Wafik S. El-Deiry, Director of Legorreta Cancer Center at Brown University and Chair of the WIN Consortium in Cancer Personalized Medicine, shared a post on LinkedIn:
“I enjoyed re-reading this post from 2015 as a nice reminder of where precision oncology was as a field in 2015 including some of the issues of the time.
Still an issue in 2026 as in 2015:
‘The problem in the era of precision medicine with the vast molecular heterogeneity of cancer (no two tumors are alike) is the problem of rare tumors and orphan diseases. The lack of universal genomic testing platforms and widespread data sharing in real time of clinical outcomes associated with genomic signatures for specific individual tumors adds to the challenge of this catch-22.’
One area with much progress since 2015 is liquid biopsy that is much more main stream in 2026 (although I don’t think less expensive): ‘Liquid biopsy has a future in the approach to deliver precision medicine over time to a patient’
A significant problem that remains in 2026 that was there in 2015 is the ability to predict exceptional responders in a sea of heterogeneity:
‘Not predicting drug value accurately for a given patient’s tumor and its genome may deprive patients of exceptional responses if the value is deemed low and the drug ends up not covered by insurance based on a population and statistics argument. Median OS or PFS while providing important information that helps in discussion, they are not relevant to the exceptional responders or the outliers as those are not predicted.’
‘But we are not so good at predicting who will get great benefit versus little or no benefit for much of what is between the extremes [of therapy response rates].’
There has been little to no progress by 2026 against 2015 in predicting accurately who will respond to targeted therapy based on co-mutations with some rare exceptions (the pace has been slow due to not enough emphasis or appreciation of impact on the value of care):
‘If we only treat patients who are accurately predicted to benefit then we maximize value, including by lowering overall costs. Perhaps in the future genomics may help predict accurately which specific patients will benefit and for how long, for their specific tumor signatures, at the time of drug approval but how do we get there with the hundreds of already approved drugs?’
Are we ready to assess the value of treatment options in oncology?”
Other articles featuring Wafik S. El-Deiry on OncoDaily.