Care pathway broad molecular diagnostics approved, important step forward

On World Cancer Day, we reflected on the enormous impact of cancer. But this impact is visible every day—on patients, their loved ones, healthcare professionals, and society at large.

New figures from IKNL show that in the Netherlands alone, nearly 135,000 people are diagnosed with cancer each year. At the same time, the decline in, among other things, metastatic colorectal cancer demonstrates that targeted efforts—such as early diagnostics and population-based screening—save lives. Progress is possible when we combine knowledge.

This progress also raises a new question: how do we ensure that all patients with cancer have access to the best possible, data-driven and personalized treatment?

Only together we can make care better and more personal. That is what United in Unique stands for—and what the Hartwig Medical Foundation is committed to every day: learning from and for each unique patient to improve treatments.
United in Unique is therefore not a slogan, but a shared mission for oncology care today and tomorrow.

Biomarkers

Cancer is not a uniform disease. Even within common tumors, such as colorectal cancer, there are major biological differences. Biomarkers determine whether a patient will benefit from a specific treatment and therefore form the basis of personalized care. This question becomes even more critical in advanced cancer.

‘ Once cancer has progressed, the question remains: which treatment fits this one patient?
Without molecular diagnostics, the answer is largely trial and error.’
— Hilde Nienhuis, internist–oncologist at UMC Utrecht and lead of the medical team at Hartwig

Reimbursement of comprehensive molecular diagnostics: an important step forward

There is positive news on this front. The Dutch Association of Medical Oncology (NVMO) has approved and publicly released the care pathway Comprehensive Molecular Diagnostics. As a result, comprehensive molecular diagnostics—including whole genome sequencing (WGS)—are now reimbursed for adult patients who:

• Are in their final standard line of treatment,
• Are fit for treatment, and
• Have a wish to pursue further treatment.

This expansion is significant. Where comprehensive diagnostics were previously initiated only after completion of standard treatments, there is now room to identify treatment options during the final line of therapy. Hospitals can begin implementing this in routine clinical practice.

Learning for and from every patient

The NVMO emphasizes not only the importance of testing, but also of joint interpretation and systematic data capture. Results should be discussed in multidisciplinary Molecular Tumor Boards (MTBs) and recorded together with clinical data and treatment outcomes.

In practice, this is not yet optimally organized everywhere. Access to testing varies by institution, and data are insufficiently recorded and combined in a structured way. As a result, we are still learning too little from and for the patients being treated today.

United in Unique: data connect

Every patient is unique, but together these unique profiles form a powerful source of knowledge. By ensuring broad and equitable access to molecular diagnostics for all eligible patients, and by securely combining molecular, clinical, and outcome data across hospitals and platforms, we can identify patterns, improve treatment decisions, and better support future patients. Because only together—united—can we truly do justice to every unique patient.