The US Oncology Network: Technology Speeds Decision-Making in Precision Medicine

Twenty-five years have passed since then–President Bill Clinton and British Prime Minister Tony Blair announced completion of the “working draft” sequence of the human genome, considered by many to be the start of the precision medicine era.¹ Since then, the number of new oncology drugs has exploded, with no sign of letting up. IQVIA reports that 25 oncology novel active substances were launched globally in 2024; the average number of launches in 2020-2024 was 26, and in the 5 years prior, the average per year was 16.²

As seen during presentations at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, cancer trials today focus on narrow groups of patients with specific genomic features—or, as Julie R. Gralow, MD, said, “We’re now taking common cancers and turning them into rare cancers.”³

More than ever, testing helps clinicians and researchers learn which patients will benefit from a new drug or should enroll in a clinical trial. Gralow is chief medical officer and executive vice president of ASCO. With so many therapies and trials to choose from, that’s where technology has a role. “A big challenge with precision medicine is just distilling down all this important information seamlessly and quickly, so the care teams can act upon it,” said Jason Hammonds, chief operating officer for oncology and specialty at McKesson Corporation.

Note the emphasis on quickly. Modern tools are especially helpful in community oncology practice, where most patients receive care and the care team is especially pressed for time.

Through The US Oncology Network, McKesson supports 3300 providers in independent practices, and Hammonds said equipping them with technology and precision medicine resources is a priority. Hammonds discussed this with The American Journal of Managed Care in an interview, and Eric Lander, MD, hematologist/oncologist and site research leader at Minnesota Oncology in Minneapolis, a network practice, also answered questions via email about how the current focus on technology is supporting precision medicine at the practice level.

Minnesota Oncology is among the network practices that take part in clinical trials through a joint venture launched in 2022 with Nashville, Tennessee–based Sarah Cannon Research Institute (SCRI).⁴ Although many were already participating in clinical research, the SCRI venture has expanded opportunities.
“We are all singularly focused on our mission of ensuring patients have access to cutting-edge, state-of-the-art precision medicine close to home,” Hammonds said. The technology focus starts with the electronic medical record (EMR): McKesson’s iKnowMed, which Hammonds said enables physicians to seamlessly order biomarker tests and put the results directly into clinical workflows, allowing an order for a targeted therapy to be placed with ease.

Hammonds also highlighted Precision Care Companion, an initiative announced earlier in 2025.⁵ This consortium pairs McKesson with laboratory partners to provide targeted education and technology enhancements, including several new functions within the EMR as well as operational best practices and analytics, Hammonds said at the time. “Precision Care Companion is not just another program — it is a testament to McKesson’s unwavering commitment to advance community oncology so providers can efficiently offer targeted, personalized cancer care while keeping patients close to home,” he said.⁵
This approach, he said, will ensure that patients “get the right treatment at the right time, based on where they are in their cancer treatment.”

Both Hammonds and Lander touted Genospace, the data science and technology platform developed by SCRI and acquired by McKesson in 2022.⁶ This is the difference maker in quickly finding which clinical trial is the best fit for a patient, instead of asking busy nurses to hunt for the needle in the haystack.

Lander shared what it means to have this tool compared with the old way of doing things. “It is hard for clinicians to keep up with all of the changes in medical oncology and drug development. The central screening service and Genospace platform, alongside Sarah Cannon’s precision medicine team, help providers offer the newest therapies to their patients at the earliest possible time,” he said. “We are able to prescreen patients for clinical trials via a centralized process for all practices participating in the clinical trials. This takes some of the burden off busy clinicians to identify their patients for clinical trials that are increasingly driven by molecular alterations.”

Lander continued, “Research nurses no longer have to comb through long lists of patients in clinics to find a potential patient for a study. The technology automatically finds potential patients, making it much easier to screen all patients across a practice for a particular clinical trial.” In addition, he said, “Genospace can break down potential patients by study and clinic. Thus, I can see all the potential patients for a given clinical trial within a matter of seconds.”

Hammonds noted that, besides saving time and labor, Genospace helps reduce overall accrual time in trials, reducing the risk that trials fail due to lack of enrollment. Drug manufacturers have noted this is one of the costs built into the prices of drugs that are approved by FDA.⁷

Has technology allowed community practices to connect patients with clinical trials who might otherwise have gone undiscovered? “Absolutely,” Hammonds said. “We’ve heard this from our biopharma partners as well.” It’s one of the reasons overall accruals are rising, he said, not just for practices new to the network but also for legacy practices.

Practices Learn From Each Other
The US Oncology Network includes providers from 29 states, from practices large and small; some arrive with extensive research expertise, and some with less. When a new practice joins the network, Hammonds said, “We work with them holistically to understand where they are, what some of their strategies are, and where we can lend support. We also create a forum across all our practices to come together to share ideas.”

Some practices that join have deep experience in precision medicine and can offer new insights, Hammonds said. For example, when Florida Cancer Specialists & Research Institute came to the network in 2024, it added 100 care sites, an extensive research portfolio—including a long relationship with SCRI—and a proprietary precision oncology platform.⁷

“The power of The US Oncology Network is that it is a collection of leading independent providers, where we are sharing best practices across the board so everyone’s able to learn insights from each other,” Hammonds said.

Lander explained how this happens in day-to-day practice. He said technology embedded in the EMR will suggest molecular testing for patients based on their diagnosis, thus boosting uptake of testing such as next-generation sequencing (NGS) or immunohistochemistry (IHC) testing for certain tumor types.

“Having the medical record integrate molecular test results into the patient’s diagnosis and chart so that it does not get lost in an old document will ensure providers keep the molecular profile of the tumor at top of mind,” he said. That way, the information is front and center if they want to consider a new therapy or trial.

In addition, telemedicine has put second opinions within easy reach. “We have the ability to conjure a molecular tumor board expert through clicking a button in our EMR,” Lander said. Thus, patients can gain access to a second opinion on test results that are difficult to interpret.

Reimbursement and Access
Most discussions about molecular testing at major scientific meetings turn to challenges with reimbursement. In results presented at ASCO 2025, the SERENA-6 trial (NCT04964934) showed improved progression-free survival for patients who switched to camizestrant when testing showed signs of ESR1 mutations, even before traditional signs of progression.⁸ But a commentator at the plenary session brought up the question of whether payers would fund sequential testing in real-world situations.

What would community oncology anticipate with sequential testing on the horizon? What is the payment landscape like now?

“We get to see the most diverse patient base, and our mission is making sure that everyone has access to great care close to home,” Hammonds said. “That’s one of the many great aspects of The US Oncology Network: We are committed to ensuring there is equal access, starting with comprehensive genomic profiling, and supporting the practices with technology-enabled workflows.”

Besides streamlining the process, he said, “We work with a number of parties—foundations and other patient assistance support programs. So, if there is a challenge with a patient’s ability to pay for a test or another element, we can access those funds when available, so a patient doesn’t have to forgo a test.”

He continued, “We are constantly partnering with payers, policy makers and research organizations to look to address the ongoing reimbursement challenges that may inhibit access, not just to these therapies, but to the necessary tests that help ensure these patients are getting the right therapies at the right time.”

At Minnesota Oncology, Lander said, “I have seen few challenges with reimbursement recently as a barrier to testing, particularly for third-party testing from the major national vendors such as Tempus, Caris, and Foundation Medicine.” His patients, who have a variety of insurance types, “have only very rarely told me they received a significant bill for testing from the national vendors.”

The bigger problem Lander sees comes when a pathology laboratory “reflexively” performs in-house NGS tests, most of which are still limited gene panels that “use precious tissue,” he said. That makes it difficult later to complete comprehensive genomic and IHC profiling.

“We need to educate our pathologists on the realities of the ever-evolving treatment landscapes in oncology. Because a gene may not be currently actionable at the time of testing, [but] the gene could have a targeted therapy in the near future, by the time the patient is needing a treatment switch,” Lander said. “Thus, it’s important we are comprehensive in our upfront testing and retesting of patients’ tumors.”

Testing a tumor with the idea that a therapy may come later is a sign of how quickly cancer research is progressing. “It’s exciting to see the advancements in cancer care and the progress that’s being made,” Hammonds said. “In the past 5 years, 61% of FDA-approved novel oncology drugs have been targeted therapy.9 This is not going to slow down—it’s only going to increase.”

References
1. President Clinton announces completion of the first survey of the entire human genome. News release. The White House. June 26, 2000. Accessed October 3, 2025. https://clintonwhitehouse5.archives.gov/WH/EOP/OSTP/html/00628_4.html
2. Global oncology trends 2025: adopting new therapies as modalities shift and expenditures rise. IQVIA. May 22, 2025. Accessed October 3, 2025. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/global-oncology-trends-2025
3. Caffrey M. At ASCO, testing and AI rival drugs for attention, but reimbursement remains a barrier. Am J Manag Care. 2025;31(8):SP507-SP510.
4. McKesson to form an oncology research joint venture with HCA Healthcare. News release. Simpson Thatcher. June 27, 2022. Accessed October 3, 2025. https://www.stblaw.com/about-us/news/view/2022/06/27/mckesson-to-form-an-oncology-research-joint-venture-with-hca-healthcare
5. McKesson unveils Precision Care Companion, revolutionizing precision medicine in community oncology. News release. The US Oncology Network. April 16, 2025. Accessed October 3, 2025. https://usoncology.com/news/mckesson-unveils-precision-care-companion-revolutionizing-precision-medicine-in-community-oncology/
6. McKesson and HCA Healthcare announce plans to form an oncology research joint venture to advance cancer care and increase access to oncology clinical research. News release. McKesson. June 30, 2022. Accessed October 3, 2025. https://www.mckesson.com/about-us/newsroom/press-releases/2022/mckesson-hca-healthcare-form-oncology-research-joint-venture/
7. Caffrey M. Beyond McKesson and Florida Cancer Specialists, deals are reshaping community oncology. Am J Manag Care. 2024;30(suppl 11):SP870-SP873. doi:10.37765/ajmc.2024.89692
8. Bidard FC, Mayer EL, Park YH; SERENA-6 Study Group. First-line camizestrant for emerging ESR1-mutated advanced breast cancer. N Engl J Med. 2025;393(6):569-580. doi:10.1056/NEJMoa2502929
9. Suenholz SP, Kundra R, Zhang H, et al. Tracking the FDA precision oncology drug approval landscape in OncoKB. J Clin Oncol. 2024;42(suppl 16):e13507 doi:10.1200/JCO.2024.42.16_suppl.e13507