Precision medicine is one of the most promising initiatives for the cost-effective improvement of treating diseases, especially cancer. In layman’s terms, “precision medicine” can be described as customized healthcare for each patient based on their biological, behavioral and environmental differences. Many developed countries are investing heavily in research into precision medicine; however, countries outside the U.S., Europe, and Japan, collectively make up to 60 percent of the world’s population but contribute less than 1 percent of sequenced genomic data globally (Genetic Literacy Project).
Developing countries such as the Philippines historically focus their health resources on managing and eliminating communicable diseases, but do not create programs like the Human Genome Project, which was conducted with the goal of sequencing all of the DNA that make up the human genome, and mapping and understanding all the genes in the genome. As a consequence of this effort, researchers have discovered just over 1,800 disease genes with more than 2,000 genetic tests for human conditions and 350 biotechnology-based products currently in clinical trials (Genome Mag).
PILAR briefly met with Dr. Gerardo Cornelio, who was previously President of the Philippine Society of Medical Oncology and is currently Chair of the Cancer Institute, St Luke’s Global City. PILAR asked Dr. Cornelio on his thoughts about precision medicine in the Philippines, with a focus on genomics-based precision medicine.
Why in your opinion does the Philippines need genomics-fuelled precision medicine especially given the prohibitive costs of genomics techniques?
The Philippines needs genomics and precision medicine to keep up with current state-of-the-art treatments. We have always found a way to counter costs by the “bayanihan” method amongst Filipinos. Many of our patients survive because of support coming from relatives working overseas since they pay out of pocket. Insurance does not cover expensive medicines such as chemo or targeted therapies unless it has a critical care rider. Relatives from all over the world help out but most of these treatments by pharma industries depend on each country’s GDP so we get to keep up with costs.
What is the current state of genomics-based precision medicine in the Philippines in terms of both knowledge and clinical practice?
The current state is still slow, only a few centers in the Philippines have the capability to do these tests.
How is your organisation working to overcome these challenges?
St Luke’s just acquired a next-generation-sequencing machine and is in the process of validating its use. We want to keep up with the best in the world so we partnered with the Mayo Clinic in the U.S. The biggest challenges are ignorance, and refusal to believe from some sectors. A lot still believe in alternative treatments without science hence we often see more advanced cases of cancer. Another challenge is the rising cost, we need more government funding and support for healthcare.
How can universities and non-profits like PILAR work with your organisation to go further, faster and with more confidence in delivering on the promise of genomics-based precision medicine? Also, what are your views on balancing the need for privacy against the benefit that these data can have on research and clinical practice?
Partnering with universities would be best so that trials are carried out academically. I believe healthcare is one sector that may be exploited with regards to encroaching on individual’s privacy but in the end it would benefit more people if done properly and ethically.
What advice would you give to young Filipino clinicians, scientists or entrepreneurs thinking of doing something related to genomics-based precision medicine?
I would really encourage participation in investigator- or industry-sponsored clinical trials with genomic-based precision medicine because it is the only way we can prove the benefits of precision medicine to our patients in the long term.