New Jersey, Where Cancer Care Choice Abounds, Puts Patients at the Center

A generation ago, most patients in New Jersey seeking “the best” cancer care would look to New York City; those in the state’s southern counties might investigate choices in Philadelphia.

Today, those global brands—think Memorial Sloan Kettering Cancer Center, Penn Medicine, or The University of Texas MD Anderson Cancer Center—have come to New Jersey, either to form partnerships or to affiliate with existing hospitals. They must compete with homegrown choices, from the Rutgers Cancer Institute of New Jersey to research-driven community oncology practices, that have shattered the idea that good cancer care requires long car rides and paying bridge tolls. In many cases, patients don’t have to leave the state for a clinical trial.

On May 7, 2026, the theme of putting patients at the center, whether to deliver chimeric antigen receptor (CAR) T-cell therapy close to home or to align care with patients’ values, came through across the panels at the Institute for Value-Based Medicine^® event held at the Westin Princeton at Forrestal Village in Princeton, New Jersey. The evening opened with the session, “Scaling Innovation: Delivering Targeted Therapies, CAR T and Bispecifics in Multiple Myeloma,” featuring moderator Mansi Shah, MD, clinical director of multiple myeloma, Rutgers Cancer Institute; and panelists Joshua Kra, MD, of Rutgers Cancer Institute; Harsh Parmar, MD, a specialist in multiple myeloma from John Theurer Cancer Center in Hackensack; and Andy Hui, PharmD, BCPS, an oncology clinical pharmacist at Hackensack Meridian Health.

Keeping Patients Connected Without Overwhelming Teams

Evidence shows that support between clinic visits can catch emerging infections and keep patients with cancer out of the emergency department. But what is the best way to deliver this level of care?

Coral Omene, MD, PhD, medical oncologist, associate professor and program director, breast cancer disparities research at Rutgers Cancer Institute, moderated the panel “Patient-Centered Innovations in Cancer Care Delivery,” which featured Pallav Mehta, MD, director of integrative oncology, MD Anderson Cancer Center at Cooper; Julianne Ani, MPH, senior manager, Center for Cancer and Aging at Penn Center for Cancer Care Innovation; and Shannon Woerner, MBA, AOCNP, ANP-BC, vice president of clinical operations, Astera Cancer Care.

The panel opened with a shared recognition that patients need more than episodic clinical encounters; they benefit from continuous, coordinated support that extends well beyond the office visit. Mehta noted that after-hours access for patients with cancer has changed little in 2 decades. “We don’t often think about what they’re going through,” he said. “I think we just have to do a better job at allowing patients to feel like we’re always around without overburdening the clinical staff.”

Ani described her program’s geriatric oncology model, in which all patients 65 years and older receive structured assessments across multiple life domains—physical, social, and financial—using validated tools. Nurse navigators and social workers accompany patients throughout treatment, ensuring the entire multidisciplinary team is aligned with each patient’s values and treatment goals from the outset. Woerner emphasized the essential role of pretreatment education sessions, where advanced practice providers not only prepare patients for new therapies but also identify gaps in support needs—from nutrition and social work to financial assistance and medication management.

The clinical coordination team then takes over, and Woerner said the focus today is to not wait for issues “as they come in.”

“We’re trying to extend that, to be more proactive in identifying these high-risk patients,” she said, by “utilizing our technology platforms to help take off the operational burden and really allow our clinicians to focus on the patient care and symptom management.”

Omene described operationalizing this patient-centered philosophy at Rutgers Cancer Institute, where distress screening tools are embedded at intake, and multidisciplinary appointments are coordinated on the same day to reduce patient burden. She spotlighted Rutgers’ community-based clinical trial access model, which has achieved nearly 50% minority enrollment by bringing trials to affiliate sites across New Jersey—a strategy for mitigating racial and socioeconomic disparities in access.

New Jersey is among the nation’s most diverse states—US Census data show the population is 55% White, 21.6% Latino, 13.1% Black, and 10% Asian.¹ By raw numbers, New Jersey Cancer Registry Data show that members of minority groups are not overrepresented with cancer²; however, this is because White patients are overrepresented among cancer types that affect those in older age groups. Age-adjusted rates and mortality data show a different story, however.

The state registry data show that non-Hispanic Black males have the highest rate of new prostate cancer cases, more than 1.5 times the rate for White or Hispanic males and 3 times that for Asian males.² Non-Hispanic Black men also have the highest rates of new colorectal cancer (CRC) cases; among women, non-Hispanic Black women have the highest rates of CRC.

Omene said Rutgers has an active education program to dispel myths about clinical trials and undo the damage of unethical behavior toward the Black community by earlier generations of researchers, which led to the limited enrollment that continues today. It takes an institutional commitment, she said, “from the leadership all the way down…[so] you know this is something that has to be addressed.”

On shared decision-making, panelists agreed that artificial intelligence tools, expanded care teams, and individualized benefit-risk communication are reshaping how complex treatment conversations are conducted. Mehta cautioned against binary recommendations, stressing that absolute benefit must be contextualized for each patient.

Regarding digital health, the panel endorsed telehealth and electronic patient-reported outcomes as powerful tools for surfacing unmet needs, while warning against widening disparities through technology. Woerner and Ani emphasized provider-facing electronic health record (EHR) tools; Mehta advocated for text-based, caregiver-accessible remote monitoring platforms.

Focusing on providers is consistent with a recommendation heard at the Community Oncology Alliance annual conference³: finding tools that improve physicians’ workflows leads to better care, while patients need to be met where they are.

Regarding their older patients, Ani noted, “Our patient population is very unique in that some are more early adopters of technology, and some are very afraid [of] or resistant to using technology…. For some patients, having a telehealth appointment eliminates the need for them to arrange transportation, and that is huge for them; for other patients, that in-person interaction is what really makes everything for them.”

Building Trials That Match the Patient Population

Omene’s presentation on Rutgers’ strategy led into the panel examining systemic barriers that keep underrepresented groups from enrolling in clinical trials. Moderated by Neil Palmisiano, MD, MS, associate professor and system leader for leukemia at Rutgers Cancer Institute, this panel featured Rutgers urological oncologist Saum Ghodoussipour, MD; lymphoma and chronic lymphocytic leukemia specialist Lori Leslie, MD, of John Theurer Cancer Center and Regional Cancer Care Associates; and hematology-oncology physician Anupama Nehra, MD, of Rutgers.

“Eligibility criteria are the lowest hanging fruit,” said Ghodoussipour, who noted that clinical trial populations in bladder cancer skew roughly a decade younger than real-world patients, with fewer comorbidities. He called for more pragmatic trial designs that accommodate patients with prior therapies and complex medical histories. Leslie echoed this, adding that rigid screening windows—such as requiring a repeat PET scan because a prior scan fell 1 day outside the protocol window—impose unnecessary burdens without meaningfully improving safety or data quality.

Nehra said most patients receive care in community settings, yet trials remain concentrated at large academic centers—especially phase 1 trials. She agreed with the need to loosen eligibility criteria, as some make no sense. “Oftentimes we exclude patients [who] have had a history of previous cancer, even though they've been cancer free for a long time,” she said. “A patient population like that is probably what we should look at.”

The travel burden, financial toxicity, and multiple required visits deter enrollment, Nehra said, especially among patients from socioeconomically vulnerable populations. She highlighted Rutgers Cancer Institute’s 13-hospital health system model, where approximately one-third of trial accrual occurs outside the main academic site and roughly half of enrolled patients are from underrepresented minority groups.

Leslie proposed the concept of centralized “research hubs” that would serve as collaborative infrastructure shared across academic, community, and industry partners as a potential structural solution, especially in geographically dense regions such as New Jersey.

Panelists highlighted some wins, including fewer required visits, expanded inclusion for patients with well-controlled HIV or hepatitis B, relaxed washout periods, and more flexible performance status requirements. However, Nehra called for stronger incentive structures and systematic demographic tracking to hold sponsors and institutions accountable for meaningful diversity in enrollment, including incorporating trial-site demographics into site selection decisions.

She said distrust of clinical trials among minority patients is often mischaracterized. From her perspective, patients are willing to participate when approached with transparency, cultural competency, and language-appropriate materials. Investing in diverse research staff, addressing language barriers, and offering travel reimbursement, for example, are critical. Community advisory boards, faith-based outreach, and sharing trial results with communities are tools for building trust.

“Trust is a long-term relationship,” Nehra said, one that depends on excellent ongoing care as well as community feedback. “It doesn’t begin when you are actually talking to the patient about the trial; trust is institutional. It may be provider related, but it all goes back to what your relationship is with the local community and how you have provided care in that local community.

“Have you addressed their concerns? Has the institution built a level of trust where patients feel comfortable coming in and getting treated at that institution, and then you know that that kind of gets transferred to the provider when they’re seen there? Once you build that trust, the conversation becomes easier.”

Treatment Complexity Raises Visibility—and Demands—on Oncology Pharmacy

Moderator Eileen Peng, PharmD, MS, vice president and chief administrative and pharmacy officer, Astera Cancer Care, led the final conversation, “Oncology Pharmacy: The Room Where It Happens.” As the title suggests, the panel focused on the increased visibility and responsibility of the oncology pharmacist in the era of CAR T-cell therapy, bispecific antibodies, and the ever-growing number of combination treatments.

“We evaluate all the financial impact, patient access impact, financial [impact] for the practice, for the hospital health system, and also the bigger view for the…entire health system,” Peng said. “We cannot waste health care money here.”

Panelists shared varied approaches to embracing new therapies. Maribel Pereiras, PharmD, BCPS, BCOP, of Hackensack University Medical Center, described a deliberate “go slow” philosophy, one that calls for launching new programs with a handful of patients and leveraging the EHR to manage workflows without immediately knowing staffing needs. By contrast, David Awad, PharmD, BCOP, of Rutgers Cancer Institute/Robert Wood Johnson University Hospital, described his institution’s push to operationalize new agents on the day of FDA approval, building disease-state specialists to manage the nuances of each patient population.

Melissa Pozotrigo, PharmD, BCOP, now on the managed care side with OncoHealth, highlighted the value of robust patient education, financial counseling teams, and patient navigators in supporting complex care journeys.

On prior authorizations (PAs), Pozotrigo stressed the importance of submitting complete clinical documentation up front, including staging, prior therapies, biomarkers, and pathology. Awad credited dedicated pharmacist-led PA teams with dramatically faster turnaround times and higher approval rates. Pereiras emphasized pharmacists’ ability to bridge clinical intent with payer expectations, augmenting provider notes with emerging clinical data to support coverage decisions.

Pharmacists in the PA process have a positive effect on revenue, Awad said. “So having a pharmacist embedded in all those spaces is important,” and so is EHR optimization. The latter allows safety signals for specific therapies to be caught quickly. He referred to adverse events related to a generic version of a cancer therapy that have been occurring frequently, requiring more desensitization for patients.

Panelists argued for total-cost-of-care thinking, particularly as gene therapies priced at up to $3 million enter the market. At the opposite end, new modalities such as greater use of subcutaneous therapies could improve access or even enable greater use of home-based care, something Awad supports.

“I don’t like driving into New Brunswick. I can’t imagine a patient who has to do it multiple times in the middle of the day, going home during rush hour, driving 30 minutes [to] an hour just to get their treatment,” he said.

All 3 panelists envisioned pharmacists of the future embedded across managed care, community settings, and data analytics, moving decisively from contributor to leader in oncology.

“We need to see pharmacists expand into so many different areas to really help demonstrate the value—and to…bring patients the care and access that they really need,” Pereiras said.

References

1. Census information. New Jersey State League of Municipalities. Accessed May 25, 2026. https://www.njlm.org/384/2020-Census-Information
2. New Jersey State Cancer Registry. Five leading sites of new cancer cases: rates by sex, race, and ethnicity, 2018-2022. New Jersey Department of Health. July 2025. Accessed May 25, 2026. https://bit.ly/42UhXWO
3. Caffrey M. AI in oncology practice: innovation in the delivery of care itself. AJMC. May 1, 2026. Accessed May 25, 2026. https://www.ajmc.com/view/ai-in-oncology-practice-innovation-in-the-delivery-of-care-itself