Supporting Access to Precision Medicine in Community Care Settings

Precision medicine was long heralded as the future of cancer therapy, and thanks to research advancements, it is now at the core of oncology treatment plans, leading to better patient outcomes.¹ The number of targeted therapies in oncology continues to grow, and in 2024, 16% of the novel drugs approved by the FDA were oncology targeted therapies.² With more than half of patients receiving cancer care in the community setting, ensuring these sites are supported in their efforts to apply precision medicine in clinical practice is crucial.³

Precision medicine is now at the core of oncology treatment plans | Image credit: Pixel-Shot | stock.adobe.com

However, studies and real-world experience have demonstrated there are several challenges associated with the adoption of and access to precision medicine in a community practice setting. These include difficulties in keeping up with the latest biomarker testing and treatment guidelines, slow turnaround time for testing, challenges in procuring tissue necessary for test completion, limited technical assistance, insufficient support with biomarker-directed clinical trials, and difficulty interpreting biomarker test results. The high cost of comprehensive genomic profiling and potential lack of payer coverage can also create financial barriers for patients, especially those in rural communities, exacerbating disparities in access to and coverage of precision medicine.

Overcoming these barriers requires coordinated efforts from health care providers, researchers, policymakers, and patients. Community oncology practices, often serving diverse patient populations in rural areas, play a key role in cancer care. The US Oncology Network, supported by McKesson, is an organization that provides robust operational support, financial stability, education, and cutting-edge clinical resources to approximately 3300 independent community-based providers and clinical research sites across 29 states, empowering them to deliver the highest-quality patient care.

Increasing Access to Biomarker Testing

One of the most significant barriers to accessing precision therapy is that biomarker tests are not always conducted when indicated by clinical guidelines. A lack of appropriate testing can be driven by physician education gaps as well as patients’ socioeconomic status, geography, race, ethnicity, language, and age. Because biomarker testing is a key first step to identifying treatment opportunities such as precision therapies and clinical trials, equal access to these testing tools is crucial to ensure patients receive the right treatments at the right time.

However, appropriate biomarker testing is not consistently utilized, potentially missing opportunities to prescribe targeted therapies that are shown to reduce adverse effects and lead to better outcomes. The lack of testing may be due to cost, lack of reimbursement, limited access, regulatory hurdles, or even lack of knowledge—all of which can limit appropriate utilization of targeted therapies.⁴

In one example of strategies to address these challenges, McKesson has developed an education program to support oncologists in applying precision medicine in clinical practice. The training covers areas such as interpreting molecular test results, using biomarker data to guide treatment decisions, selecting appropriate molecular tests for specific cancers, and applying best practices in tissue biopsy workflows. Oncologists in the network also have access to reference guides for biomarker testing, intended to help integrate precision medicine more effectively into patient care.

Expanding Clinical Trials in the Community

Clinical trials should be considered early in the treatment journey. There are more than 2000 oncology clinical trials initiated each year, though it is difficult to determine how many are specifically investigating precision therapies.^5,6 As the focus on precision medicine continues to grow, it is critical to match eligible patients with appropriate clinical trial options, which provide them with access to cutting-edge treatments in the community setting.

By bridging the gap between these resources and patients, providers can integrate clinical research and precision medicine directly into their care plans. In turn, this can significantly reduce costs and travel time for patients who might otherwise be deterred from enrolling in a clinical trial that does not have an enrollment site close to home. Empowering community practices to support clinical trial enrollment expands the pool of patients who may fit into a trial, especially with biomarker-driven trials and rare cancers where the patient populations may be small.

This can also help address challenges related to clinical trial diversity by opening important research to a broader population. This allows for the development of cancer therapies that are both safe and effective across diverse patient populations, recognizing that pharmacologic responses can vary significantly among demographic groups. It also ensures the people in these clinical trials are representative of those who are living with the disease.

Embracing Technology to Broaden Access

Providing technology-driven tools to the frontline care team in the electronic health record (EHR) is an effective way to support the use of precision medicine at scale across community oncology practices. A range of functionalities aimed at easing the complexity of precision medicine can be integrated directly into the EHR, such as modules to support appropriate biomarker test selection, electronic test ordering, integration of results into the therapy selection tool, and identification of patients for clinical trials based on biomarker test results. With this comprehensive point-of-care support and adaptable workflow integration with EHRs, oncologists are better able to deliver high-quality, precision-focused care without interruptions.

A Bright Future

Oncology care is quickly evolving. Although there are barriers we must overcome, many opportunities and breakthroughs remain that can drive precision medicine forward. To ensure broad adoption of precision care in community oncology, a comprehensive approach is needed, including relevant ongoing education, technology enhancements in the EHR, support with clinical trial enrollment, and assistance with interpreting complex biomarker test results. These advancements and support services are transforming how community practices deliver cutting-edge therapies, empowering community practices to provide the most advanced cancer care to all patients.

REFERENCES

1. Zhou Z, Li M. Targeted therapies for cancer. BMC Medicine. 2022;20(90). doi:10.1186/s12916-022-02287-3

2. New Drug Therapy Approvals 2024. FDA Center for Drug Evaluation and Research. January 2025. Accessed August 19, 2025. https://www.fda.gov/files/drugs/published/new-drug-therapy-2025-annual-report.pdf

3. Nguyen CA, Beaulieu ND, Wright AA, Cutler DM, Keating NL, Landrum MB. Organization of cancer specialists in US physician practices and health systems. J Clin Oncol. 2023;41(26):4226-4235. doi:10.1200/JCO.23.00626

4. Lawler M, Keeling P, Kholmanskikh O, et al. Empowering effective biomarker-driven precision oncology: a call to action. Eur J Cancer. 2024;209:114225. doi:10.1016/j.ejca.2024.114225

5. Annual number of oncology clinical trial starts worldwide from 2000 to 2018. Statista. July 18, 2025. Accessed August 19, 2025. https://www.statista.com/statistics/1092600/oncology-clinical-trial-starts-worldwide/

6. Precision Oncology Clinical Trials & Statistics 2024. Novotech. March 5, 2024. Accessed August 19, 2025. https://novotech-cro.com/whitepapers/precision-oncology-clinical-trials-statistics-2024