Th e HealtH | MAy, 2019
20
TECH & innoVATion
biology as well as the founding director of the UKM
Medical Molecular biology institute (UMbi) talks about
how precision medicine can provide better chances of
treatment for cancer patients.
“For any given medication or treatment, the response
from each individual is diff erent. Th is is because of the
enzymes in our bodies which metabolises the drugs.
some may have more active enzymes and some may
have lesser active enzymes,” Prof rahman starts.
As an example, Prof rahman tells of the medication
called carbamazepine (sold as tegretol). it is a medica-
tion commonly used to treat epilepsy and neuropathic
pain. “if you have a certain genetic variant, you are at
higher risk of developing a severe rash when taking said
drug. A patient could even die from the eff ect of the
drug if he or she is of that particular genetic variant.”
Th e adverse eff ect of this drug to patients with that
specifi c genetic variant is well-known in the Us, and
so the FDA have made it compulsory for patients to be
tested before prescribing them with said medication.
Th is is a simple example of how precision medicine
can provide better treatment for a patient.
Cancer treatment included
it is the same with cancer treatment. “Not all tumors
will respond the same to chemotherapy or radiotherapy.
in terms of treatment, it is not a one-size-fi ts-all. in
lung cancer for example, you have to get tested for a
genetic variant called the eGFr gene. treatment will
depend on whether you are tested positive or negative
for the genetic variant.”
“it is a way for us to guide the clinicians on the right
treatment for each individual patient,” he explains.
Going further into genetic testing, Prof rahman
also explains about cancer profi ling and ‘actionable
mutations’. it is simply to look at the cancer tumor at a
molecular level and see how it mutates.
“With this, we will have an opportunity to give
targeted treatment if the patient’s cancer goes into
recurrence. Moreover, the targeted treatments are
not chemotherapy, but inhibitors to melt the tumor
without any serious side eff ects.”
“Th at would provide the patient with opportunity
for a cure if the cancer comes back,” he tells.
our genetic makeup dictates how we may respond to certain type of treatment.
Better cancer
treatment through
precision medicine
By studying our genes, we can
have a more personalised and
eff ective treatment for various
diseases
t
Genetic makeup is
key to better treatment
Prof Datuk Dr A rahman A Jamal, a professor of
Paediatric Oncology and Haematology, and Molecular
Maybe we might remember the whole deal with Holly-
wood actress Angelina Jolie, where she took an extreme
preventative measure of having her breasts and ovaries
removed. she was found to have a high risk of getting
breast and ovarian cancer due to her family history.
Her case is an example of hereditary cancer. cancers
such as breast, ovarian, and colon cancer are actually
found to be genetically predisposed. Th at means that
an existence of specifi c genes in our bodies can predict
high chance of developing said cancers.
And of course, there is a test to see whether you
might have a high risk of developing said cancers as
well.
“if you have a strong family history of breast,
ovarian, or colon cancer, it is worth to take the test
so that you may undergo closer monitoring, and have
a higher chance of early detection and more eff ective
treatment,” says Prof rahman.
Testing is actually available
He word treatment can be just as devas-
tating as the disease it helps to cure. For
cancer patients predominantly, treatments
to help fight the disease may involve
multiple surgeries, drugs, chemotherapy,
and radiotherapy, resulting in awful side
eff ects.
Having said that, there also people who responds
better to treatment than others. some we may have
heard had no problem going through all the chemo-
therapy cycles, and some who have experience recession
after only a few sessions of treatment.
Th ese people respond better to their treatment is
not because they are given diff erent treatment than
the ones who are not responding well. it actually has
to do with the genes.
Precision medicine
as preventative measure
Prof rahman says that precision medicine can make
for more precise and personalised treatment of
cancer and other non-communicable diseases.
“UMbi was actually the fi rst to off er the genetic test for
the epilepsy medication in Malaysia. We did in-house
and off ered the test to paediatricians and neurologists
of Hospital UKM. And only later the test are made more
widespread through the Ministry of Health.”
Genetic testing is readily available in Malaysia, and
UMbi is spearheading the awareness to get tested for
better treatment.
“Th e tests comes at quite a cost, therefore it is admit-
tedly not for everyone,” he says.
Th e high cost is because of not just the test itself, but
the following procedures as well. closer monitoring for
potential cancer, inhibitors to eff ectively shrink cancer
tumors, and even surgeries comes at a high cost – and
they are not reimbursable.
“UMbi have made eff orts to present the benefi ts of
precision medicine and make it a mainstream option
for patients suff ering from various diseases. Th e cost
for treatment on the long-term, if patients know their
predisposition to diseases, can be reduced signifi cantly.
Th is is what are presenting to the Ministry of Health,”
he says.
Precision medicine can really change the way health-
care is delivered, and can lead to better prevention of
diseases rather than treatment itself. — Th e Health