Accelerating cancer omics and precision oncology in health care and research: a Lancet Oncology Commission

We have made substantial progress in developing cancer treatments that target specific molecular vulnerabilities in an increasing number of cancer types. Interrogation of complex genomic, transcriptomic, and metabolomic (referred to as omics) profiles, integrated with comprehensive clinical data, represents the essential next step to inform the development and application of selective approaches to cancer prevention, diagnosis, and treatment. However, the majority of patients with cancer around the world, and particularly those living in resource-limited settings, cannot access molecular testing and targeted therapies due to regulatory, financial, logistical, educational, and clinical barriers. This widespread inaccessibility drives substantial health disparities both within and between countries and hampers the investigation of new preventative and therapeutic opportunities due to restricted access to biomarker-based clinical trials and translational research programmes. In addition to the inadequacy of cancer molecular testing, therapeutic development is limited by the scarcity of crucial data concerning response and resistance mechanisms.