Background: Precision oncology offers promise for improving cancer outcomes by matching patients to genomically informed treatments. However, in Australia, many precision oncology advances remain difficult to translate into routine care at scale. Access to genomic expertise, molecular tumour board review, targeted trials and coordinated follow-up is uneven, particularly for people with rare, advanced or treatment-refractory cancers and those treated outside major metropolitan centres. Translation is further challenged by fragmented referral pathways, scarce specialist workforce, uncertain funding mechanisms, data governance requirements and rapidly evolving evidence.
Methods: We established the Precision Care Clinic as a research-informed model of care incorporating molecular multidisciplinary team review, genomic interpretation and contextualised clinical recommendations. Implementation science methods were embedded from the outset, including process mapping, stakeholder interviews, audit and resource-use data collection, co-design of implementation strategies, and selection of implementation, service, clinical and patient-reported outcome measures. These methods were used to understand existing care pathways and continuously refine the Clinic using barriers and enablers identified across the pilot phase.
Results: Since launching, the clinic has demonstrated national reach, accepting more than 200 referrals from over 100 clinicians across approximately 70 cancer sites in all Australian states and territories, with one in five referrals from regional and rural settings. Early pilot data suggest the model provides distinct clinical value by prioritising treatment and clinical trial options, recommending further investigations, supporting diagnostic revision and de-prioritising low-value care. Feedback from patients and clinicians indicates high perceived utility, trustworthiness and value in coordinated, expert-informed decision support.
Conclusion: Implementing precision oncology in routine cancer care isn't a simple technical exercise; it requires attention to workflows, governance, workforce, equity, sustainability and clinician engagement. The next phase will test effectiveness through longitudinal data collection, cost analyses and implementation, service and clinical outcomes, generating evidence to inform sustainable scale-up of precision oncology in Australia.