Volume 39 Number 6 | December 2025
Summary
Precision oncology is essential today, not someday. Matching cancer treatments to a tumor’s unique molecular profile can save lives, but widespread adoption is limited by choosing the right tests, balancing cost with value, and integrating complex tools into real-world workflows. Laboratory professionals play a critical role in overcoming these barriers to deliver timely, targeted care.
Shraddha Hakani, B.Pharm, MS
Think of cancer treatment like defusing a bomb. Each tumor is wired differently, and if you cut the wrong wire, nothing happens—or worse, you speed up the countdown. In oncology, a mismatched treatment isn’t just ineffective, it gives the disease more time to spread. That delay can be the difference between life and death.
Precision oncology is our bomb squad. It’s the science of matching a patient’s treatment to the unique “wiring diagram” of their cancer, right down to the genes, proteins, and molecular markers that drive it. For medical laboratory science professionals, this means more than running a test—it means choosing the right test, at the right time, and delivering results fast enough to guide a life-saving decision.
When it works, precision medicine is transformative. Patients avoid toxic treatments that won’t help them, providers prescribe with confidence, and health systems focus resources where they matter most. So why isn’t it everywhere?
Three persistent, interconnected barriers keep precision oncology from becoming universal.
Barrier 1: How? Choosing the Right Tools
In the lab, using the wrong tool for the job doesn’t just delay results—it can mean missing the biomarker that determines a patient’s only effective therapy. Over the past decade, we’ve moved from basic histology and immunohistochemistry (IHC) to next-generation sequencing (NGS), liquid biopsies, and AI-driven biomarker discovery.
The challenge? No single tool tells the whole story. Like an orchestra, every instrument—the genetic profile, the protein expression, the cellular morphology—must be brought together in harmony to understand the disease fully.
Yet, according to a 2021 JCO Precision Oncology study, up to 30 percent of eligible patients never receive targeted therapy, often because the right test wasn’t ordered, wasn’t available, or the results came too late to guide treatment.
“For laboratory science professionals, the mission is clear: the right test leads to the right diagnosis, and the right diagnosis leads to the right treatment—slowing the clock, and sometimes, stopping it entirely.”
Barrier 2: How Much? Balancing Cost and Clinical Value
Cancer care is already expensive. U.S. healthcare spends more than $200 billion annually on cancer treatment. For patients, costs are devastating. Over 50 percent experience “financial toxicity,” and out-of-pocket expenses can rise by $600/month post-diagnosis.
High-value genetic tests often cost $3,000–$5,000, and when insurance denies coverage, patients may forgo testing entirely, missing the opportunity for targeted therapy. In lung cancer, patients without comprehensive genomic testing had shorter survival rates, according to a 2019 JAMA Oncology analysis.
For laboratories, this raises the question: how much testing is enough to guide treatment without overburdening the system or the patient?
Barrier 3: How to? Integration into Real-World
Even the most accurate and affordable test is useless if it doesn’t fit into existing workflows. From the patient perspective, each additional appointment adds travel, time off work, and stress. From the provider perspective, the average oncologist already uses nearly four different digital platforms daily, each with its own logins, interfaces, and quirks.
This barrier is now front and center with technologies like digital pathology, where a single whole-slide image can be several gigabytes. Moving, storing, and integrating this data requires high-bandwidth infrastructure, secure storage, and compatibility with systems like LIS, EMR, and PACS.
For laboratory professionals, this is about interoperability standards—HL7, FHIR, and DICOM—and ensuring that new tools add value without slowing turnaround times or creating new bottlenecks.
The Path Forward
Mitigating these barriers, selecting the right tools, making them affordable, and integrating them seamlessly will transform precision oncology from an elite service into standard care. But solving just one won’t defuse the bomb.
An affordable test is useless if it’s the wrong one. A perfect test that can’t be integrated into the lab’s workflow will sit unused. These challenges are tightly interconnected, and cutting only one “wire” won’t stop the countdown.
For laboratory science professionals, the mission is clear: the right test leads to the right diagnosis, and the right diagnosis leads to the right treatment—slowing the clock, and sometimes, stopping it entirely. Millions of patients are on this journey right now. The countdown is real, and it’s running out.
We don’t have the luxury to call precision medicine “the future.” We are already late.
References
- Docter-Loeb, H. (2025, August 4). After cancer diagnosis, out-of-pocket costs jump, study says. The Washington Post. https://www.washingtonpost.com/wellness/2025/08/04/cancer-diagnosis-health-care-costs/
- Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, Part I: A new name for a growing problem. The Oncologist, 18(4), 381–382. https://doi.org/10.1634/theoncologist.2012-0279
- National Cancer Institute. (2020). Cancer statistics. National Institutes of Health. https://seer.cancer.gov/statfacts/html/all.html
- Trosman, J. R., Weldon, C. B., Kelley, R. K., et al. (2019). Challenges of coverage policy development for next-generation tumor sequencing panels: Experts and payers weigh in. JAMA Oncology, 5(7), 936–942.
- Zullig, L. L., Jackson, G. L., Provenzale, D. T., et al. (2023). Transportation barriers to care among cancer survivors. The Journal of Rural Health, 39(1), 120–128.
- American Medical Association. (2022, October 17). 5 insights into how physicians view, use digital health tools. https://www.ama-assn.org/practice-management/digital-health/5-insights-how-physicians-view-use-digital-health-tools
Shraddha Hakani is a pharmacist with a Master’s in Healthcare Decision Analysis. She has led precision medicine and AI-driven healthcare initiatives at Roche, Proscia, and AstraZeneca, where she is currently Senior Manager, Precision Medicine Marketing. Originally from India, Shraddha is based in Gaithersburg, Maryland.
Disclosure Statement
The views expressed in this article are solely those of the author and do not necessarily reflect the views of AstraZeneca or any other organization with which the author is affiliated.