The New Era of Precision Oncology. Practicing Pathology in Low Resource Countries and Settings

Zubair Ahmad,1 Shabina Rahim,2 Maha Zubair,3 Jamshid Abdul-Ghafar4 1Department of Pathology, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman; 2Pathology Department, Royal Medical Services, Military Hospital, Manama, Bahrain; 3Department of Internal Medicine, LSU Health Shreveport, Shreveport, LA, USA; 4Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, AfghanistanCorrespondence: Jamshid Abdul-Ghafar, Department of Pathology and Clinical Laboratory, French Medical Institute for Mother and Children (FMIC), Kabul, Afghanistan, Tel +93792827287, Email [email protected]: Personalized or precision medicine is the future of cancer treatment modalities. It is advancing at a rapid pace and transforming the practice of oncology. Personalized oncology demands personalized (precision) pathology. New biomarkers are continuously being discovered, and there is increasing emphasis on individualized care. The primary aim of oncology in the new era is to utilize the molecular characteristics of malignant tumors to design the best and most optimal treatment for each cancer patient. Molecular diagnostics is the cornerstone of precision oncology. Pathology always had a crucial and major role in cancer care encompassing all aspects of oncology and this role is becoming even more critical. It is expanding and transforming into an even more dynamic specialty. Pathologists in developing countries and low resource settings need to understand these changes, take up the new challenges and opportunities, and modify their practice accordingly not only in order to remain relevant, but even more importantly to embrace a more central and vital role in cancer care. They need to embrace molecular technologies like next-generation sequencing (NGS) and familiarize themselves with new and emerging molecular biomarkers, and how these help in deciding the best targeted therapy for individual cancer patients. They also need to incorporate digital pathology (DP) and artificial intelligence (AI) in their routine practice. Herein, we present our views and perspective regarding opportunities and challenges for pathologists in the era of “precision oncology”.Keywords: precision, pathology, oncology, developing country