Education Is Key as Precision Oncology Advances: William K. Oh, MD

Precision medicine is advancing quickly in oncology, but access to its benefits may not keep pace, according to William K. Oh, MD, director of precision medicine at Yale Cancer Center. Oh spoke on a panel titled “Is Precision Medicine Making Cancer Care More or Less Equitable?” at the Patient-Centered Oncology Care^® 2026 conference hosted by The American Journal of Managed Care^®.

"The problem with new technologies, though, is it can widen the gap for patients who do have access to those tools and those who don't," he said in an interview.

Cost and Coverage Shape Who Benefits

Biomarker testing must come first to identify which patients should receive which drug, Oh said, and adequate insurance is then needed to cover costly targeted therapies. He described a patient in his 50s with metastatic prostate cancer who was unhoused. Testing found multiple mutations that made him a candidate for chemotherapy, a PARP inhibitor, or a protein kinase B inhibitor, in addition to standard hormonal therapy. Oh's first attempt to obtain a targeted therapy was unsuccessful, but the patient's insurance and a team effort involving finance staff, nurses, and nurse practitioners ultimately secured treatment.

"If you don't do the testing, you'll never know if a patient would be a candidate," he said.

Most available germline data come from patients of European ancestry, Oh said. That imbalance limits understanding of whether pathogenic variants differ across geographies, races, and ethnic backgrounds. Data collection is expanding nationally and internationally, but the pace of research keeps progress slow.

Coverage Laws Trail Newer Assays

Laws requiring coverage of biomarker testing may not extend to liquid biopsy or minimal residual disease testing, Oh said. Researchers must still demonstrate clinical benefit for these approaches. He urged continued pressure on payers, states, and regulators to provide access once data show value for patients.

Even top academic centers struggle to keep up with new technology, Oh said. He is prioritizing education at Yale for trainees and attending physicians through precision medicine tumor boards, webinars, and other learning opportunities.