Kira Finkel, MSPH

We recently highlighted a new landmark publication from JCO Precision Oncology which explores the clinical practice gaps limiting patient access to targeted treatments. The study focused on advanced non-small cell lung cancer (aNSCLC) because this disease provides significant opportunities for the deployment of personalized medicine strategies, with 70% of patients expressing an actionable mutation potentially amenable to available targeted therapies.

The study highlights seven clinical gaps including those related to testing access and availability, sample processing, test interpretation and utilization of results. The report quantified where patients are lost in their personalized medicine journey and found that more than 60% of patients who may have benefited from targeted therapies did not receive them.

Previous research showcases personalized medicine’s ability to improve oncology patients' outcomes and still remain cost-efficient for the U.S. healthcare system. Yet, many patients do not receive the most appropriate cancer treatment. Implementing personalized medicine strategies requires a system-wide approach; here are three gaps the new study revealed that should be addressed to drive broader clinical adoption:

  • Integration and Communication: Tissue procurement, triaging and handling is a significant hurdle to biomarker testing. A lack of care continuity across healthcare institutions can lead to confusion about when and how patients should be tested. Improving practice integration and cross stakeholder communication, including with clinical labs, is essential to optimizing testing for actionable mutations.
  • Results Interpretation: Provider awareness of actionable biomarkers is relatively low and testing guidelines are fragmented. Clinician associations and other experts should work together to develop best practices to ensure tumor sampling and testing is timely and efficient. Furthermore, greater support is needed to enhance clinicians’ understanding of testing protocols and interpretation of results.
  • Coverage and Payment: Existing insurance coverage is fragmented, and reimbursement fails to cover the breadth of vital genetic testing available to oncology patients. In addition, cost-sharing leaves patients with prohibitively expensive out-of-pocket costs for medicines. Provider payment policies must be modified to cover essential test panels and treatments underpinning personalized medicine.

The benefits of personalized medicine will only be realized if new tests and treatments reach the patients who need them. This clinical paradigm shift requires concerted attention from policymakers and other healthcare stakeholders to update policies which can enhance the delivery of personalized healthcare.

The Reservoir team was proud to contribute to this landmark study. We hope that the release of this research can provide experts with needed data to advance the clinical adoption of personalized medicine. We must #ClosetheGap and ensure that we have fewer #PatientsLost.