Real-Time Data to Drive Cancer Pathways: Edward Arrowsmith, MD, MPH

The rapid pace of new cancer therapies is pushing oncology pathways to update faster, and within 5 years they could draw on real-time data feeds to guide treatment decisions, according to Edward "Ted" Arrowsmith, MD, MPH, of Tennessee Oncology and OneOncology. In an interview at the Patient-Centered Oncology Care® (PCOC) 2026 conference hosted by The American Journal of Managed Care^® in Nashville, Tennessee, September 24-25, 2026, Arrowsmith discussed how OneOncology keeps its pathways current and where pathway programs are headed.

How Pathways Keep Pace With New Cancer Drug Approvals

The field is seeing a dramatic increase in the pace of new therapies, and pathway updates happen in 2 main ways, Arrowsmith explained.

For newly approved drugs, timing depends on when a treatment is actually available in the clinic. Months can pass between FDA approval and commercial availability. In those cases, OneOncology waits for its regular quarterly disease group process to add the drug to its pathways.

Other updates move faster. When a drug that is already available receives a new indication and a new publication, the disease groups sometimes hold emergency meetings, often conducted by email, to add the drug to the pathway.

Those changes are often anticipated, Arrowsmith said. The group may discuss a potential update at a previous meeting after early data are presented at a major conference, such as the European Society for Medical Oncology (ESMO) Congress.

"If at the time of publication this looks as strong as it was at the ESMO presentation, we'll plan to add that to pathways," Arrowsmith said.

What the Future of Oncology Pathways Could Look Like

Arrowsmith said the goal is for pathways to become even more dynamic over the next 5 years. Today, pathways largely function as static documents that are updated periodically and rely on providers to supply data and make decisions.

In the future, pathways could incorporate multiple automatic data feeds that give providers real-time input. Those sources could include genomic data, patient-reported outcomes, staging data, and new artificial intelligence (AI) diagnostics.

"Those will all be integrated into real-time information to that provider to make both initial treatment decisions and ongoing treatment decisions," Arrowsmith said.

That vision would shift pathways from periodic reference tools to systems that continuously inform care as new information about a patient and the evidence base becomes available.