Diaceutics, the intelligence and engagement company unlocking the full potential of diagnostic-driven therapies, has released new research revealing a critical shift in precision medicine. Despite major advances in biomarker testing, nearly two-thirds of eligible patients with advanced non-small cell lung cancer (aNSCLC) in the US are still not receiving the most appropriate treatment.
The updated Clinical Practice Gaps report builds on Diaceutics' widely cited 2022 study, published in the Journal of Clinical Oncology. It applies the same seven-step framework to real-world data from more than 35,800 newly diagnosed aNSCLC patients in the US, comparing outcomes from 2019 to 2023.
The analysis reveals that overall patient loss across the precision medicine pathway remains virtually unchanged at 65.1 % in 2023 versus 64.4 % in 2019, despite significant advances in testing.
However, the study identifies a critical shift: the largest gap now occurs at the point of treatment decision. Patient loss at this stage has surged from 29.2 % to 43.3 %, a 12 % rise. Patient losses earlier in the pathway have declined, demonstrating positive diagnostic progress. However, this is not translating into overall better patient options due to suboptimal treatment decisions.
The headline hasn't changed - around two-thirds of patients still miss out on the right treatment. But where we're losing them has fundamentally shifted. Testing has improved thanks to a number of innovations and system-wide investments, the problem has just moved downstream. This is no longer primarily a testing problem; it is now a translation problem, and it demands a different response from the wider ecosystem, including industry."
Susanne Munksted, Chief Precision Medicine Officer, Diaceutics
The findings highlight a growing disconnect between expanding diagnostic capabilities and treatment decision-making, driven by increasing complexity and time pressure on clinicians. Diaceutics' research shows:
- 86 % of oncologists form treatment plans before full biomarker results are available
- Only 43 % consistently wait for results before initiating first-line therapy
- More than half do not consistently act on biomarker report recommendations.
The report calls for a fundamental shift in how precision medicine is operationalized, rebalancing focus toward treatment decision-making, improving consistency in biomarker test ordering, and delivering real-time, actionable support to physicians at the point of care. Diaceutics will continue to expand its real-world analysis to further understand and address the drivers of treatment decision failure.
"We need a more systemic approach to making precision medicine the path of least resistance," Munksted added. "To close the gap between testing and treatment, the industry must develop and adopt operating models that are diagnostic-enabled, data-driven, and continuously adaptive, to optimize the patient journey from tested, to identified, to appropriately treated."