India is yet to get its share of modern Theranostics field. There are a few start-up companies in India that are operating in the Theranostics and personalized medicine in general.
“Theranostics and personalized medicine are very nascent sectors in India, as compared to the West, where personalised medical approaches have reached the clinic on a much larger scale,” shares Dr Nilay Lakhkar, Founder & CEO, SynThera Biomedical, a start-up focusing on manufacturing and commercialization of biomaterials-based medical devices.
The West may be early adopters of the evolving field of Theranostics into their routine healthcare as it promotes safer and more efficacious pharmacotherapies to patients which is supported by patients, and encouraged by insurance companies.
“Whereas in India, we may gradually implement Theranostics across urban areas as it becomes affordable with appropriate testing systems, and expertise becomes available,” remarks Dr Arumugam.
Currently in the West, a severe disease like cancer is treated through precision medicine. For example, mutational typing of a cancer is first performed and the right therapy or drug is then prescribed based on the mutation.
Considering the Indian population and its disease burden, Theranostics will eventually enter the Indian healthcare market in a big way in the next couple of years.
“In the next 5 or 6 years, we would see some form of Theranostics in clinical use, particularly for solid tumours. I believe oncologists along with radiologists will probably be the first to introduce Theranostics in clinics,” Dr Biplab predicts.
However, the key question is whether India will be able to develop any such products indigenously?
There are several lacking factors, points Dr Biplab. “Factors include lack of access to advanced instruments. India is lacking in the development of real-life microfluidic devices. However, Indian scientists have gained reputation in the field of nano-materials, including nano-drug delivery systems. Unfortunately, Indian pharma companies are slow to
pick the thread from laboratories, and have not yet built upon the developments that have happened in our academic labs,” he stresses.
Also, the patients in India are not much clinically educated. “One of the fundamental issue is cost factor, and the absence of active clinical trials and proper counselling in government hospitals; and lack of high throughput facilities are among many reasons which retard the development of opportunities in Theranostics in our country,” highlights Dr Aman.
The key areas of Theranostics have developed rapidly in the last few years including Photo-Immunotherapy (PIT), and nano-particle-based drug-delivery and imaging systems. “We may soon see some successful clinical trials in these two segments,” reveals Dr Biplab.
In a way, personalized medicine, Theranostics and precision medicine are all interlinked from the view point of treatment.
Dr Arumugam explains, “It is all about the right drug, at the right time, for the right patients. Theranostics mainly refers to treatment strategy that combines therapeutics with diagnostics as one treatment unit. Personalized medicine imply that drugs are being customized for each individual patient. In precision medicine, the dosing regimen is designed for patients based on drugs used, condition to be treated, genetics, environmental and lifestyle factors.”
Theranostics is important for both personalized as well precision medicine, feels Dr Biplab.
“I would say, it is important more for precision medicine. Take the example of a drug-delivery system that combines targeted drug-delivery and imaging of drug-delivery. Such drugdelivery system would allow the physician to deliver the drug to specific location as well as confirm it by imaging,” he notes.