Navigating the Challenges of Advanced Cancer Remission Testing
Dong Chen, MD, PhD, discusses the obstacles and opportunities for growth in posttreatment cancer detection.
In an interview with Targeted OncologyTM, Dong Chen, MD, PhD, hematopathologist and vice chair of practice in pathology in the Department of Laboratory Medicine and Pathology at Mayo Clinic in Rochester, MN, discusses the limitations and unmet needs in posttreatment cancer detection.
The sophistication of techniques like single-cell sequencing, advanced molecular assays, and radiomics often requires specialized equipment, highly trained personnel, and complex data analysis pipelines. This inherent complexity creates several hurdles for routine clinical use, including technical expertise, standardization and quality control, data integration, and turnaround time. Overcoming these obstacles would entail the development of user-friendly platforms, automation and streamlining, collaborative networks, and solutions at the point of care.
As these technologies are in their relative infancy, the initial cost of implementing and performing highly sensitive MRD testing and other advanced assessments can be substantial due to the technology, reagents, and expertise involved. This creates a barrier to widespread adoption, particularly when reimbursement pathways are not yet well-established. Convincing payers, including insurance companies and government healthcare systems, to provide adequate reimbursement requires robust evidence demonstrating the clear clinical utility and cost-effectiveness of these tests in improving patient outcomes. Generating long-term outcome data and health economic analyses will be integral to this process.
Additionally, the rapid pace of advancements in this field means that many physicians may not be fully aware of the availability, appropriate use cases, and interpretation of these new tests. Physicians are already faced with a vast amount of medical information, making it challenging to stay abreast of every new development. Many of these tests represent a significant departure from traditional assessment methods, requiring a learning curve for understanding their principles and clinical implications. The market also offers a variety of MRD tests with different methodologies and sensitivities, which can be confusing for clinicians. Pathways forward here focus on education, including targeted educational initiatives and peer-to-peer collaboration.
