ctDNA and the Enduring Role of Value-Based Models: Lalan Wilfong, MD

During the 2025 Community Oncology Conference hosted by the Community Oncology Alliance (COA), Lalan Wilfong, MD, moderated a session on circulating tumor DNA (ctDNA), an emerging tool that holds promise for cancer diagnosis, treatment monitoring, and early detection of recurrence. He also shared his perspective on the lasting role of value-based care in oncology, despite policy uncertainty, in an interview with The American Journal of Managed Care®.

Wilfong, a medical oncologist at Texas Oncology, serves as the senior vice president of value-based care at Thyme Care and is chair of the COA Payer Reform Committee.

This transcript has been lightly edited; captions were auto-generated.

Transcript

Can you share any insight from the session you moderated, "Latest Updates in CtDNA"?

I was able to moderate the session on circulating tumor DNA. Circulating tumor DNA is an emerging technology looking at fragments of DNA within the bloodstream and with multiple different use cases, one for diagnosis and ability to do molecular diagnostics on tissue that you may not be able to find otherwise, to guide your therapy, which is important in this era of targeted therapies. The other is monitoring response to therapy and monitoring for disease recurrence. The science is still pretty nascent there, so it's not quite ready for regular use in clinical settings, but it will be soon. It's an important thing for people to learn about and to know about, because as it becomes more readily used, it's important for us to know and to use that.

As chair of the COA Payer Reform Committee, what major policy or reform themes do you anticipate in the near future?

In my opinion, value-based care will remain an important part of oncology care moving forward; with the current administration and all of the things happening outside of just cancer care in general, the flavor and what that looks like may change over the next few years. I'm not really sure what's going to happen. I don't know if anybody's sure of what's going to happen in the near future with policy and reforms and things. I still firmly believe that value-based care is going to play a part of that—value-based care being: how do we take the best care of patients while we're cognizant of the cost and outcome of those patients and truly focusing on quality care that's affordable. That's still going to be a theme and an important tenet of cancer care moving forward, the way we do that and we practice that may change, as I mentioned, so we'll see.