in cancer care in the Global South, particularly in precision population cancer medicine (PPCM). Through an interdisciplinary lens, it examines the current landscape of cancer care in India, highlighting its strengths, weaknesses, opportunities, and threats in this domain. This review explores the concept of knowledge translation and its importance in bridging the gap between knowledge generation and implementation in medical sciences and applies this to the Indian healthcare scenario. The review then delves into India's technological prowess, exemplified by its digital health initiatives such as the CoWIN (winning over COVID-19) app and the Ayushman Bharat Digital Mission, which provide a strong foundation for leveraging advanced technologies in healthcare. The authors discuss India's pharmaceutical industry, often referred to as the "pharmacy of the world," emphasizing its crucial role in global drug manufacturing and distribution. It also examines the country's emerging genomic research landscape, including initiatives such as GenomeIndia and the Indian Cancer Genome Atlas Foundation, which are pivotal for advancing personalized medicine. A significant portion of the review is dedicated to analyzing India's clinical trial ecosystem. It traces the evolution of regulatory frameworks governing clinical research in the country and highlights recent reforms that have made India an increasingly attractive destination for global studies, the potential adoption of innovative trial designs and artificial intelligence (AI)-driven analyses. Crucially, the authors confront the formidable obstacles inherent in India's complex healthcare landscape, illuminating the unique challenges that must be overcome. The review acknowledges India's underrepresentation in global clinical trials despite its large population and significant cancer burden. The issue of financial toxicity in cancer care is discussed, underscoring the need for affordable treatment options. The study also points out the nascent state of India's genomic databases, which account for only a small percentage of global genetic data. Despite these challenges, the authors posit that by effectively leveraging its information technology (IT) infrastructure, robust pharmaceutical sector, and large, diverse population, India has the potential to develop unique, country-specific solutions for cancer care. The study suggests that by fostering genomic research, strategically reforming its clinical trial ecosystem, and harnessing its digital capabilities, India could transform its cancer care landscape and emerge as a model for other developing nations in the Global South. In essence, this paper provides a roadmap for India's journey towards becoming a leader in PPCM, offering valuable insights for policymakers, healthcare professionals, and researchers in the field of oncology and precision medicine. Indeed, by using PPCM as a "pilot project," India can learn to use its new strategies to improve non-cancer care disease prevention, early detection, and improved and more cost-effective management. This approach could revolutionize cancer care in India and serve as a model for other developing nations in the Global South. By leveraging the strategies and technologies developed for PPCM, India could significantly enhance its healthcare system, highlighting the importance and urgency of improving cancer care in the region.
本文全面分析了印度在全球南方成为癌症护理领导者的潜力，特别是在精准人群癌症医学（PPCM）方面。通过跨学科视角，审视了印度当前的癌症护理格局，突出了其在该领域的优势、劣势、机遇和威胁。本综述探讨了知识转化的概念及其在弥合医学科学知识生成与实施之间差距方面的重要性，并将其应用于印度的医疗保健场景。该综述接着深入探讨了印度的技术实力，以其数字健康举措为例，如CoWIN（战胜新冠疫情）应用程序和阿育吠陀数字使命，这些为在医疗保健中利用先进技术奠定了坚实基础。作者们讨论了印度的制药行业，该行业常被称为“世界药房”，强调了其在全球药品制造和分销中的关键作用。还研究了该国新兴的基因组研究格局，包括基因组印度计划和印度癌症基因组图谱基金会等举措，这些对推进个性化医疗至关重要。综述的很大一部分致力于分析印度的临床试验生态系统。追溯了该国临床研究监管框架的演变，突出了近期改革使印度日益成为全球研究的有吸引力目的地、创新试验设计和人工智能驱动分析的潜在采用情况。至关重要的是，作者们直面了印度复杂医疗保健格局中固有的巨大障碍，阐明了必须克服的独特挑战。该综述承认，尽管印度人口众多且癌症负担沉重，但在全球临床试验中的代表性不足。讨论了癌症护理中的财务毒性问题，强调了对可负担治疗方案的需求。研究还指出了印度基因组数据库的初期状态，其仅占全球遗传数据的一小部分。尽管存在这些挑战，作者们认为，通过有效利用其信息技术（IT）基础设施、强大的制药行业以及庞大、多样化的人口，印度有潜力开发针对癌症护理的独特、符合国情的解决方案。该研究表明，通过促进基因组研究、战略性改革其临床试验生态系统以及利用其数字能力，印度可以改变其癌症护理格局，并成为全球南方其他发展中国家的典范。从本质上讲，本文为印度迈向成为PPCM领导者的征程提供了路线图，为肿瘤学和精准医学领域的政策制定者、医疗保健专业人员和研究人员提供了宝贵见解。实际上，通过将PPCM用作“试点项目”，印度可以学会运用其新战略来改善非癌症护理、疾病预防、早期检测以及改进和更具成本效益的管理。这种方法可以彻底改变印度的癌症护理，并成为全球南方其他发展中国家的典范。通过利用为PPCM开发的战略和技术，印度可以显著提升其医疗保健系统，突出改善该地区癌症护理的重要性和紧迫性。
