Abstract
With the increasing use of genomic profiling for diagnosis and therapy guidance in many tumor types, precision oncology is rapidly reshaping cancer care. However, the current trajectory of drug development in oncology results in a paradox: if patients cannot access advanced diagnostics, we may be developing drugs that will reach few patients. In this Perspective, we outline the major challenges to the implementation of precision oncology and discuss critical steps toward resolving these, including facilitation of equal access to genomics tests, ensuring that clinical studies provide robust evidence for new drugs and technologies, enabling physicians to interpret genomics data, and empowering patients toward shared decision-making. A multi-stakeholder approach to evidence generation, value assessment, and healthcare delivery is necessary to translate advances in precision oncology into benefits for patients with cancer globally.
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Acknowledgements
Funding support and role of the funder/sponsor: F. Hoffmann-La Roche funded third-party writing assistance for the initial draft of this manuscript, furnished by S. Salem at Health Interactions. The sponsor was not involved in discussions relating to content. All subsequent versions were written, reviewed, and submitted solely by the authors.
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J.M., L.S., and E.V. contributed to drafting of the manuscript. All authors contributed to critical revision of the manuscript for important intellectual content and approved the final version for submission.
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J.M. has received grants to his institution (as principal investigator) from AstraZeneca and Pfizer Oncology; consulting fees from Monterosa, consulting fees for an advisory board from AstraZeneca, MSD, Clovis Oncology, F. Hoffmann-La Roche, Pfizer, and Janssen; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca, Pfizer Oncology, F. Hoffmann-La Roche, Guardant Health, Astellas, and Janssen; support for attending meetings and/or travel from AstraZeneca and IPSEN; and drugs for preclinical testing in research from AstraZeneca. L.S. has received support for the present manuscript (for example, funding, provision of study materials, medical writing, article processing charges) to her institution from F. Hoffmann-La Roche, grants or contracts to her institution from the Personalized Medicine Coalition, and support for attending meetings and/or travel from the Personalized Medicine Coalition. P.A. has received personal fees from Boehringer Ingelheim, Marcogenics, Amcure, Synthon, Servier, G1 Therapeutics, F. Hoffmann-La Roche, Novartis, Deloitte, Radius, Menarini, Gilead, and Amgen; and travel grants from MSD, F. Hoffmann-La Roche, Pfizer, and Amgen. F.A. has received institutional research funding from F. Hoffmann-La Roche, Pfizer, Eli Lilly, Novartis, AstraZeneca, and Daiichi Sankyo. M.D. has received personal-speaker fees from F. Hoffmann-La Roche, Pfizer, and Eli Lilly. E.G. has received grants or contracts from Novartis, F. Hoffmann-La Roche, ThermoFisher, AstraZeneca, Taiho, and BeiGene; payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from F. Hoffmann-La Roche/Genentech, Ellipses Pharma, Neomed Therapeutics 1, Boehringer Ingelheim, Janssen Global Services, Seagen, TFS, Alkermes, ThermoFisher, and BMS; and has participated on a data-safety monitory or advisory board for F. Hoffmann-La Roche/Genentech, Boehringer Ingelheim, Janssen Global Services, MabDiscovery, Anaveon, and ThermoFisher. J.G. has served a consulting or advisory role for Amgen, Alnylam, BMS, Bayer, BioMarin, Janssen, Novartis, Pfizer, F. Hoffmann-La Roche, Servier, Takeda, and UCB; and has received institutional research funding from EFPIA companies to IMI projects, and travel/accommodation expenses from Amgen, Alnylam, BMS, Bayer, BioMarin, Janssen, Novartis, Pfizer, F. Hoffmann-La Roche, Servier, Takeda, and UCB. D.H. has received honoraria and consulting fees from F. Hoffmann-La Roche, Thermofisher Scientific, Amgen, AstraZeneca, BMS, Boeringher Ingelheim, Eli Llilly, Janssen, and Pfizer, as well as from contract research organizations and not-for-profit entities, including the Canadian Agency for Drugs and Technologies in Health, the Institute of Health Economics, and The Ministry of Health of Ontario; and has received consultation fees from life-sciences companies with an interest in the adoption of advanced testing. I.M.-L. has received support for the present manuscript (for example, funding, provision of study materials, medical writing, article processing charges) from F. Hoffmann-La Roche; consulting fees from Novartis; and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from GSK, AstraZeneca, and BH. N.N. has received personal fees from MSD, Qiagen, Biocartis, Incyte, F. Hoffmann-La Roche, BMS, Merck, ThermoFisher, Boehringer Ingelheim, AstraZeneca, Sanofi, Eli Lilly, Bayer, ArcherDx, Illumina, and Amgen; and grants from Qiagen, Biocartis, Incyte, F. Hoffmann-La Roche, BMS, Merck, ThermoFisher, Boehringer Ingelheim, AstraZeneca, and Illumina. J.S.R.-F. has received consulting fees from Paige.AI, Repare Therapeutics, Goldman Sachs, and Eli Lilly; has participated on a data-safety monitoring or an advisory board for F. Hoffmann-La Roche, Roche Tissue Diagnostics, Genentech, Novartis, and InVicro; has a leadership or fiduciary role in Grupo Oncoclinicas (as a member of the board of directors); and has stock or stock options in Paige.AI, Repare Therapeutics, and Grupo Oncoclinicas. S.S. has received consulting fees (all were institutional contracts) from F. Hoffmann-La Roche, Novartis, AstraZeneca, Pfizer, Libbs, Merck, MSD, Eli Lilly, BMS, and Sanofi Aventis. D.M.T. reports grants, personal fees, and non-financial support from F. Hoffmann-La Roche, Pfizer, and Bayer; grants and non-financial support from AstraZeneca, Seattle Genetics, Amgen, Eli Lilly, and Eisai; personal fees from Omico; and non-financial support from Elevation Oncology, outside the submitted work. C.B.W. has received honoraria from Amgen, Bayer, Chugai, Celgene, Falk, GSK, MSD, Merck, Janssen, Ipsen, Roche, Servier, SIRTeX, Taiho; has served on advisory boards for Bayer, BMS, Celgene, Servier, Shire/Baxalta, Rafael Pharmaceuticals, RedHill, and Roche; and has received travel support from Bayer, Celgene, RedHill, Roche, Servier, and Taiho and research grants (institutional) from Roche outside of the submitted work. E.V. has received clinical study grants to his institution from Amgen, AstraZeneca, Pfizer, F. Hoffmann-La Roche, Clovis, GSK, Novartis, Bayer, Sanofi, BMS, MSD, and BI. The Netherlands Cancer Institute (NKI) has received a speaker’s fee from F. Hoffmann-La Roche. All authors received support in the form of third-party medical writing assistance for this manuscript, furnished by S. Salem of Health Interactions, from F. Hoffmann-La Roche, Basel, Switzerland.
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Mateo, J., Steuten, L., Aftimos, P. et al. Delivering precision oncology to patients with cancer. Nat Med 28, 658–665 (2022). https://doi.org/10.1038/s41591-022-01717-2
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DOI: https://doi.org/10.1038/s41591-022-01717-2
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