Community oncology practices are bringing personalized medicine into everyday cancer care, substantially expanding their use of advanced biomarker testing and novel therapies for patients with metastatic breast cancer and metastatic non–small cell lung cancer, according to new research from Flatiron Health and the Community Oncology Alliance (COA). The study of more than 240,000 patients across more than 200 community oncology practices documented how these practices are translating advances in cancer science into testing and treatment that help tailor care to each patient’s cancer.
The findings were presented by Divers et al at the 2026 ASCO Quality Care Symposium (Abstract 566).
The study builds on the collaboration’s first analysis—results of which were published this spring—which found longer survival among patients treated at participating community oncology practices compared with national benchmarks.
More than half of all patients with cancer in the United States receive treatment in the independent community oncology setting. Despite these practices’ central role in cancer care delivery, comprehensive national data evaluating their adoption of modern diagnostic testing and guideline-concordant treatments has been limited. This research helps address that gap by examining how advances in cancer care reach patients treated in the community.
Key Study Findings
Using the Flatiron Health Research Network, researchers evaluated biomarker testing, receipt of therapies aligned with NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), and timeliness of treatment among more than 104,000 patients with metastatic breast cancer and nearly 139,000 patients with metastatic non–small cell lung cancer treated across more than 200 community oncology practices.
Key findings included:
- Substantial growth in advanced genomic testing: Among patients with metastatic non–small cell lung cancer, next-generation sequencing increased from 8% to 90% over the study period.
- Increased adoption of immunotherapy: Immunotherapy use among patients with metastatic non–small cell lung cancer increased from 15% to 77% over the study period.
- Timely treatment initiation: Approximately 80% of patients initiated treatment within 6 weeks of their first oncology visit.
Together, the findings support the ability of the community oncology practices studied to deliver high-quality, national clinical guideline–aligned care, with sustained adoption of complex diagnostics and novel therapies.
“These findings reinforce the quality of personalized cancer care available to patients in community oncology settings,” said Stephen “Fred” Divers, MD, a member of COA’s Board of Directors and a medical oncologist and hematologist at Genesis Cancer and Blood Institute in Hot Springs, Arkansas. “This means adopting advanced biomarker testing to help guide treatment choices, incorporating new therapies, and expediting patients into treatment. Protecting access to this care means helping patients benefit from advances in cancer treatment close to their families and support networks.”
This second phase of the Flatiron and COA collaboration extends the focus beyond survival outcomes to examine key measures of care delivery. By assessing testing, treatment selection, and time to treatment, the research provides a more detailed view of how community oncology practices translate advances in cancer medicine into care for patients.
“As an oncologist, I’ve seen firsthand how advances in testing and treatment have transformed care for patients with lung and breast cancer,” said Emily Castellanos, MD, MPH, Senior Medical Director and Head of Research Oncology at Flatiron Health. “What’s especially encouraging about these findings is how community oncology practices have embraced innovation, bringing new testing approaches and treatments into everyday care. Real-world data allows us to understand how these advances are reaching patients and provides greater visibility into the care delivered in community oncology settings.”
The initial phase of the Flatiron and COA collaboration examined survival among nearly 98,000 patients with metastatic breast cancer or non–small cell lung cancer. Compared with population-based estimates from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, median survival among patients treated at participating Flatiron Health Research Network community oncology practices was 8 months longer for metastatic breast cancer and 2 months longer for metastatic non–small cell lung cancer.
The new findings build on that work by documenting the adoption of diagnostics and therapies that have reshaped treatment for these diseases, adding to the evidence supporting community oncology’s role in delivering modern cancer care close to where patients live.
DISCLOSURE: This research was funded by BioNTech, Gilead, Johnson & Johnson, and Pfizer. For full disclosures of the study authors, visit coi.asco.org.
