A new era has begun in oncology

We continue to gather the views of Prof. Dr. Mutlu Demiray — Specialist in Internal Medicine and Medical Oncology, head of the Medical Oncology Clinic at Istanbul International Hospital and Oncology Coordinator of the Medicana Hospitals Group — specifically on oncology.

Is progress in oncology treatment methods satisfying? For example, are there cancer types with far more encouraging outcomes today than ten years ago?

A new era has now begun in oncology. We are moving away from organ-based treatments toward molecular-based treatments. Cancer is cancer, but its molecular features differ. For this reason, personalized treatment designs have come to the fore. The advancement of these methods is leading to significantly more successful outcomes.

In which direction are developments mostly happening — chemotherapy, immunotherapy, etc.?

The priority right now is immunotherapies and targeted tyrosine kinase inhibitors. But the next stage will be adaptive immunotherapies. For that reason, cell laboratories need to be ready.

What is the situation in our country regarding personalized treatment? Are there aspects — equipment and so on — that we still need to complete?

Our country has substantial infrastructure and capacity. However, we have a serious shortcoming in bioinformatics. Because of this, many foreign companies have set up representative offices here and our tissue samples are processed abroad. We must accelerate our work on this — both through collaboration and by sending our people abroad for training or recalling those already trained. We should be guiding treatments not with spot genetic analyses, but with tests that sequence all exons through next-generation sequencing.

Molecular biologists and geneticists should now also take part in oncology councils — indeed they should be permanent members. As a personal experience, I learned a great deal at the international molecular tumour boards I attended. This field is challenging for us clinicians, but also highly rewarding.

I take great pleasure in studying a patient's mutation map; solving the puzzle — and in doing so being able to touch a person's life — is a profound joy.

We must build our infrastructure as soon as possible. Preliminary work in this area has begun at the technopark of the University of Health Sciences, and hopefully it will come to fruition. Director General Dr. Orhan Çömlek is making a serious effort on this; our deputy minister Dr. Şuayip and our rector Prof. Dr. Cevdet Erdöl, who also sit on the board of this technopark, are providing significant support.