Diagnostics, AI, access: Cancer care areas ripe for innovation, per 6 leaders

From overlooked diagnostics and underused screening to AI potential and workforce gaps, these are the innovation challenges in oncology that cancer leaders told Becker’s they feel deserve more attention.

Editor’s note: These responses have been lightly edited for length and clarity.

Bruce Brockstein, MD. Medical Director of NorthShore Kellogg Cancer Center & Division Head of Hematology/Oncology for Endeavor Health (Evanston, Ill.): One innovation not getting enough attention from the medical community may be the range of cancer diagnostic tools available right now, including genomics, proteomics and metabolomics. These tools are giving us a better understanding of cancer, but we still lag behind on converting these diagnostics to therapies routinely.

Additionally, immunotherapy. Specifically, checkpoint inhibitors. These drugs make a huge difference in outcomes for patients, but they are not as familiar with the concept as they are with chemotherapy. The pharmaceutical industry does a good job advertising these drugs for each drug’s purpose, but it is not getting out the big picture concept or drug category. 

Likewise, and disappointingly, medical schools seem quite behind. Early residents don’t seem to have learned about these drugs consistently in medical school. Cell and gene therapy get a lot of attention but are relevant for a much smaller population right now, though over the next decade, the numbers will increase.

Julian Kim, MD. President of Prisma Health Cancer Institute (Greenville, S.C.): There is no doubt that minimally invasive and robotic surgery are transforming the way we remove many cancers, including pancreatic cancer. Patients have benefited with quicker recovery and fewer pain medication requirements. However, modern techniques of ablative stereotactic body radiation therapy are quickly replacing surgical resection of primary and metastatic tumors. SBRT can be performed as an outpatient, does not require anesthesia and is incisionless. All better for our patients.

As a leader, it is important to envision what the future looks like for delivering cancer care. This includes not only how cancer care is delivered, but also where it is delivered. As radiation therapy techniques evolve, one could envision curative radiosurgery increasing and surgical resection being reserved for palliative and salvage situations. Some systemic therapies will be delivered at home. The shift out of acute care and into the outpatient and home setting is best for our patients and will help lower the cost of care. 

Ranee Mehra, MD. Associate Director for Clinical Research, Director of Head and Neck Medical Oncology and Solid Tumor Section Head of the University of Maryland Greenbaum Comprehensive Cancer Center at the University of Maryland Medical Center (Baltimore): One innovation challenge facing oncology research is how to maximize the potential of AI towards developing effective cancer therapies.  We have unprecedented capacity to better understand the biology of cancer on a personalized level with the ability to sequence tumors, obtain genomic and gene expression data from a blood draw, and develop a greater understanding of tumor heterogeneity. Our ability to analyze large data sets with informatics and modeling tools coupled with AI has the potential for accelerating breakthroughs and a better understanding of current therapies. 

However, for us to fully maximize these technologies, we really need to understand what types of information are useful to enter into AI models so we can obtain meaningful, actionable outputs. It is crucial that we work together as a community of providers, patients, and cancer researchers to enhance our culture of data sharing and collaboration as we strive for this goal.

Ruben Mesa, MD. President of Atrium Health Levine Cancer, Executive Director of the Atrium Health Wake Forest Baptist Comprehensive Cancer Center and Clinical Leader of the Advocate Health National Cancer Service Line (Charlotte, N.C.): The impact of mobile cancer screening! Cancer screening is frequently underutilized by patients who would benefit from it because of time, access, financial concerns, health literacy, etc. 

Across Advocate Health, easy access to screenings is a priority. In the Charlotte region, the team at Atrium Health Levine Cancer launched the first-of-its-kind “Lung Bus” program years ago offering low-dose CT lung cancer screening as a collaborative effort between the cancer center, pulmonary medicine, radiology and our philanthropic community. It led to increases in lung cancer screening rates, particularly for rural communities and underserved areas. 

In the Rome, Ga., region, the Atrium Health Floyd cancer team has leveraged mobile mammography, working with large manufacturing plant-based employers to bring mammography to female workers in a “24 hour” format to have access to cancer screening while “on shift” even for women who work the night shift. Making cancer screening more feasible and accessible is a key opportunity!

​​Eben Rosenthal, MD. Chair and Professor of the Department of Otolaryngology – Head and Neck Surgery. Vanderbilt University Medical Center (Nashville): The most controversial and challenging aspect of oncology drugs is the dosing and cost of biologic therapies.

In 2024, the FDA produced a document outlining the need to move away from conventional 3+3 maximally tolerated dose paradigms and instead ask for optimal biologic dosing, giving the right amount of drug for each patient to reduce toxicities and cost. This has been very challenging to implement and is controversial since the economics of these agents require pharma to minimize time in trial development and maximize the drug given. 

There are recent developments in molecular imaging, trial design and window trials to obtain this information, but it is difficult to implement these in part because many of the new developments are new and untested.

Robert Winn, MD. Director and Lipman Chair in Oncology at VCU Massey Comprehensive Cancer Center (Richmond, Va.): A major oncology innovation challenge that is not getting enough attention right now, but should be, is the shortage of oncologists nationwide. The average age of oncologists in the U.S. is 53, indicating a significant drop off in the next decade as this generation enters retirement. Combined with the increased level of burnout that oncologists experience, it has created a dire need for more oncologists to enter the field. 

With projected cuts to federal insurance coverage, changes to federal student loan caps for medical school, and potential reductions in residency spots as a result of current federal funding cuts, the system has made it even more difficult to enter the field. This leaves more communities without a sustainable option for cancer care, especially rural communities, which often rely on one or two oncologists to treat a large population of patients. When that oncologist retires, it leaves potentially thousands of patients without a lifeline.

Editor’s note: This article was updated July 29, 2025 at 10:38 am CT.