Between August and December of 2023, Precision Oncology News reached out several  small and large cancer centers, hospitals, and community practices in the US involved in precision oncology programs, to interview 20 individuals that play a role in guiding the use of precision medicine and molecular testing, including oncologists, program or cancer center directors, physician scientists, pharmacists, genetics experts, and pathologists. This cross-section is biased versus top-resourced health institutions that in US (and in EU also) are early adopters of precision oncology and have the capabilities for delivering precision oncology to patients; most of these sites are also seeing patients who are referred from other cancer centers and hospitals and traveling “a reasonable geographic distance” to get the diagnosis and treatments.

Due to lack of in-hospital testing capabilities, only 10% of patients that might be eligible for precision oncology drugs clinical trials were enrolled in top ranked cancer centers in the US in 2023.

Of  all the top healthcare centres and clinical oncologists included in the survey, only less than 5% had in house capabilities for molecular testing necessary to make precision treatment decisions in liquid biopsy, the rest of samples are sent out for molecular testing (83%) highlighting huge opportunities for IVD providers of precision diagnostics. This ultimately translated into less than 10% of eligible patients getting timely access to targeted therapies. This limits both testing and market adoption of novel drugs  that can be offered only to patients with particular molecular lesions, today detectable with very expensive and low-capacity technologies such as NGS or imaging. This survey illustrates well the overlapping needs of clinical trials and treatment optimisation, with a huge opportunity for novel sustainable technologies. Indeed, the survey also evidenced ever more pronounced adoption and shifting of molecular testing to early-stage cancer patients, possibly spurred by the greater availability of biomarker-informed therapies.