Precision Oncology & Genetic Testing

Personalised Cancer Care Driven by Molecular Science

Introduction

Precision Oncology represents a transformative approach to cancer care—one that recognises that each tumour is biologically unique. Rather than relying solely on tumour location (breast, lung, colon, etc.), precision oncology focuses on genetic mutations, molecular pathways, and biomarker profiles that drive cancer growth. Genetic testing allows us to identify these alterations and match patients with therapies that target their cancer’s specific vulnerabilities.

At our clinic, precision oncology is integrated into every stage of care—from diagnosis and prognostic assessment to treatment selection and long-term follow-up. This ensures that each patient receives a treatment plan built around their tumour’s biology and their individual health needs, consistent with our ethos of Cure, Precision, and Compassion.

1. What Is Precision Oncology?

Precision oncology uses advanced molecular testing to analyse the genetic and biological characteristics of a tumour. These findings guide the selection of the most effective and safest treatments for each patient.

Key Principles of Precision Oncology

Precision oncology has expanded rapidly due to advancements in genomic sequencing and targeted drug development.

2. Types of Genetic Testing in Cancer Care

Genetic testing in oncology can refer to somatic tumour testing (mutations within the cancer) or germline testing (inherited gene mutations). Both are important.

A. Somatic (Tumour) Genetic Testing

These mutations occur only in the tumour and are not inherited.

Common Tests

These are essential for choosing targeted therapies, immunotherapies, and some chemotherapy strategies.

B. Germline Genetic Testing

These mutations are inherited and present in all cells.

Common Germline Mutations

Germline testing guides cancer risk assessment, prevention, family counselling, and treatment selection.

3. Why Genetic Testing Is Important

1. Identifying Actionable Mutations

Actionable mutations predict whether a patient will benefit from a targeted drug.

Examples:

2. Determining Immunotherapy Eligibility

Biomarkers such as:

Help determine whether immunotherapy will be effective.

3. Predicting Prognosis

Some mutations indicate aggressive behaviour; others predict slow growth.

4. Avoiding Ineffective Treatments

If genetic testing reveals resistance markers (e.g., RAS mutation in colorectal cancer), certain drugs can be avoided.

5. Long-Term Prevention for Families

Inherited mutations allow:

4. When Is Precision Oncology Recommended?

Precision oncology is now recommended for many cancers at diagnosis, recurrence, or treatment resistance.

Common Indications

● Lung cancer (all non-small-cell lung cancers should undergo molecular testing)

● Breast cancer

● Ovarian cancer

● Prostate cancer

● Colorectal cancer

● Melanoma

● Sarcoma

● Pancreatic cancer

● Thyroid cancer

● Paediatric cancers

● Rare cancers (NTRK fusions, ROS1 rearrangements)

Advanced or Metastatic Disease

Precision testing is essential to determine:

● Targeted therapy options

● Immunotherapy eligibility

● Clinical trial suitability

Early-Stage Disease

Genetic testing helps refine:

● Adjuvant therapy choices

● Duration of treatment

● Risk of recurrence

5. How Genetic Testing Is Conducted

The process is simple and patient-friendly.

1. Sample Collection

Samples may include:

● Tumour tissue (biopsy or surgery)

● Blood (liquid biopsy)

● Saliva or cheek swab (for germline testing)

2. Laboratory Analysis

Advanced platforms sequence DNA, RNA, or protein markers.

3. Interpretation by Molecular Tumor Board

Our multidisciplinary team reviews:

● Mutations

● Actionability

● Targeted treatment options

● Clinical trial relevance

● Prognostic implications

4. Integration into Treatment Plan

Treatment may include:

● Targeted therapy

● Immunotherapy

● Hormonal therapy

● Chemotherapy adjustments

● Surgery or radiation guidance

6. Common Actionable Mutations and Their Treatments

Cancer Mutation / Biomarker Targeted Therapy
Lung cancer EGFR Osimertinib, Erlotinib
Lung cancer ALK/ROS1 Alectinib, Crizotinib
Breast cancer HER2 Trastuzumab, Pertuzumab
Breast/ovary BRCA Olaparib
Colorectal RAS Wild-type Anti-EGFR therapy
Melanoma BRAF V600E Dabrafenib + Trametinib
All cancers MSI-H/dMMR Pembrolizumab
Thyroid RET / NTRK Selpercatinib / Larotrectinib

These treatments dramatically improve outcomes when matched correctly.

7. Advantages of Precision Oncology

1. Higher Treatment Accuracy

Therapies are chosen based on tumour biology, not just cancer type

2. Better Treatment Outcomes

Patients often experience:

● Higher response rates

● Longer survival

● Better quality of life

3. Avoidance of Unnecessary Toxicity

Treatments unlikely to work are avoided.

4. Options After Treatment Failure

Targetable mutations may appear later in the disease course

5. Family Impact

Germline findings allow cascade testing for relatives.

6. Access to Clinical Trials

Many cutting-edge therapies are available only through biomarker-based trials.

8. Limitations of Precision Oncology

● Not all tumours have actionable mutations

● Testing may take days to weeks

● Some targeted therapies are expensive

● Tumour heterogeneity can lead to mixed responses

● Some mutations signal poor prognosis rather than actionable targets

Our clinic helps patients navigate these complexities with clear, compassionate counselling.

9. Precision Oncology in Treatment Planning

Precision oncology informs decisions at multiple stages:

A. At Diagnosis

● Determines prognosis

● Selects therapy

● Identifies hereditary syndromes

B. During Treatment

● Monitors response through liquid biopsy

● Detects resistance mutations

● Adjusts therapy accordingly

C. At Recurrence

● Identifies new targets

● Guides shift to second- or third-line therapies

D. Survivorship & Prevention

● Surveillance tailored to genetic risk

● Prevention strategies for high-risk individuals

10. Our Clinic’s Precision Oncology Program

1. Comprehensive Genetic Testing Access

We offer:

● NGS panels

● Liquid biopsies

● Germline testing

● Re-biopsy for resistance

2. Multidisciplinary Molecular Tumor Board

Cases are reviewed by:

● Medical oncologists

● Surgical oncologists

● Radiologists

● Pathologists

● Genetic counsellors

3. Personalised Treatment Plans

Therapies are matched precisely to tumour genetics.

4. Dedicated Genetic Counselling

Patients and families receive guidance on:

● Hereditary cancer risk

● Family testing

● Preventive strategies

5. Ongoing Monitoring

We use real-time assessments and repeat testing when necessary

6. Compassionate Support

We ensure patients understand:

● The meaning of results

● Treatment implications

● Financial considerations

● Long-term follow-up needs

Conclusion

Precision oncology and genetic testing have redefined the way cancer is diagnosed and treated. By understanding a tumour’s unique molecular fingerprint, we can offer therapies that are more effective, more personalised, and more aligned with each patient’s needs. At our clinic, we combine scientific expertise with compassionate care to help patients navigate the rapidly evolving world of genomic medicine, ensuring that every treatment decision reflects our commitment to Cure, Precision, and Compassion.