The NCI Community Oncology Research Program is revolutionizing cancer care by making precision medicine accessible in local communities across the country.
Imagine receiving a cancer diagnosis and having your treatment tailored specifically to the genetic makeup of your tumor—not based on a one-size-fits-all approach, but designed uniquely for you. This is the promise of precision medicine, a revolutionary approach transforming cancer care. What makes this revolution particularly remarkable is that these cutting-edge treatments are no longer confined to major academic centers. Through the NCI Community Oncology Research Program (NCORP), patients in their local communities can access groundbreaking clinical trials that deliver personalized cancer treatments based on their unique genetic profiles 1 .
This article explores how NCORP serves as the bridge between revolutionary cancer science and real-world patient care, making precision medicine accessible to everyone regardless of their zip code.
Tailored to individual genetic profiles
Available in communities across the country
Clinical trials with innovative approaches
Precision medicine, sometimes called personalized medicine, involves identifying disease risks and treatments based on a person's unique genes, environment, and lifestyle rather than taking the traditional approach that bases treatments on what works for the average patient 4 .
The goal is simple yet revolutionary: "to target the right treatments to the right patients at the right time" 4 . When applied to cancer, this approach is often called precision oncology.
The NCI's National Clinical Trials Network (NCTN) conducts large-scale, national oncology treatment and advanced imaging clinical trials. NCORP serves as the community-based component of this network, allowing patients to access cutting-edge research close to home 1 .
This integrated network infrastructure draws from NCI-designated Cancer Centers, NCORP Community Sites, and other academic and community hospitals across the U.S. and internationally 1 . This collaborative model allows researchers to screen large numbers of patients to identify those whose tumors have molecular features that may be responsive to new targeted treatments—a crucial capability in the era of precision medicine 1 .
The significance of this network becomes clear when we examine its track record. Between 1980 and 2018, the NCTN published results from 162 positive phase 3 randomized trials, with more than 85% of these trials helping change cancer care guidelines. Through 2020, these trials generated an estimated 14.2 million additional life years for patients—a testament to the real-world impact of this research 1 .
One compelling area of precision medicine research involves using circulating tumor DNA (ctDNA)—tiny fragments of genetic material from cancer cells found in the bloodstream—to monitor treatment response and detect recurrence earlier than traditional methods.
Researchers enroll patients with specific cancer types (e.g., melanoma, breast, or colorectal cancer) who are beginning new treatment regimens.
Before treatment begins, researchers collect initial blood samples to establish baseline ctDNA levels and identify tumor-specific genetic markers.
Patients receive precisely targeted therapies based on their tumor's genetic profile—for example, drugs targeting specific mutations like KRASG12C or KRASG12D 7 .
Researchers collect additional blood samples at regular intervals during treatment—often at 4, 8, and 12-week intervals—to track changes in ctDNA levels.
Advanced laboratory techniques isolate and sequence ctDNA from blood samples, comparing the results with clinical outcomes to determine correlations.
In a study conducted by NYU Langone Health and its Perlmutter Cancer Center, researchers found that nearly all melanoma patients with detectable ctDNA at various stages of treatment experienced recurrence 4 . Previous research has shown similar accuracy for ctDNA testing in tracing the progression of breast and colorectal cancers 4 .
| Cancer Type | Recurrence with Detectable ctDNA |
|---|---|
| Melanoma | Nearly 100% |
| Breast Cancer | Accurately traces progression |
| Colorectal Cancer | Accurately traces progression |
| Method | Detection Capability |
|---|---|
| ctDNA Blood Test | Molecular evidence (earliest) |
| CT/MRI Scans | Established tumors (later) |
| Tumor Biopsies | Existing tumors |
The significance of these findings lies in their potential to transform how we monitor cancer treatment. Unlike traditional imaging that reveals established tumors, ctDNA testing can detect molecular evidence of cancer recurrence much earlier—potentially allowing for earlier intervention when treatments might be more effective.
Precision medicine research relies on specialized laboratory tools and reagents. The following table details essential components used in typical precision medicine laboratories, particularly those processing patient samples for genetic analysis.
| Reagent/Material | Vendor Examples | Function in Precision Medicine Research |
|---|---|---|
| Alexa 488 goat anti-rabbit IgG | Invitrogen | Detection antibody for visualizing specific proteins in tumor samples |
| Dimethylsulfoxide (DMSO) | Thermo | Preservative for storing cancer cell lines at ultra-low temperatures |
| Fetal Bovine Serum, Defined | Thermo | Growth supplement for cell culture media to maintain cancer cells for testing |
| Formaldehyde/Paraformaldehyde | Sigma, Polysciences | Fixative agents for preserving tissue architecture in biopsy samples |
| HeLa cells | ATCC | Reference cancer cell line used as controls in experimental assays |
| Hoehst 33342 | Invitrogen | Fluorescent stain that binds to DNA, allowing visualization of cell nuclei |
| L-Glutamine | Lonza | Essential nutrient added to cell culture media to support cell growth |
| Minimum Essential Medium Eagle (EMEM) | Lonza | Base medium for growing and maintaining cancer cells in laboratory settings |
| NF-κB p65 Rabbit Polyclonal IgG | Santa Cruz | Antibody for detecting specific protein activation pathways in cancer cells |
| Recombinant Cytokines (IL-1α, TNF-α) | R&D Systems | Signaling proteins used to simulate inflammatory conditions in cancer models |
| Trypsin-EDTA | Invitrogen/Gibco | Enzyme solution used to detach adherent cells from culture vessels |
| BAY 11-7082 | Enzo | Reference compound that inhibits NF-κB pathway, used as experimental control |
| 96-well View Plates | Perkin Elmer | Specialized plates for high-throughput drug screening assays |
| Cell Strainer, 70 µM | BD Falcon | Filters to create single-cell suspensions from tumor tissue |
These reagents form the backbone of the laboratory work that enables precision medicine discoveries. Proper handling and quality assurance of these materials is critical, as quality analytical work can only be performed if all materials used are suitable for the job, properly organized, and well cared for 9 .
As we look ahead, experts forecast several exciting developments in precision medicine. Dr. Lillian Siu of Princess Margaret Cancer Centre notes that we're entering "a new era for drugging the undruggable with the next generation of mutant-specific molecules" 7 .
Research is moving beyond first-generation KRASG12C inhibitors to second-generation inhibitors and early evaluation of KRASG12D, KRASG12V, pan-KRAS, and pan-RAS inhibitors 7 .
Beyond current biomarkers like PD-L1 and microsatellite instability status, researchers are using high-resolution spatial technologies and AI/ML in digital pathology 7 .
Clinical trials are testing vaccines against mutation-derived antigens across cancers with varying mutation rates 7 .
Researchers are working to identify better biomarkers for ADC selection and develop novel ADC designs with improved therapeutic indexes 7 .
The expansion of precision medicine research into community settings through NCORP represents more than just a scientific advancement—it embodies a fundamental shift toward more personalized, effective, and accessible cancer care for all patients, regardless of their geographic location or economic status.
As this research continues to evolve, the vision of delivering "the right treatments to the right patients at the right time" 4 is increasingly becoming a reality in communities across the country. This democratization of cutting-edge cancer research ensures that the benefits of scientific discovery reach beyond academic centers to the local hospitals and clinics where most Americans receive their care.
References will be listed here in the final publication.