2026-10-03

Dr. Sanket Mehta, Founder and Lead Surgeon, SSO Cancer Hospitals, explains how pharma can strengthen cancer drug development, diagnostics and treatment access while building evidence tailored to Indian patients.

Q. What do you see as the key gaps in oncology drug development and research investment that the pharmaceutical industry must still address to improve survival rates and treatment outcomes?

Dr. Sanket Mehta: Drug development needs a strong Research & Development (R&D) budget and latest technology and log duration of clinical trials. The Indian pharma industry, while being second largest after the United States, only a very small percentage of the budget is invested in clinical trials, which in certain pioneering pharma companies can be as less as 10 percent whereas in companies in the United States it is almost 10 to 16 percent. Also, companies involved in drug development businesses has only recently started in India and therefore have much more scope of scale in this space. Drug development needs to increase in scale.

Drug development is a science and you need to give time to the scientist to do the right thing and follow the right protocol, which is expensive, As India is a very cost sensitive market and the incentive structure to develop new drugs is lacking in India.

I would also like to see more clinical research originating from India. Our patient population, disease presentation and healthcare realities are different. We need evidence generated here, through stronger partnerships between pharmaceutical companies, clinicians and academic institutions.

Finally, access has to be considered part of innovation. A treatment has limited impact if the patient cannot afford the drug, the diagnostic test or the complete course of care.

Q. What have been the major pharmaceutical advances in the treatment of GI cancers, and how can the industry help address the factors contributing to delayed diagnosis?

Dr. Sanket Mehta: The biggest change I have seen is that Gastro-Intestinal (GI) cancer treatment is no longer centred around chemotherapy alone. Targeted therapies and immunotherapy have created new possibilities for appropriately selected patients, and molecular information is increasingly becoming part of how we decide treatment.

For example in carefully selected stage 4 colorectal cancer patients even a stage 4 disease can go into remission and the patient can have a chance of long term survival and cure which was not a possibility a few years back and is applicable across several spectrum of cancer. This is possible because of the recent development in drugs.

This is where I believe pharma can contribute beyond developing medicines. There is an opportunity to support better diagnostic awareness, improve access to appropriate testing and work with doctors and healthcare institutions to reduce the gap between suspicion and confirmed diagnosis.

A drug can change the outcome for a patient only after we identify the disease and establish that the patient is likely to benefit from it. Earlier diagnosis and better treatment selection have to move together.

Q. Over the past decade, how has the pharmaceutical industry's approach to cancer R&D, drug development and diagnostics evolved, and which industry-led developments do you consider the most significant?

Dr. Sanket Mehta: The most important change in my view is that major pharma companies involved in cancer therapeutics have started allocating budgets trying to develop novel therapies including treatments like immunotherapies and carticel therapy on the Indian patient base. The major pharma companies have also started working with companies to develop drugs to cater to Indian population. These are still in initial phases but it's a very encouraging sign. I also see diagnostics becoming much more closely linked to treatment. We are moving towards a situation where the diagnostic report is not simply telling us what cancer is present; it can help determine which treatment may or may not work.

The next step, for me, is making this sophistication clinically practical in India. Advanced diagnostics and newer therapies should not remain available only to a small section of patients in major cities.

Technology has changed what is scientifically possible. The next challenge is making that progress usable, affordable and meaningful at scale.

Q. How is precision medicine reshaping pharma's approach to GI cancer treatment, and what role does molecular or genomic profiling play in guiding drug development and treatment decisions?

Dr. Sanket Mehta: Precision medicine is particularly relevant to GI oncology because these are not biologically uniform diseases. Two patients may have a tumour in the same organ, at the same stage, and still have very different biology and treatment options.

For me, molecular profiling is useful when it answers a clinical question. It may identify a biomarker that makes a patient eligible for a targeted therapy, indicate whether immunotherapy could be relevant, or open the door to a clinical trial. That information can fundamentally change the treatment discussion.

It also changes how pharmaceutical companies should develop drugs. Instead of looking only at a large disease category, we are increasingly identifying smaller groups of patients whose tumours share a particular biological characteristic.

But precision medicine should not become synonymous with ordering every available test. The real value lies in connecting pathology, molecular information, imaging and clinical judgement to make a better treatment decision.

Ultimately, precision medicine should make cancer treatment more precise not simply more complicated.

Q. Beyond developing new therapies, what role can the pharmaceutical industry play in driving systemic change — across awareness, screening, diagnosis, and access — to significantly improve cancer outcomes in India?

Dr. Sanket Mehta: I believe the pharmaceutical industry has an opportunity to participate much earlier in the cancer pathway. By the time a patient approaches me as a surgical oncologist, many of the decisions that influence outcome have already been made or delayed.

We need patients to recognise concerning symptoms earlier. We need doctors to have clear referral pathways. We need diagnostic facilities capable of providing timely pathology, imaging and molecular testing. And once a diagnosis is made, the patient needs access to the appropriate multidisciplinary treatment.

Pharma can work with hospitals, clinicians, professional organisations and healthcare systems across these areas. It can also support clinical research and help bring newer therapies into India in a way that generates evidence relevant to our patients.

Access is another major issue. We should look at the entire cost of cancer care, not just the price of a drug.

If we want better cancer outcomes in India, we cannot look at the medicine in isolation. We have to strengthen the pathway that gets the right patient to the right diagnosis and, ultimately, the right treatment.