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Precision Oncology: Where are we headed?

May 21, 2024

ORION by VieCure

Volume 5, Issue 4

William K. Oh, MD; Icahn School of Medicine at Mount Sinai

Over the past 25 years, we have witnessed a genomic revolution where sequencing a patient’s tumor is becoming increasingly easy and less expensive.  In addition, the number of new therapies tied to genomic alterations has grown considerably and most oncologists do not think twice about using a drug only in populations of cancer patients with a specific mutation (such as PARP inhibitors in BRCA1/2 patients).  However there have also been skeptics that suggest that this genomic “revolution” has overpromised and underdelivered.  Indeed, despite the increasing feasibility of detecting mutations in tissue and blood, the actionability of these mutations remains limited. 

A recent paper from Memorial Sloan-Kettering in NYC—one of the world leaders in routine sequencing of cancer tissue for clinical care—highlights the significant improvements over just the past 5 years.  In 2017, 44% of patients had tumor mutations without drugs that could be used or were “actionable.”  By 2022, this was cut in half to 22.8%.  Similarly, level 1 or 2 findings, which would make the patient eligible for standard of care treatment, rose from 8.9% to 31.6%.  While it is still a minority of the patients, such a rapid improvement suggests that as the biology of mutations are better understood and companies develop drugs against those targets, that more and better treatments are on the way.

There are still concerns:  this study was at a large, well-funded NCI Cancer Center, with highly specialized oncologists who study only 1 or 2 diseases.  There is a need for representation among rural, underrepresented patients, or those with poor or no insurance.  Hope remains as oncology has adopted this precision approach that can be applied at the community level, especially with tools that help clinicians at the point of care. As clinicians, will continue to pursue identifying the right treatment for the right patient at the right time.


How does VieCure support the innovations surrounding precision oncology? Utilizing VieCure’s AI-inference engine, the clinician can promptly and efficiently review active considerations for treatment, order genomic sequencing, receive timely and discrete results in a detailed report, then proceed with a recommended guideline-based course of action from additional considerations. The VieCure platform and partnerships continue to support the rapidly evolving world of genomics and mitigate the complexity of management in the clinical setting.

Dr William Oh, MD

Icahn School of Medicine at Mount Sinai

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