Three Disruptors transforming cancer care

An article written by Reenita Das in Forbes magazine more than 18 months ago – evaluating the primary disruptors in medical technology – sparked considerable interest in medical circles and prompted debate in publications such as The Lancet and Nature. It was particularly striking in that the majority of factors highlighted were in the realm of cancer care. Moreover, since the publication of the article, in many cases, these oncological initiatives are leading to a ‘sixth front’: a new mood of patient empowerment as technology leads to  multipolarity in the implementation of healthcare – and the breakdown of traditional, highly structured (and often traumatic) therapies.

1)    Artificial Intellgience (AI): combining patient focus and lower costs

First things first. AI in healthcare aims to improve patient outcomes by assisting healthcare practitioners in using medical knowledge. This can be at the level of AI-led diagnosis or by actual clincial intervention, whereby AI is now regularly at the threshold of surpassing human action. In the case of diagnosis, for example, certain areas of medical practice have already been transformed by AI – radiography being a classic example. AI rediographic diagnosis can bring the equivalent of 1000 years’ experience of interpreting the presence or not of tumours and their likely operability. In other words, a level of experiential data far exceeding that of any human, and causing (amost literally!) a storm when first demonstrated at the Chicago World Radiographers’ Convention in 2016.

By 2020, chronic conditions, such as cancer and diabetes, are expected to be diagnosed in minutes using cognitive systems that provide real-time 3D images by identifying typical physiological characteristics in the scans. By 2025, AI systems are expected to be implemented in 90% of the U.S. and 60% of global hospitals and insurance companies.

But there’s more. AI’s ability to improve the accuracy of medical image analysis draws on help from digital image processing, pattern recognition and machine-learning AI platforms. Forbes comments, for example: “How a startup, Butterfly Network, has developed a handheld 3D-ultrasound tool that creates 3D images of the medical image in real time and sends the data to a cloud service that identifies the characteristics and automates diagnosis. Such clinical support from AI is expected to have a significant impact on the overall medical imaging diagnosis market and its growth.”

The patient dimension

AI systems can also give physicians and researchers clinically relevant, real-time, information courtesy of electronic health records (EHRs). This can then be cross-matched to diagnostic and therapeutic tools – taken up or down the hosptital’s treatment path without the need for human conferral.

This in turn means reduced treatment costs, and elimination of unnecessary hospital procedures – and of course, far easier hospital workflows. Yet perhaps the main bonus here is that the entire process is patient-centric, because the digital data factors in the spectrum of ‘relational’ issues, likes and dislikes of the patient and their parameters for multiple procedures, location of care, and so forth.

2)    Immunotherapies: the sleeping giant of cancer care

Immunotherapy is the science of unlocking the potential of the immune system to dispel cancerous or benign tumours – and potentially, drawing on the emerging field of epi-genetics – to form a preventive wall against first formation or recurrence. Case studies show the potential for individual survival can be enhanced massively.

The promise of immunotherapy rests largely in its potential for very broad application across entire patient populations. Moreover, once the algorithm for its effective use in the oncology setting is properly identified, the potential is staggering. Forbes comments that “While checkpoint inhibitors dominate the current headlines in the clinical care communities, other promising approaches include novel molecular constructs such as chimeric antigen receptors (CARs), therapeutic combinations with old and new drugs, dosing regimen modifications and vaccines. The market for check point inhibitors was valued at $3 billion in 2015 and is expected to reach $21.1 billion by 2020, growing at CAGR of 139%.”

3)    Liquid Biopsy: non-invasive monitoring of tumours

Liquid biopsy extracts cancer cells from a single blood sample and completely eliminates many of the potentail ‘false signals’ of traditional, invasive biopsy. It analyses the actual constituents of the blood and can (virtually infallibly) recognise and read the protein traces of many cancer variants.

Compare this with traditional scenarios, where repeated biopsies are needed to study the changing tumour and can mean considerable discomfort for the patient.

Commercial factors

Liquid biopsy of course means an entire universe of investment and marketing opportunities for diagnostic companies. The focus on blood biomarkers, such as ctDNA and CTCs, unleashes the potential to now track and monitor tumors in a non-invasive manner. It is also so accurate that it can detect the worsening of a disease condition faster than any other available technology.

Two other factors here are the cost-to-patient, as well as the almost complete decentralisation of the diagnostic process. Since liquid biopsy doesn’t require invasive sampling, it needn’t take place in a medical facility, or indeed, in most cases even be adminisitered by a qualified practitioner. Instead, it is the aim of many diagnositc companies to make a self-diagnosis kit available through retail pharmacies, making home-testing a reality. This not only vastly alters the availability of dioagnostic testing, but dramatically lowers cost, shifting the process from a thousand-dollar operation to a few dollars for an over-the-counter test kit. A truly disruptive innovation for which we’ll see the full impact by the early 2020s.

This article was attributed and provided by PG International


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