Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm
The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outc...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-01-01
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| Series: | Cambridge Prisms: Precision Medicine |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2752614324000012/type/journal_article |
| _version_ | 1797213119837110272 |
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| author | Nesrine Lajmi Sofia Alves-Vasconcelos Apostolos Tsiachristas Andrew Haworth Kerrie Woods Charles Crichton Theresa Noble Hizni Salih Kinga A. Várnai Harriet Branford-White Liam Orrell Andrew Osman Kevin M. Bradley Lara Bonney Daniel R. McGowan Jim Davies Matthew S. Prime Andrew Bassim Hassan |
| author_facet | Nesrine Lajmi Sofia Alves-Vasconcelos Apostolos Tsiachristas Andrew Haworth Kerrie Woods Charles Crichton Theresa Noble Hizni Salih Kinga A. Várnai Harriet Branford-White Liam Orrell Andrew Osman Kevin M. Bradley Lara Bonney Daniel R. McGowan Jim Davies Matthew S. Prime Andrew Bassim Hassan |
| author_sort | Nesrine Lajmi |
| collection | DOAJ |
| description | The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries. |
| first_indexed | 2024-04-24T10:53:13Z |
| format | Article |
| id | doaj.art-7338436f990d4a39a0a9ec2593a3623f |
| institution | Directory Open Access Journal |
| issn | 2752-6143 |
| language | English |
| last_indexed | 2024-04-24T10:53:13Z |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Cambridge Prisms: Precision Medicine |
| spelling | doaj.art-7338436f990d4a39a0a9ec2593a3623f2024-04-12T07:44:02ZengCambridge University PressCambridge Prisms: Precision Medicine2752-61432024-01-01210.1017/pcm.2024.1Challenges and solutions to system-wide use of precision oncology as the standard of care paradigmNesrine Lajmi0https://orcid.org/0009-0007-6575-5243Sofia Alves-Vasconcelos1Apostolos Tsiachristas2Andrew Haworth3Kerrie Woods4Charles Crichton5Theresa Noble6Hizni Salih7Kinga A. Várnai8Harriet Branford-White9Liam Orrell10Andrew Osman11Kevin M. Bradley12Lara Bonney13Daniel R. McGowan14Jim Davies15Matthew S. Prime16Andrew Bassim Hassan17Diagnostics Division, Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, SwitzerlandOxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UKDiagnostics Division, Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, SwitzerlandOxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKDiagnostics Division, Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, SwitzerlandRoche Healthcare Consulting, Roche Diagnostics Limited, West Sussex, UKWales Research and Diagnostic PET Imaging Centre, University Hospital of Wales, Cardiff, UKOxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK Oxford University Hospitals NHS Foundation Trust, Oxford, UKOxford University Hospitals NHS Foundation Trust, Oxford, UKBig Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford, UKDiagnostics Division, Roche Information Solutions, F. Hoffmann-La Roche Ltd., Basel, SwitzerlandOxford Molecular Pathology Institute, Sir William Dunn School of Pathology, University of Oxford, Oxford, UK Oxford University Hospitals NHS Foundation Trust, Oxford, UKThe personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries.https://www.cambridge.org/core/product/identifier/S2752614324000012/type/journal_articleprecision medicineprecision oncologycost-effectivenesshealth datapatient recordinteroperabilitystandard of carepatient centred |
| spellingShingle | Nesrine Lajmi Sofia Alves-Vasconcelos Apostolos Tsiachristas Andrew Haworth Kerrie Woods Charles Crichton Theresa Noble Hizni Salih Kinga A. Várnai Harriet Branford-White Liam Orrell Andrew Osman Kevin M. Bradley Lara Bonney Daniel R. McGowan Jim Davies Matthew S. Prime Andrew Bassim Hassan Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm Cambridge Prisms: Precision Medicine precision medicine precision oncology cost-effectiveness health data patient record interoperability standard of care patient centred |
| title | Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm |
| title_full | Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm |
| title_fullStr | Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm |
| title_full_unstemmed | Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm |
| title_short | Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm |
| title_sort | challenges and solutions to system wide use of precision oncology as the standard of care paradigm |
| topic | precision medicine precision oncology cost-effectiveness health data patient record interoperability standard of care patient centred |
| url | https://www.cambridge.org/core/product/identifier/S2752614324000012/type/journal_article |
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