Last updated : May 18, 2026 6:09 am
Access to genomic testing, not therapy cost, is the biggest challenge
In an exclusive interview with Rahul Koul, Editor, Indian Pharma Post, Dr. Vidya Veldore explains how genomics, AI, and data analytics are transforming cancer care in India and why precision oncology must reach Tier 2 and Tier 3 cities. Read the excerpts:
What role do you see genomics and genomics research playing in enabling personalized cancer treatment over the next five years?
The scientific understanding of how cancer develops, along with public awareness of personalized medicine in oncology, has improved significantly over the last decade. Genomics is no longer just a research frontier; it is rapidly becoming the backbone of modern healthcare. The convergence of AI, genomics, and epigenetics is paving the way for a future where prevention, early diagnosis, and treatment are seamlessly personalized. The increasing adoption of genomics in cancer management has the potential to improve clinical outcomes, enhance longevity and quality of life for cancer patients, and significantly reduce early cancer incidence among high-risk individuals through prophylactic interventions.
By decoding individual tumour genetic profiles, clinicians can tailor therapies to maximize efficacy while minimizing side effects, which is especially critical in oncology due to tumour heterogeneity. Genomic sequencing also enables oncologists to monitor tumour evolution under treatment pressure, allowing adaptive treatment strategies such as changing drug combinations or introducing immunotherapies. Liquid biopsy, a minimally invasive approach that detects circulating tumour DNA, is emerging as an important tool for early detection, treatment monitoring, and relapse prediction. Beyond DNA sequencing, epigenetic markers such as DNA methylation are becoming valuable tools for early cancer screening, helping identify risk profiles long before symptoms appear. Population genomics is also enabling preventive strategies by identifying high-risk groups and informing public health interventions and lifestyle modifications to reduce cancer incidence.
What are the biggest barriers preventing patients in Tier 2 and Tier 3 cities from accessing advanced cancer diagnostics and precision oncology services in India?
The key barriers to accessing advanced cancer diagnostics are delayed diagnosis and the lack of specialized cancer care infrastructure, particularly in smaller towns and villages. Due to late diagnosis, a large number of patients present at Stage III or Stage IV, where treatment becomes significantly more complex, expensive, and less effective compared to cancers detected at an early stage in high-resource settings.
Another major issue is the shortage of specialists and advanced therapeutic facilities outside metropolitan cities. Due to inadequate infrastructure, many patients are compelled to travel to Tier 1 cities for treatment, creating what is commonly referred to as the “travel burden.” This not only places immense financial strain on families but also disrupts livelihoods, especially when the patient or caregiver is the primary breadwinner. Travel expenses, accommodation costs, loss of wages, and prolonged treatment frequently lead to financial exhaustion, delayed treatment decisions, or even treatment abandonment midway.
How is 4baseCare working to bridge the gap in genomic testing access beyond metro cities?
At 4baseCare, we believe the only way to make precision oncology truly accessible is by bringing it closer to patients through strategic collaborations. Our aim is to decentralize advanced diagnostics and reduce the travel burden that often leads to treatment abandonment. We have partnered with hospitals across India, especially in Tier 2 and Tier 3 cities, to ensure that patients can access advanced cancer care within their hometowns.
How is the company leveraging advances in AI, bioinformatics, and data analytics to improve cancer diagnostics and therapy selection?
We are currently leveraging our scientific understanding of tumour biology and tumour behaviour over time, especially under the influence of multiple lines of therapy. We have been systematically cataloguing the tumour sample journey through the laboratory while adhering to ISO 15189 guidelines and stringent quality control measures during sample processing, next-generation sequencing data analysis, and clinical interpretation of genomic mutations.
By integrating clinico-genomic profiles with treatment outcome patterns across diverse cancer patient groups, we are able to predict treatment responses for future patients with similar genomic patterns. This evidence-based approach supports more accurate treatment selection while helping avoid toxicities associated with conventional decision-making approaches.
We are also utilizing data analytics to assess genetic diversity across different ethnic populations in Asia and globally to understand population-based cancer risk patterns that could influence public health strategies for cancer prevention.
How can actionable genomic insights help oncologists in non-metro cities make more personalized and effective treatment decisions?
Actionable genomic insights can significantly improve how oncologists approach cancer treatment by enabling more personalized, data-driven decisions instead of relying on generalized treatment protocols. Identifying specific genetic drivers such as EGFR or ALK mutations allows oncologists to prescribe targeted therapies instead of broad-spectrum chemotherapy. Genomic insights also help avoid unnecessary treatment costs by identifying therapies that are most likely to benefit a patient’s specific cancer subtype.
At the same time, local genomic infrastructure can be strengthened through virtual molecular tumour boards and AI-backed clinical decision support systems. While sequencing may be performed locally, the interpretation of complex genomic data can happen collaboratively through digital platforms involving leading geneticists and specialists. Solutions such as our OncoTwin platform are designed to facilitate such data-backed decision-making by matching patients with similar genomic and clinical profiles from larger databases. This helps bridge the gap between local oncologists and advanced precision oncology expertise, enabling patients in smaller towns to access a metropolitan standard of care without leaving their districts.
How can technology and digital health platforms help improve access to advanced cancer diagnostics in smaller cities?
One of the major challenges in establishing genomic testing in smaller cities is the lack of trained manpower for sample processing, along with the absence of well-established end-to-end workflows aligned with GCP, GLP, and ISO 15189 recommendations. Developing validated in-house genomic testing assays, building robust frameworks for genomic data analysis, and ensuring scalability could significantly improve the adoption of genomic diagnostics in cancer care.
What policy or ecosystem-level interventions are needed to make precision oncology more accessible and affordable across India? What more needs to be done towards precision oncology research?
Government healthcare schemes and population research funds should support genomic testing as part of the initial diagnostic workup for all cancers. This would enable accurate diagnosis and more effective treatment decisions based on an individual patient’s tumour mutation profile. India is projected to become the global capital of cancer incidence by 2040, making timely interventions essential.
Since the majority of patients belong to low-income groups and rely on government hospitals and public healthcare schemes, the absence of genomic testing at the grassroots level could result in patients being treated with generalized regimens that may not align with their tumour biology. Tumour profiling helps oncologists identify the exact genetic drivers of cancer, allowing them to match therapies to mutations, avoid ineffective treatments, and improve survival rates. With many targeted therapies now available in generic forms at lower costs, access to testing rather than therapy costs has become the primary challenge. Evidence-based medicine has consistently demonstrated that genomics-driven treatment approaches can reduce relapse, resistance, and unnecessary treatment-related toxicities.
Several countries, including the UK, the US, and Australia, have already integrated genomic testing into public healthcare systems, providing India with valuable models for expanding precision oncology access. India can learn from these models to embed genomic testing into public healthcare, ensuring equitable access for low-income patients and preparing for the projected rise in cancer incidence.
What role can public-private collaborations play in strengthening cancer diagnostics infrastructure in underserved regions?
Public-private collaborations have repeatedly demonstrated their value in improving cancer care quality and clinical outcomes globally. In many Western countries, technology providers have collaborated with cancer hospitals to increase accessibility, provide training to medical staff, and improve the adoption of genomic testing and clinical decision-making.
In India, awareness and adoption of genomics initially progressed slowly due to limited technology access and affordability. Over the last five years, there has been a significant shift in government policies and research frameworks encouraging public-private collaborations. This has created opportunities to build infrastructure and train talent pools, including oncopathologists, scientists, and laboratory technicians, with the specialized skills needed for genomic testing.
With the support of centralized data processing and cloud-based analytics, we believe diagnostic services in underserved regions can be significantly improved. 4baseCare is also proud to be part of the LuNGS alliance, one of India’s largest free genomic testing initiatives for lung cancer patients under the “Cancer Research Statistics and Treatment” programme. Through this initiative, we have demonstrated that genomic services can be delivered across Tier 2 and Tier 3 cities and villages in India, positively impacting the lives of more than 6,000 lung cancer patients by supporting genomic profiling for diagnosis and treatment decisions.