Bringing Oncology Innovation Closer to Patients

The pace of oncology innovation continues to accelerate. In its 2025 Oncology Center of Excellence annual report, the FDA reported 70 oncology therapeutic product approvals, including 17 new molecular entities or biological license applications and approvals across pediatric cancer treatments, international review pathways and expanded access requests.

For patients, that progress represents new hope. For the healthcare system, it also raises a practical question: how do we make sure innovation reaches patients in the places where they receive care?

That question is especially important as more cancer care moves into community settings. Today, more than half of oncology care is delivered in community practices, where patients can often receive treatment closer to home, near their families, support systems and daily lives. For many patients, that proximity matters. But delivering advanced oncology care closer to home requires community practices to manage the same level of clinical, logistical and financial complexity that historically may have been concentrated in larger academic centers.

Access to advanced therapies is not only about whether a product is approved or available in the market. It is also about whether the systems around that therapy can support delivery safely, reliably and efficiently.

As oncology innovation accelerates, the central access challenge is no longer only scientific discovery. It is whether providers, distributors, manufacturers and technology partners can build the infrastructure needed to help those therapies reach patients in real-world care settings.

Advanced treatments, including cell therapies, gene therapies, bispecifics and radioligand therapies, can require specialized storage, handling, timing and coordination. Many depend on cold chain or ultra-cold chain capabilities. Some require coordination across manufacturers, payers, providers, academic medical centers and community oncology practices. Others require careful inventory management and reimbursement planning before a product ever reaches the point of care.

For community providers, this creates real operational and financial pressure. In a buy-and-bill environment, practices may take on the responsibility of acquiring high-cost therapies before reimbursement is certain. They also need the infrastructure, trained staff, payer coordination and administrative support to ensure the right therapy is available for the right patient at the right time.

That level of coordination is not always visible to patients, but it can determine whether innovation becomes meaningful access.

Specialty distribution plays an increasingly important role in that process. In advanced oncology care, distribution is no longer only about moving products from one point to another. It is part of the infrastructure that helps providers manage logistics, storage, inventory visibility, payer coordination and other operational requirements that can affect whether a therapy reaches the right patient at the right time.

Cold chain requirements are a clear example. A few years ago, only about 37% of products required cold chain logistics. Today and into the future, that figure is expected to be well over half of products. In response to these shifts, Cencora is making a $1 billion investment in its distribution infrastructure, reflecting the scale of support needed as more advanced and temperature-sensitive therapies enter the market.

The same need for coordination extends beyond logistics. Community oncology practices are also navigating prior authorizations, reimbursement uncertainty, patient assistance challenges and coordination with payers and larger health systems. These pressures can slow access even after a therapy has been approved.

Technology and data may help close some of those gaps. Artificial intelligence, for example, has the potential to connect complex systems, support clinical trial enrollment, help identify appropriate patients for specialized therapies and reduce administrative burden across the care journey. As precision oncology advances, providers are increasingly looking for specific biomarkers or genetic markers that may apply to smaller and more targeted patient populations. For a community practice, that may mean identifying only a handful of eligible patients, or even one patient in a year.

In that environment, access depends on more than scientific progress. It depends on whether patients receive the appropriate testing, whether providers can quickly interpret and act on new information, whether payer coordination can happen efficiently, and whether practices have the support needed to deliver treatment without adding unsustainable burden.

Manufacturers, distributors, providers, payers and technology partners all have a role to play in helping therapies move from approval to real-world delivery. When those groups work together, they can help reduce friction, improve coordination and make it more feasible for community practices to offer advanced treatments closer to where patients live.

The stakes are significant. If patients cannot access a therapy, the promise of innovation is not fully realized. For some patients, traveling to a major academic medical center may be difficult or impossible. Others may face financial, logistical or personal barriers that make care away from home harder to sustain. Expanding the ability of community practices to deliver advanced oncology care can help reduce those barriers and support more equitable access.

Oncology innovation will only continue to grow more specialized. That progress should be matched by continued investment in the infrastructure, logistics, technology and partnerships needed to support care delivery in the real world.

For patients, stronger oncology infrastructure can mean fewer delays, fewer logistical barriers and more opportunities to receive advanced care closer to home.

The future of cancer care will depend not only on what is discovered in the lab or approved by regulators, but on whether the healthcare system can help those advances reach the patients who need them. Specialty distribution and operational innovation are central to that work, helping connect scientific progress to patient access in communities across the country.

Editor’s note: This article is adapted from Lisa Smith’s Onco Daily interview on oncology innovation, specialty distribution and expanding patient access to advanced therapies. Listen to the full conversation here.