Precision, Personalization, and Equity: Key Trends Shaping the Future of Cancer Care

Joseph Alvarnas, MD, vice president of government affairs and professor of hematology at City of Hope, predicts that the future of cancer care will grow more complex through advances in genetics and personalized treatments, while also requiring more compassionate, equitable care for a diverse patient population.

Alvarnas chaired the Institute for Value-Based Medicine^® (IVBM) event, "Prioritizing the Patient in Value-Based Oncology Care," on September 19 in Garden Grove, California.

This transcript has been lightly edited for clarity.

Transcript

What emerging trends do you believe will significantly shape the future of cancer care delivery over the next decade?

Back in the 1970s, Time magazine ran a cover story about magic bullets in cancer because there was this naive belief that somebody would discover this one singular thing and put it in a pill and, suddenly, every patient with cancer would be better. What we've learned after the last 3, 4, 5 decades after that article was published is that nothing could be further from the truth.

The first thing that I predict is that this is going to get a lot more complicated. As we have a better understanding of the genetic and genomic underpinnings of cancer, as we begin to appreciate the role of the gut microbiome, as we understand a whole slew of -omics regarding individual patients, then how we approach a person with cancer has to be reflective of a full breadth of data that has yet to be discovered and will lend greater and greater levels of complexity to the decisions that best serve that individual.

The second thing that I think is really going to be important about oncology is that making sure that our system is better suited for serving an increasingly diverse group of patients is going to be really essential. The US continues to grow in diversity. There's linguistic diversity, there's diversity throughout all avenues of how people talk about themselves. Our system has to adapt to tailor care to people and deliver it in a way that's executed with the utmost respect, with compassion, with a greater capacity to listen to what patients wan and what their goals are.

I've talked about 2 things that may seem kind of divergent. One is that care is going to be really, really technically complex, increasingly so. Also, care has to be more personalized and delivered in a more humanized way. This is my greatest hope for the future of oncology: We'll be able to do this, but it requires a number of paradigm shifts in terms of how patients access care, how they're supported, how that technology is delivered, and, as patients enter the domain of survivorship, how we continue to serve their interests carefully in differentiated ways and with the utmost of compassion.

Over the last 3 years, we've seen cancer survival rates grow by the greatest increments ever. I think the goal set forth in the Biden Moonshot 2.0 of decreasing cancer mortality by 50% over the next several decades is absolutely realizable. The biggest challenge for our system, however, is to make sure that those gains and those advances in knowledge are enjoyed equitably by all members of society. If we can achieve that, then we will have done something truly extraordinary.