Expanding Precision Medicine’s Impact on All Tumor Types

Precision medicine has transformed cancer care, ushering in an era of targeted therapies and personalized insights for patients. For individuals like Terri Conneran, a cancer survivor and patient advocate, genomic testing revealed a KRAS mutation, igniting an “aha moment” in her lung cancer journey. “Patients need to know their biomarkers to build a strategic, intentional plan of action,” said Conneran, founder of KRAS Kickers, a patient support organization. This insight captures the essence of what precision medicine can offer: clarity, empowerment, and a path forward in cancer care.

However, staying up to date with these complex, personalized treatments in community settings can be daunting and potentially delay the use of these promising therapies. For many providers, the challenge lies in not only keeping up with the science behind these complex treatments but also integrating them into everyday, busy workflows. Approximately 80% of US patients with cancer receive care in community practices,¹ so overcoming these barriers is essential to unlocking the full, transformative potential of precision medicine in oncology.

Although challenges remain, progress is being made through creative collaboration and innovative technologies. By examining the challenges and the strategies being used to address them, we can gain valuable insights that might also apply to other specialized areas of medicine.

Hurdles to Come

The rapid discovery of novel biomarkers holds great promise for the future of targeted therapies. However, this dramatic progress also creates the biggest barriers to implementation. With the overwhelming volume and fragmentation of data being created, it can be challenging for busy providers who treat a wide range of cancers to stay current.

“In community oncology, many of us are tasked with seeing patients of all tumor types,” said Eric Lander, MD, a medical oncologist and hematologist at Minnesota Oncology, a leading practice within The US Oncology Network (The Network) in St Paul, Minnesota. “I’m a gastrointestinal medical oncologist, but because I run our research program, I review studies across tumor types. This means I must be up to date with new information. As clinicians, we face the challenge of balancing the latest novel precision drugs and research pipelines while ensuring we’re delivering the best care to all patients.”

With so many narrow indications across numerous cancers today, new targeted treatments are increasingly complex. The information is often buried in siloed systems that are difficult to access. Even when precision medicine tools are available, they are often underutilized when not embedded into the workflow. The frontline team needs solutions that simplify—not complicate— day-to-day tasks. User-friendly tools that deliver the right information at the right time are essential, helping providers feel confident they are delivering optimal care.

Navigating the evolving landscape of diagnostic testing can present challenges. Clinicians often order molecular diagnostic tests with the quickest turnaround times. However, not all tests analyze the same genes or detect the same types of alterations (eg, mutations, deletions, fusions). This can create a trade-off between speed and comprehensiveness. As the number of available biomarker tests continues to grow, determining the most appropriate test for each patient becomes increasingly complex. To support the most effective care, it’s essential that clinicians have seamless access to clear, up-to-date guidance on which tests are most appropriate for each patient’s condition—and what insights those tests will yield. Incorporating this information into clinical workflows can empower providers to make confident, timely decisions aligned with the latest standards of care.

Physicians must also be aware of available clinical trials and integrate that information into the patient’s care paradigm, combining standard of care with research opportunities. Having these treatment pathways happening simultaneously is an extremely complex environment, but huge opportunities exist to impact patients when this happens.

Meeting the Challenges

Precision medicine stakeholders are collab- orating and using leading-edge technologies to solve many of the problems inhibiting this promising approach. One example of this is McKesson’s innovative program, Precision Care Companion (PCC), a critical, multifaceted initiative being implemented across The Network. The program unites diverse perspectives, providing technologies, targeted education, expert guidance, best practices, and detailed analytics on biomarker testing.

PCC embeds precision care solutions directly into Ontada’s market-leading oncology electronic health record (EHR), iKnowMed, rather than separate platforms, incorporating several elements that tie precision care together. Ordering modules will streamline test selection by offering real-time insights and streamlined order placement through iKnowMed, with provider oversight. Results are received directly in the EHR workflows in PDFs and structured formats as well. To simplify this information and make it easier to take clinical action on biomarker test results, McKesson is leveraging molecular results mapping into iKnowMed’s clinical decision support tool. This innovative functionality is designed to ease the burden of documenting and interpreting complex results while helping facilitate guideline-driven targeted therapy treatment selections. The results can be combined with clinical pathways and trial-matching capabilities, all integrated directly into the existing workflow.

Although technology is vital to PCC, the program is much more than just a technology product. Collaboration with key stakeholders to deliver timely support to oncologists is also a critical component. PCC participants have access to a wide range of educational and consultative services to meet their specific needs. Offerings include monthly master class webinars, a precision medicine boot camp, lab-agnostic molecular tumor boards, and a molecular helpline for urgent questions about a specific patient’s biomarker test results.

The PCC molecular helpline gives providers immediate access to molecular oncology experts from the Sarah Cannon Research Institute in Nashville, Tennessee, McKesson’s joint venture. These knowledge specialists help answer questions on appropriate tests to order and assist with interpreting complex molecular test results within a few hours. T he complex nature of clinical trials can be a barrier to delivering precision care in community settings, as it often results in low clinical trial participation. By leveraging McKesson’s Genospace technology, a cutting-edge precision medicine platform, practices can make data-driven decisions about which trials to open and which therapies to offer, both of which are dependent on the practice and community patient population.

Precision Care Technologies in the Real World

Practices across The Network are embracing these technological solutions to drive and simplify precision care. For instance, Minnesota Oncology has transformed how it performs research through its collaboration with the Sarah Cannon Research Institute and Genospace. By integrating data on biomarker results, physicians can log into Genospace, select a clinical trial for a particular cancer, and automatically receive a list of potential patients to prescreen for the trial.

“That’s an extremely powerful tool,” Lander said. “We’re taking the onus from the provider to go look for these trials. As we find a patient match through Genospace, we can send a chart alert to the provider and research nurse to start a discussion about that patient. We’re now prescreening each new patient for a clinical trial, and we’re also conducting screenings of current patients for future trials.” The integration of systems, including the scheduling systems, has proven successful in connecting patients with clinical trials. “We’ve keyed in on several different appointment types, particularly those where patients are getting a scan or reviewing results, which are referred to as ‘high probability of therapy change visits,’” said Andrew McKenzie, PhD, vice president of personalized medicine at the Sarah Cannon Research Institute and scientific director at Genospace. Alerts are automatically sent to the physician about the upcoming visit, seamlessly integrated into the workflow when the physician would intuitively be thinking about next steps, should progression occur.

Success Requires More ThanJust Technology

The ability to harness innovations such as artificial intelligence, machine learning, and natural language processing is critical for precision medicine to thrive, especially in community oncology.

However, technology alone is not enough. “Our ability to use the newest technologies is important for our future success, but it’s half of the equation,” McKenzie said. “The other half is layering in the support systems, human interactions, and interventions so we can extract the most valuable information from [this] data-rich environment.”

This multidimensional approach addresses the persistent pain points associated with precision medicine from several angles, helping to unleash its full potential in community oncology.

REFERENCE:

1. Quality improvement collaboration: integration of precision medicine in community oncology. Association of Cancer Care Centers. Accessed June 17, 2025. https://tinyurl.com/3m3yfen2