Home News & Updates A New Era in Oncology: Personalising Cancer Care

A New Era in Oncology: Personalising Cancer Care

Associate Professor Louise Nott / 14 Jul, 2025

How personalised care, clinical trials, and equity are reshaping the future of cancer treatment

By A/Prof Louise Nott, Icon Cancer Centre (Hobart) Medical Oncologist and Icon Group Director of Medical Oncology (Australia and New Zealand).

Cancer care is changing faster than ever before. As clinicians, we are witnessing a profound shift in how we understand, diagnose and treat cancer. What once felt like the distant promise of innovation is rapidly becoming part of routine care. This next chapter in oncology is defined by personalised medicine, including targeted therapies and immune-based treatments — transforming every aspect of clinical care, research, and the patient experience.

Always evolving

Over the course of my career, I’ve seen cancer care transform in many ways. When I first began treating patients with metastatic melanoma and lung cancer more than 15 years ago, options were limited and prognoses often measured in months.

The emergence of immune checkpoint inhibitors changed everything. From the introduction of ipilimumab, to the evolution of dual checkpoint blockade and more recently LAG-3/PD-1 combinations, treatment has been revolutionised. Patients not only lived longer, some experienced lasting remissions.

At the same time, we witnessed a parallel transformation in other tumour streams through personalised targeted therapies. In lung cancer, where platinum-based chemotherapy was once the only option, we now routinely use epidermal growth factor receptor (EGFR) inhibitors like osimertinib and anaplastic lymphoma kinase (ALK) inhibitors like lorlatinib, providing life-extending oral therapies with better tolerability. In breast cancer, CDK4/6 inhibitors have dramatically improved progression-free survival in hormone receptor-positive disease.

These advances have fundamentally changed how we talk to patients. For many, we can now offer realistic hope for longer, better-quality lives.

Precision medicine in practice

Cancer treatment has moved beyond a one-size-fits-all approach. Genomic profiling, transcriptomic analysis, and tumour-specific biomarkers now inform real-time treatment decisions, enabling us to treat the individual rather than the average.

Targeted therapies and immunotherapies are now commonplace, supported by comprehensive molecular panels that detect even rare, actionable mutations in cancers previously considered untreatable.

But with these advances comes a critical question: How do we ensure everyone has access to them?

Equity in access

Personalisation in cancer care is only as powerful as it is accessible. Ensuring patients in regional and remote areas have the same access to new treatments, advanced diagnostics and clinical trials remains a challenge.

That’s why at Icon, we’ve partnered with Omico, a national, independent not-for-profit organisation increasing access to genomic profiling.

This partnership is helping expand access to genomic screening and biomarker-led clinical trials, giving patients greater access to these innovative and emerging options, regardless of location.

Trials for rare mutations often require national collaboration, as individual sites may only see one eligible patient per year.

Through hub-and-spoke models, teletrials, and cross-site coordination, we can ensure that a patient in rural Queensland or Tasmania has the same opportunity to participate in a cutting-edge clinical trial as someone in a capital city.

With our unified electronic medical record (EMR) system, we can identify candidates across the network and ensure access to trials that match their specific cancer profile. A better understanding of our patient population allows us to assess trial feasibility and enable more strategic research in the planning and protocol phase.

Genomic testing across the network not only informs care but also enhances our ability to bring relevant trials to the communities we treat.

Expanding the trial landscape

The future of clinical trials is adaptive, inclusive and patient-centred. Innovative trial designs such as basket trials, platform studies and adaptive protocols, are bringing research closer to patients and enabling faster access to new treatments, even for rare cancers.

These models are better aligned with real-world practice and more responsive to patient needs, helping to accelerate the journey from discovery to delivery.

The patient benefit is clear: better access leads to better outcomes. More inclusive criteria and earlier access mean more patients can benefit directly from research.

By embracing digital platforms, teletrials, and real-world endpoints we are helping to democratise research and extend clinical trial access to communities outside metropolitan centres.

What matters most

As we adopt new technologies and expand clinical trials, we must ensure they are measured not just by scientific merit, but by the lived experiences and outcomes of the patients we serve and care for.

We must keep asking: How does this benefit the patient? Does this improve survival, reduce side effects, or enhance quality of life?

At Icon, we remain focused on equity, access and impact – ensuring that breakthroughs in care translate into real-world outcomes that are accessible to as many patients as possible, as close to home as possible.

Associate Professor Louise Nott is a Medical Oncologist at Icon Cancer Centre Hobart and Icon Group Director of Medical Oncology (Australia and New Zealand).

She is passionate about improving access to research and care in regional communities and ensuring innovation is always centred on patient outcomes.

In 2024, A/Prof Nott was awarded the Icon Cancer Foundation’s inaugural Research Grant to support her COMPRES study, aimed at enhancing patient care and improving treatment outcomes.

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