Memorial Sloan Kettering physicians outline the future of precision oncology

Precision medicine efforts have only scratched the surface of cancer treatment transformation, and experts at one of the nation’s leading oncology centers say continued success will rely on advancements in genomic sequencing technology, improved data sharing and better access to cutting-edge medication.

Over the last several years there have been significant advancements in precision medicine research, particularly for oncology patients. The $1 billion Cancer Moonshot initiative, announced by President Barack Obama last year, has provided an enormous boost to precision medicine research efforts.

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Already, genomic research has improved outcomes for certain leukemia patients and women diagnosed with breast cancer, but plenty of challenges lie ahead for cancer researchers and clinicians, according to a report in Cell, authored by three oncologists at Memorial Sloan Kettering Cancer Center.

“We are at the end of the beginning of this process. We have learned a lot and we have a lot to learn,” Barry Taylor, one of the co-authors and the associate director of the Marie Josée and Henry R. Kravis Center for Molecular Oncology at MSK, said in a press release. “Precision oncology is an attractive yet challenging strategy. A healthy dose of skepticism is essential to advancing a scientific dialogue.”

The authors say the new report serves as a roadmap for future precision medicine efforts tied to cancer care. They emphasized the importance of “basket trials,” which include patients with specific genetic mutations, and the need to “move beyond” DNA sequencing to much more pointed RNA-sequencing technology. The Food and Drug Administration recently issued updated recommendations it says will facilitate innovation within precision medicine technology. 

But the authors also highlighted a significant “engineering problem” within precision medicine initiatives that limits information sharing among researchers and clinicians. Future progress will rely on routine tumor sequencing, incorporating genetic findings into medical records, improved education for both patients and physicians, and better patient access to the appropriate clinical trials.

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“The strategies we propose here establish a framework to begin to address this critical knowledge and implementation gap,” the authors wrote. “We cannot achieve the progress needed with conventional approaches. Rapid progress demands a new degree of collaboration and information exchange between basic and translational laboratory scientists and clinical investigators acting as equal partners.”

In September, an expert panel for the Cancer Moonshot initiative outlined 10 key recommendations, including establishing a “national ecosystem” for physicians and researchers to share data.

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However, some have wondered whether the initiative is at risk under the Trump administration. In a recent interview with FierceHealthcare, former CMS administrator Andy Slavitt said health technology vendors are concerned an ACA repeal will leave hospitals will less capital to invest in new technology.