2026 Advanced Therapies Report: Partnership Pathways and the Road Ahead

As advanced therapies continue to move beyond academic medical centers, the success of this transition will increasingly depend on how well community oncology practices and health systems collaborate. The 2026 Advanced Therapies Report from Cardinal Health highlights that no single site-of-care model will fit all therapies or patients. Instead, there are a range of partnership approaches that can support safe administration, manage toxicity, and extend long-term follow-up closer to the patient’s home.

In an interview with Targeted Oncology, Fran Gregory, PharmD, MBA, vice president of Emerging Therapies at Cardinal Health, outlines 3 collaboration models gaining traction across the field and discusses emerging priorities for community oncologists as adoption grows over the coming years.

This is part 2 of a 2-part interview. Read the first part of the interview here.

Targeted Oncology: The report emphasizes the need for collaboration between community practices and health systems.¹ Could you briefly describe the 3 examples of partnership models outlined in the report, and what each might look like in practice?

Fran Gregory, PharmD, MBA: The first model that we talked about in the report was what we call a hybrid administration. Some of these treatments, including bispecifics, require step-up dosing, and sometimes that can be done at the health system or the academic medical center, and then the maintenance dosing can be handled by that community provider. That hybrid model works really well for the bispecific products. So we are seeing a lot of those processes being set up so that you have that patient’s “critical high-risk phase” per se taking place in that controlled environment in the academic medical center, and then handing that off to the community provider to do the maintenance dosing after we know how that patient responds to the treatment and how they handle adverse events [AEs].

The second model we talk about in the report is community administration with health system toxicity backup. This is where the community provider is administering the therapy, taking on that whole patient care model and taking care of that patient unless that patient needs to be escalated to a health system for any AEs, an ICU [intensive care unit] need, or any toxicity that they might experience that [necessitates] escalated care. [It’s] giving the community provider the ability to manage that patient overall unless that patient truly does need escalated care.

The third model that we talked about was health system administration and community long-term follow up. This would be where you have a cell therapy or a gene therapy that is administered at the academic medical center or the health system, and then that information is deliberately handed to the community provider for the long-term follow up. So there's a relationship in the opposite direction where the hospital provider is working directly and intentionally with a community provider to follow up on each specific patient as they treat them. That includes long-term monitoring, labs, follow-up as far as imaging. We really want to get more of these community providers involved in that durability and real-world evidence tracking as well, whether they administer the treatment or whether they're responsible for that long-term follow up. So those are 3 of the models that we discussed in the report; each of them work really well and get the community provider more involved in either administering or monitoring advanced therapies.

What findings in the report do you think community oncologists should pay the most attention to?

I think what's important when we think about advanced therapies for community oncologists is that this wave of advanced therapies is just beginning. The first cell therapies for cancer indications came to market in 2017 and that was a very limited population, a very limited provider pool that was able to provide these treatments to patients. Those were all academic medical centers, very large treatment centers who were able to provide these treatments to patients. So over time, we've seen that shift quite a bit, which we're really excited about. There are a lot more treatment centers involved today, and community providers are getting more and more involved, and maybe not only wanting to be involved, but we're seeing them step into treating patients with complex therapies, like cell therapies, gene therapies, and maybe even beginning a little bit, but it's still not easy with some of the bispecifics and other complex treatments.

I think that the important thing for everyone to think about—community oncologists as well as the rest of the healthcare industry—is that these are the wave of the future. These treatments are not going to go away. We see manufacturers investing in science and technology every day in the news. Our forecast—which, of course, every forecast is going to be wrong to some extent—is estimating that there will be almost 180 advanced therapy approvals by the year 2030, so if you think about all of the oncologists who are providing the treatments today, there's not enough of them to handle 180 treatments. Not all of those would be for cancer, but about half of them will most likely be in the oncology/hematology space, so we really need more providers to get involved. We need more oncologists to embrace these treatments and administer them closer to the patient's home… Eventually, these academic medical centers can't handle the volume, and they might not necessarily want to handle all that volume long term. You'll see in some of the data that these academic medical centers want to see community providers getting more involved, which I think is great.

I think the other important part is, again, I mentioned more than half of the pipeline is going to be focused on oncology or oncology/hematology indications… We know that patients want to be able to access treatments closer to home, so I think that's really important too. The community readiness is growing; we're definitely seeing more community providers becoming more involved in this area. But the data show that about half of the respondents—and we surveyed 161 respondents in this report—stated that they need a year or 2 to prepare for advanced therapies. That's a significant runway, so now is a good time to get started. Ninety-one percent of respondents agreed that patients and caregivers would be comfortable receiving advanced therapy in the community setting; 92% agree that caregivers are capable of monitoring for AEs at home.

So just pulling some statistics out of the report from these respondents, it is clear that we all want to see these patients get the best treatment for their cancer type, and they want to get that closer to home, and we're seeing that that providers are ready to start doing that more. I think all of this underscores that advanced therapies are moving beyond inpatient hospitals, beyond academic medical centers, and providers are increasingly supporting this shift.

Looking ahead, what do you see as the most important or necessary change on the horizon for community oncology over the next 5 years, and how should practices prepare?

We look a lot at technology solutions to help supplement clinical practice and provider practices. If you think about clinical practice today, there are a lot of manual processes happening. Some of the things that we might think about, in addition to what we've already discussed, is the operational infrastructure. Of the respondents, 76% of them said they have some infrastructure, but they would love to have more automation and more interoperability. This will become more important as they have more patients and more treatments to manage. There's a protocol for 1 drug today, but there might be a protocol for 20 drugs in 5 years. How do they manage the different protocols required for each of those products? That's where the EMR technologies and smart prompts and even AI [artificial intelligence] can help steer decision making—obviously the clinician having the final say in that, but [those tools can] help automate a lot of those steps that are being done manually today to make the process much more efficient moving forward.

And then the collection of outcomes data…I'm a huge advocate of showing the long-term effects and the long-term durability of these treatments, and real-world evidence is such a huge part of what we focus on at Cardinal Health. It was very reassuring to hear that 75% of the respondents agree that outcomes data collection is critically important, but it's a lot easier when the care occurs in a community setting. But again, that goes back to the technology solutions and the ability to efficiently collect patient outcomes, data components in an easy and automated way over time. So, I think that technology and long-term follow up fit hand-in-hand. We are encouraging, not only in healthcare, but across all the industries, probably investing in digital technologies, interoperability, data systems that are trackable and can link EHR [electronic health record] claims to outcomes data, real-world evidence, and health economics metrics that we can report on as well. This is really important when we think about long-term payer support; how do we prove that the total cost of care with one of these high-cost treatments today is lower than the total cost of care over time with the standard of care? Continuing to show that data and those financial components will become more and more important as well.

REFERENCE

1. 2026 Advanced Therapies Report. Cardinal Health. 2026. Accessed April 24, 2026. https://tinyurl.com/35rjhnpd