Recent review of evidence reveals critical barriers to biomarker testing in cancer care and highlights strategies to improve clinical uptake.
A systematic review led by researchers at the Daffodil Centre – a research partnership between the University of Sydney and Cancer Council NSW – and Melanoma Institute Australia has identified key barriers preventing the widespread implementation of biomarker testing in cancer care – a cornerstone of precision medicine. The study, published in JCO Precision Oncology, synthesises evidence from 77 global studies and highlights targeted strategies to improve access, understanding, and uptake of biomarker testing among clinicians and patients.
Biomarker testing enables personalised cancer treatment by identifying patient’s unique genetic and tumour profile that guide therapy decisions. Despite its promise, the review found that both clinicians and patients face significant challenges — from limited knowledge and communication gaps to logistical constraints and inequities in access.
“Precision oncology has the potential to transform cancer care, but without addressing the real-world barriers to biomarker testing, many patients may miss out on life-changing treatments,” said lead author and Daffodil Centre researcher Dr Rehana Salam.
Key findings
- Clinicians report inconsistent knowledge and low confidence in interpreting biomarker results and making treatment recommendations.
- Patients often lack understanding of what biomarker testing entails and how it affects their treatment options.
- Long turnaround times for the results of biomarker testing, inadequate insurance coverage, and lack of institutional support hinder implementation.
- Emotional burden and unrealistic expectations around test outcomes further complicate decision-making.
Promising strategies
The review highlights several actionable strategies to improve uptake:
- Establishing institutional tumour boards and multidisciplinary teams.
- Providing formal and ongoing education for clinicians.
- Developing patient-friendly educational resources.
- Leveraging digital tools to streamline testing and reporting.
“We need coordinated efforts to ensure biomarker testing becomes a routine part of cancer care – not a privilege for the few,” said co-senior author Professor Anne Cust, Interim Director of the Daffodil Centre.
This study was supported by the Cancer Institute NSW and the National Health and Medical Research Council NHMRC, and represents a collaborative effort across leading cancer research institutions in Australia.
