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Realizing the Potential of Precision Medicine

Collaborate across the MDT to address health inequity in biomarker testing and precision medicine.

Reading time: 18 min

Precision Medicine is Changing the Way Cancer is Diagnosed and Treated1‑3

Precision Medicine is advancing cancer diagnostics and optimizing treatment through a tailored approach to each patient’s genetic and molecular cancer profile.1–3

Dividing cells icon

In a study of more than 9,000 tumors from 33 cancer types,

57%

harbored potentially actionable oncogenic driver events.4

Since actionable biomarkers have been discovered in many common tumors, biomarker testing is vital for early cancer detection and determining eligibility for targeted treatment.1

Guidelines icon

What the Guidelines Say

American Society of Clinical Oncology (ASCO), College of American Pathologists (CAP), and NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines® ) all recommend the use of tumor biomarker testing to establish eligibility for targeted treatment and clinical trials.5–12

ASCO, American Society of Clinical Oncology; CAP, College of American Pathologists; NCCN, National Comprehensive Cancer Network.

Targeted therapies are improving outcomes across cancer types13–18

Meta-analyses and retrospective studies discovered improved response rates, progression-free and overall survival for patients treated with precision therapies than those who are not.13–18

Two arrows: one for targeted therapy and one for standard therapy. The targeted therapy arrow shows a 53% lower risk of progression compared to standard therapy.

RISK OF PROGRESSION

Standard
therapies

Targeted
therapy

Targeted therapy contributed to

53%

less risk of progression vs. standard therapy17,a

aAfter adjusting for other factors in a pan-tumor study of actionable mutations.17

Target icon

Cancer targeted therapies have notably improved outcomes. Equitable access to and use of biomarker testing is crucial to ensure that patients don’t miss out on the potential benefits of precision medicine and targeted therapies.17

Removing Barriers so More Patients Can Benefit From Precision Medicine

Social determinants of health may impact access to biomarker testing and leave the promise of precision medicine unrealized for many.19–21

Lung icon

Despite a history of targeted treatment availability in non-small cell lung cancer (NSCLC),19

64%

of over 500,000 people with NSCLC in the US did not receive a personalized treatment.19

While biomarker testing was not completed for patients (%) with22:

  • breast infographic showing 39% on a pie chart style graphic

    Metastatic HER2-positive breast cancer

    39%

  • ovarian infographic showing 15% on a pie chart style graphic

    Advanced ovarian cancer

    15%

  • prostate infographic showing 40% on a pie chart style graphic

    Metastatic prostate cancer

    40%

DNA helix icon

With biomarker testing informing targeted treatment, this example highlights the need for optimized testing protocols and reporting to minimize disparities in cancer treatment.19

HER2, human epidermal growth factor 2; NSCLC, non-small cell lung cancer.

MDTs Can Boost Patient Health Literacy for Improved Understanding of Biomarker Testing

Infographic about communication between healthcare providers and their patients about biomarker testing

75%

of patients remembered having a biomarker testing conversation with their multidisciplinary team (MDT)

48%

of patients still struggled with biomarker testing terms23

By putting communication strategies and formal support systems in place, and improving shared decision-making on treatment options, MDTs can help reduce disparities in cancer-related outcomes while helping patients and caregivers better understand the concept and implications of biomarker testing.23

Disparities in oncology trials limit precision medicine access, affecting specific subgroups more20,21

Limited knowledge of underlying cancer biology in racial and ethnic minority groups highlights the urgent need for MDTs to advocate for and prioritize enrollment of these groups (proportionate to their cancer incidence) in future clinical studies. The resulting discoveries can then be used to personalize treatments for underrepresented racial and ethnic groups in cancer with greater confidence.20,24

MDT, multidisciplinary team.

Socioeconomic disparities can affect biomarker testing and precision medicine outcomes21

A systematic review and meta-analysis found that persons with low socioeconomic status were21:

Infographic stating that persons with low socioeconomic status were 17% less likely to be treated with precision therapies

17%

less likely to be treated with precision therapies

Further, the intersection of social determinants of health with environmental, and genomic and/or biologic factors and how they influence disease outcomes is not well understood, and highlights the need to capture more data in future precision medicine studies to evaluate the level of impact on health outcomes.20

MDT collaboration can help improve equitable access to precision medicine20

Standardized testing and reporting protocols to identify and treat all patients eligible for targeted therapies

Improved education on biomarker testing, genetic studies, and genetic counseling in patients living with cancer

Strengthening formal support systems, verbal communication strategies, and MDT coordination to address health literacy barriers on biomarker testing for patients with cancer

Continued implementation of strategies to target economic barriers to testing and treatment

Increased advocacy for diversifying patient recruitment to clinical studies

MDT, multidisciplinary team.

Enhance your MDT’s approach to biomarker testing to help improve patient outcomes20

Coordinator icon

Implement reflexive testing

Shorten the time to obtain molecular test results, minimize tissue insufficiencies, and increase your lab’s testing capacity.25 Reflexive testing may decrease average biomarker testing turnaround time by over 2 weeks.25–29

Pathologists generally drive reflexive testing protocols, for example, by sharing test results directly with genetic counselors to minimize the potential of missed patients.27

Coordinator icon

Connect patients with a genetic counselor:

They are uniquely equipped to help MDTs identify people who may have a hereditary cause for their cancer. Promote greater access to genetic counseling services by30:

  • Educating non-genetic healthcare providers
  • Triaging patients according to expected complexity
  • Offering telehealth services
Guidelines icon

Use consistent terminology:

Synoptic reporting and standard terminology allow for clearer communication of test results to the broader MDT, avoiding misunderstandings.31

Refer to our Glossary of common terms in precision medicine:

View Glossary
People with a chat box behind icon

Form a molecular tumor board:

This multidisciplinary panel convenes regularly to discuss important results during care. This can aid the interpretation of complex genomic data and improve a patient’s access to targeted therapies.32,33 One study found over half of board-reviewed biomarker testing results led to a change in a patient’s treatment plan.34

Find practical tips on forming a molecular tumor board along with discussions about common challenges and potential solutions.

Form a molecular tumor board
Scalpel icon

Designate a team member to coordinate care:

Patient navigators play a crucial role in providing patients with education, support, and bridging communication with the broader care team.35

Access ASCO’s Cancer.net podcast, explaining the benefits of patient navigators and how to implement a navigation process:

Assign a patient navigator

ASCO, American Society for Clinical Oncology; MDT, multidisciplinary team.

CAP Cancer Protocols provide biomarker reporting guidelines outlining essential reporting elements 
based on the latest standards.36

Read CAP guidelines
Woman working at her computer

CAP, College of American Pathologists.

Dark key takeaway icon

Considerations for Your Practice

The full potential of precision medicine to transform the lives of patients with cancer relies on addressing health inequities and offering optimized testing workflows that consider1,19:

  • Pathologist-driven (reflexive) biomarker testing
  • Increasing access to genetic counselors, e.g. with telehealth
  • Ongoing patient education to increase awareness in all communities and build trust 
  • Ongoing MDT education to address knowledge gaps and inform decision-making
  • Focused strategies to increase clinical study enrollment and representation of patients from various racial and ethnic groups to ensure that diverse communities can benefit from precision medicine
  • Standardizing terminology and reporting
  • Keeping regular molecular tumor boards
  • Appointing patient navigators to support patients throughout their biomarker testing journey and help remove barriers to treatment

MDT, multidisciplinary team.

Helpful Resources

Check out these featured resources to drive understanding and uptake of biomarker testing.

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Add your preferred resources to My Favorites—a personalized list of resources to download and share with your peers or patients.

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2:07 min

FOR PATIENTS

What your genetic test means for your family members

Share this brief explanation with your patients on how germline (or inherited) genetic mutations can provide information to other family members if they choose to pursue genetic testing for hereditary cancer risk.

1:55 min

FOR PATIENTS

Genetic testing: How much does it really cost?

Share this video with patients to give a brief overview of insurance coverage of genetic testing, including what information may be needed, and questions or considerations for patients and their healthcare team.

2:18 min

FOR PATIENTS

How does GINA protect you?

Share the Genetic Information Nondiscrimination Act (GINA) with your patients to highlight benefits and limitations of this law as it pertains to genetic testing.

View more resources 
  1. Jardim DL, et al. J Natl Cancer Inst. 2015;107(11):djv253.
  2. Kato S, et al. Nat Commun. 2020;11(1):4965.
  3. Tsimberidou AM, et al. JCO Precis Oncol. 2017;2017:PO.17.00002.
  4. Bailey MH, et al. Cell. 2018;174(4):1034–1035.
  5. Chakravarty D, et al. J Clin Oncol. 2022;40(11):1231–1258.
  6. Allison KH, et al. J Clin Oncol. 2020;38(12):1346–1366.
  7. Wolff AC, et al. Arch Pathol Lab Med. 2023;147(9):993–1000.
  8. Lindeman NI, et al. Arch Pathol Lab Med. 2018;142(3):321–346.
  9. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer. V.4.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed November 27, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
  10. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer. V.3.2024.
    © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed October 01, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
  11. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer. V.6.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed November 11, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
  12. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer. V.11.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed October 15, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
  13. Yi T, et al. Int J Cancer. 2019;145(5):1209–1220.
  14. John A, et al. Oncologist. 2020;25(11):e1743–e1752.
  15. Singal G, et al. JAMA. 2019;321(14):1391–1399.
  16. Schwaederle M, et al. JAMA Oncol. 2016;2(11):1452–1459.
  17. Haslem DS, et al. J Oncol Pract. 2017;13(2):e108–e119.
  18. Tsimberidou AM, et al. J Hematol Oncol. 2019;12(1):145.
  19. Sadik H, et al. JCO Precis Oncol. 2022;6:e2200246.
  20. Aldrighetti CM, et al. JAMA Netw Open. 2021;4(11):e2133205.
  21. Norris RP, et al. BMC Med. 2020;18(1):282.
  22. Goldfarb SD, et al. J Clin Oncol. 2021;39(28_suppl):16.
  23. Fortune EE, et al. Patient Educ Couns. 2023;112:107720.
  24. Lillard JW, et al. Cancer. 2022;128(21):3783–3795.
  25. Hooper K, et al. J Clin Oncol. 2022;[abstract taken from 40(16):3127].
  26. Braxton DR, et al. J Clin Oncol. 2021;[abstract taken from 39(15):e13507].
  27. Anand K, et al. Clin Lung Cancer. 2020;21(5):437–442.
  28. Tsang M, et al. Arch Pathol Lab Med. 2022;146(12):1535–1539.
  29. Seidman AD, et al. Popul Health Manag. 2017;20(4):252–254.
  30. Cohen SA, et al. Am Soc Clin Oncol Educ Book. 2019;39:e34–e44.
  31. Strickland-Marmol LB, et al. Arch Pathol Lab Med. 2016;140(6):578–587.
  32. Salgia R, et al. JCO Oncol Pract. 2021;17(8):e1120–e1130.
  33. Sadaps M, et al. JCO. 2021;39(15):suppl.3128.
  34. Behel V, et al. JCO Glob Oncol. 2022;8:e2200030.
  35. Gorin SS, et al. Ann Behav Med. 2017;51(4):532–546.
  36. Cancer Protocol Templates. College of American Pathologists. Accessed October 01, 2024. https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.