From Genomes to Better Treatment: 4baseCare’s Vision for Personalised Cancer Care

What if cancer treatment could be chosen for the patient—not just for the disease? As precision oncology advances, genomic testing is helping doctors understand the unique genetic profile of a tumour and identify treatments that may work better for individual patients.

In this interview, Hitesh Goswami, CEO and Co-Founder of 4baseCare, discusses the company’s efforts to make precision oncology more accessible across India. He shares insights into the LuNGS Alliance, an initiative focused on expanding free genomic testing for lung cancer patients, particularly in Tier II and Tier III cities.

The conversation explores how genomic testing can help identify actionable mutations, reduce the limitations of one-size-fits-all cancer treatment, and support more informed clinical decisions. Goswami also discusses the challenges of making precision oncology affordable and accessible, as well as OncoTwin Insights, 4baseCare’s AI-powered platform that combines genomic data with real-world clinical outcomes to support oncologists.

The interview also looks at 4baseCare’s collaboration with healthcare and pharmaceutical partners and its vision for bringing personalised cancer care to more patients across India.

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Q. What is the vision behind the LuNGS Alliance initiative, and what key gaps in cancer diagnosis and treatment are you trying to address through it?

'LuNGS Alliance' is an initiative by the Cancer Research and Statistic Foundation (CRSF) to improve lung cancer treatment in India, specifically in tier II and tier III cities. Led by oncologist Dr Kumar Prabhash of Cancer Research and Statistic Foundation, this initiative is backed by leading pharmaceutical companies AstraZeneca, Pfizer, and Roche, with 4baseCare serving as the official lab partner. 

The vision behind LuNGS Alliance is simple: no lung cancer patient should miss out on the right treatment because they lack access to genomic testing. Today, targeted therapies have significantly improved outcomes in lung cancer, but many patients, especially outside major metropolitan centres, are unable to access the biomarker testing required to identify whether they are eligible for these therapies.

By making advanced NGS (Next Generation Sequencing)-based biomarker testing available free of cost, LuNGS Alliance is helping ensure that treatment decisions are based on the molecular profile of the tumour rather than a one-size-fits-all approach.

Q. Many cancer treatments still follow a standard approach. How does genomic testing help make treatment decisions more personalized for patients?

Genomic testing helps us understand the specific genetic mutations driving an individual's cancer. Once these are identified, oncologists can determine whether targeted therapies or other precision treatments are likely to be effective.

Instead of treating all patients with the same protocol, genomic testing enables clinicians to match the right patient with the right therapy at the right time. This improves treatment outcomes, reduces unnecessary toxicity, and helps avoid treatments that may not benefit a particular patient.

Q. The LuNGS Alliance has focused on improving access to genomic testing in Tier II and Tier III cities. Why was it important to prioritize these regions?

One of the biggest challenges in cancer care in India is the diagnosis-access gap. Patients in Tier II and Tier III cities often present with advanced disease and have limited access to specialized oncology services and precision diagnostics. Many are forced to travel to larger cities for testing and treatment, which creates financial and logistical burdens.

We believe precision oncology should not be restricted to patients living in metropolitan areas. By bringing genomic testing closer to patients in smaller cities, we can enable more informed treatment decisions and better outcomes while reducing the travel burden on patients and families.

Q. More than 1,000 tests have already been conducted through the programme. What are some of the key insights or learnings that have emerged so far?

One of the most important learnings has been that when barriers to testing are removed, both patients and oncologists are highly receptive to genomic testing. There is often an assumption that precision oncology is difficult to implement outside large metropolitan centres, but the programme has demonstrated that patients across Tier II and Tier III cities are equally willing to undergo testing when access is made easier.

We have also seen that a significant proportion of patients carry genetic mutations that can directly influence treatment decisions. This reinforces the need to make comprehensive genomic profiling a routine part of lung cancer care rather than reserving it for select patients.

Q. Among the first 100 patients tested, 64% were found to have actionable genetic mutations. What does this tell us about the importance of genomic testing in lung cancer care?

The programme has reinforced the fact that genomic testing should not be viewed as optional but as a critical component of modern lung cancer management. If nearly two-thirds of patients carry actionable mutations, it means that a significant proportion could potentially benefit from targeted therapies that may not have been considered without testing.

Genomic testing provides that missing layer of insight and helps ensure patients receive therapies that are aligned with the molecular drivers of their disease

Q. What are the major challenges in making precision oncology and genomic testing more accessible and affordable across India?

First, there is still limited awareness among patients and, in some cases, even among healthcare providers regarding the value of genomic testing. Second, affordability remains a concern, particularly in resource-constrained settings.

There are also infrastructure challenges, including access to testing facilities, sample logistics, and timely reporting. Finally, precision oncology is not just about testing—it also requires access to targeted therapies and clinicians who are trained to interpret and act upon genomic information. Addressing all these components simultaneously is critical for broader adoption.

Q. Could you explain how OncoTwin Insights supports oncologists in making treatment decisions, and what sets the platform apart from existing solutions?

OncoTwin Insights is designed to help oncologists derive meaningful clinical insights from complex genomic and clinical datasets. The platform uses AI-driven patient matching and advanced analytics to identify patients with similar molecular and clinical profiles and analyse how they responded to different treatment approaches.

What makes it unique is its ability to combine genomic information with real-world clinical outcomes, enabling more evidence-based treatment decisions. Rather than relying solely on published literature or isolated biomarkers, oncologists can access insights derived from comparable patient journeys, helping them make more informed and personalized treatment recommendations.

Q. OncoTwin Insights was recently selected for the MSK iHub program at Memorial Sloan Kettering Cancer Center. What does this recognition mean for 4baseCare and the future development of the platform?

Being selected for the MSK iHub programme is a significant validation of the work we are doing in precision oncology. Memorial Sloan Kettering is one of the world's leading cancer centres, and recognition from such an institution reinforces the relevance and potential impact of our approach.

It provides an opportunity to collaborate with global experts, refine the platform further, and accelerate the development of technologies that can support oncologists in delivering more precise and data-driven cancer care.

Q. LuNGS Alliance brings together partners such as CRSF, AstraZeneca, Pfizer, Roche, and 4baseCare. How have these collaborations helped strengthen the programme and enhance its impact?

Making precision oncology accessible requires collaboration across diagnostics, pharmaceutical companies, healthcare providers, patient advocacy groups, and research organizations.

The LuNGS Alliance demonstrates the power of this collaborative model. Each partner contributes unique expertise and resources, whether it is funding, scientific knowledge, testing infrastructure or patient outreach. Together, we have been able to create a programme that expands access to genomic testing, accelerates diagnosis, and ultimately improves treatment opportunities for patients across the country.

Q. Looking ahead, what are your priorities for expanding access to precision oncology and improving cancer outcomes for patients across India?

Our priority is to make precision oncology accessible irrespective of geography or socioeconomic background. This includes expanding access to genomic testing, strengthening partnerships with regional hospitals, building local testing capabilities, and supporting clinicians with decision-support technologies such as OncoTwin Insights.

We would also like to see successful models such as LuNGS Alliance extended beyond lung cancer to other cancer types where genomic testing can meaningfully impact treatment decisions.