Dr Michael Korn: Access to Precision Oncology Has Improved, but Remains Difficult for Some Populations

In the past, there was a greater discrepancy in access to precision oncology testing, which has closed somewhat; however, there are some disenfranchised populations who still struggle to access this care, said W. Michael Korn, MD, professor of medicine in the Division of Hematology/Oncology at the University of California, San Francisco, and chief medical officer of Caris Life Sciences.

Transcript

There has been a disparity between the technologies available in large medical centers and community practices. What does that gap look like right now for precision medicine and has it grown or diminished?

I'm looking at this from 2 perspectives. One is that I'm the chief medical officer for one of the companies that offers a very broad testing panel that enables essentially anybody to perform precision oncology testing, but I'm also with a large academic institution. And I think in the past, there was clearly this discrepancy of some of the academic centers were quite advanced, jumped into the, you know, deeper sequencing of tumors very quickly, had very comprehensive molecular screening programs, offered access to germline testing at different levels quite early on. And there were a number of centers within the United States that offered this, let's say, starting about 10 years ago.

I think what happened, really, in the last 5 or 6 years is that with industry actually catching up with academia—and I think actually taking on leadership in terms of developing, really cutting-edge testing—that whole picture has shifted. At the same time, which is always the kind of very important dimension to this is the reimbursement situation for testing. That was also difficult in the past. We would hear a lot of, “Well, it's not scientifically proven,” and so on. I think it took health insurers quite some time to understand the real advantage for the patient, but also for the system. So, now that has really improved significantly.

So, you know, it's there are still certainly some segments of the population [that] have a harder time to get access to testing. But overall, it has significantly improved.

For segments of the population who still have a hard time accessing cutting edge technology in cancer care—maybe they live in rural areas—what are they missing out on in terms of their cancer diagnosis and treatment?

I'm not so sure if this is actually a function of geographic location, I think it's more a function of social strata, you know, access to health care, in general, that could be in just in some urban setting. It's more of being able to see the right doctor, to then be able to afford the testing and afford the treatments that then are being recommended. I would say, in general, both academic institutions and industry are making efforts to close those gaps for those, kind of, disenfranchised populations. But at the same time, we know when we look at clinical trials, you know, we are still not really good in terms of bridging this gap perfectly. So, there's still some work to be done.