Resources for Precision Oncologists:

From the American Society of  Clinical Oncology Journal:

State of Geographic Access to Cancer Treatment 

...(Trials in the United States: Are Studies Located Where Patients Live?)

Most US counties have limited to no trial offerings, a disparity magnified in counties that are nonmetropolitan, with high social vulnerability, and with high cancer mortality. Effort to facilitate diverse site participation is needed to promote equitable access to trials and to ensure patients participating in trials match the characteristics of patients who will receive interventions once approved. Counties with oncology care sites but no trials provide potential expansion areas.

https://ascopubs.org/doi/10.1200/OP.24.00261

FDA approved safe cancer drugs  need more clinical trials

Many FDA-approved drugs are not available to patients with a particular cancer because there has been no successful clinical trial conducted for that drug against that cancer. In the absence of such a successful clinical trial, the drug is not included in the National Comprehensive Cancer Network (NCCN) guidelines list of approved drugs for that cancer. The absence of a drug in the NCCN Guidelines for a particular cancer is usually not an indication that the drug has been shown to be ineffective for patients with that cancer. Rather, it is an indication that there is insufficient clinical trial evidence to include it.

Cancer Common’s observational study

Methods of Identifying Effective Off-Guideline Treatments for Advanced Cancer Patients

The aim of this clinical study is to demonstrate that treatment selection tests can identify effective FDA-approved drugs not currently accessible to patients under the NCCN Guidelines.

A key benefit of the study is its site-less nature. Since the treating oncologist is the patient's own oncologist, rather than one preselected for a specific study site, both the patient and their oncologist can participate in the study at any cancer hospital in the US.Methods of Identifying Effective Off-Guideline Treatments for Advanced Cancer Patients (CC N-of-1) (CC N-of-1)

https://clinicaltrials.gov/study/NCT07343024

FDA ends two study requirement

One Pivotal Trial, the New Default Option for FDA Approval — Ending the Two-Trial Dogma | New England Journal of Medicine

Requiring two clinical trials has a powerful theoretical basis to reduce false-positive conclusions in a world where developers test inert substances (or substances with nearly no preclinical promise) without the ability to assess their effect on biomarkers or intermediate end points. Yet in the modern world, as drug discovery becomes increasingly precise and scientific, the FDA considers not just effects on survival, but biochemical and intermediate changes that tell a complete biologic story: does this drug actually work? In this setting, overreliance on two trials no longer makes sense. Two trials should be seen as just one of many interlocking facets of clinical credibility, and in 2026 there are powerful alternative ways to feel assured that our products help people live longer or better than requiring manufacturers to test them yet again.