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Podcast Summary: “Bringing Precision Medicine to Everyone” (Episode 66)
Host: Karan Cushman for Trapelo
Guests: Dr. Kashyap Patel (Community Oncologist, No One Left Alone)
Dr. Angella Charnot-Katsikas (Molecular Pathologist, Palmetto GBA)
Overview:
This inaugural episode of a new series on the Precision Medicine Podcast centers on a pressing issue: how to close the access gap in precision oncology—especially for patients in community and rural settings. Although precision medicine is now the standard of care in oncology guidelines, uptake remains uneven. The episode brings together two perspectives—clinical and payer—to discuss solutions that move beyond innovation to implementation.
Key Themes:
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Real-world barriers to access:
Dr. Patel emphasizes that lack of provider awareness, financial constraints, and restrictive payer policies still prevent many patients from receiving appropriate biomarker testing and targeted therapies—even in major academic centers. -
Underutilization of biomarker testing:
Dr. Charnot-Katsikas highlights not only delays in results and treatment initiation but also underuse of existing guidelines and failure to act on results when tests are ordered. -
Calls to action:
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Expand education efforts to include pathologists, surgeons, and all care team members.
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Address "two-week rule" constraints in DRG billing that disincentivize timely biomarker add-ons.
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Leverage platforms like Trapelo to streamline decision support and align test selection with payer policy in real-time.
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Promote team-based care and frequent tumor boards to ensure rapid, informed clinical decisions.
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Equity in practice:
Dr. Patel shares moving patient success stories, including one involving international molecular profiling that led to life-saving targeted therapy. His nonprofit, No One Left Alone, demonstrates a localized, replicable model for delivering precision care and support services (e.g., transportation, food, housing).
Takeaway:
Precision oncology cannot fulfill its promise without structural reform in access, education, and workflow integration. The podcast sets the stage for a solution-oriented series aimed at ensuring every patient, regardless of geography or socioeconomic status, receives guideline-based molecular testing and appropriate therapy.
