Phase 2 research findings from Flatiron Health and the Community Oncology Alliance to be presented at ASCO Quality Care Symposium 2026 show substantial growth in advanced biomarker testing and novel therapy adoption, alongside timely guideline-concordant treatment
Community oncology practices are bringing personalized medicine into everyday cancer care, substantially expanding their use of advanced biomarker testing and novel therapies for patients with metastatic breast cancer and metastatic non-small cell lung cancer, according to new research from Flatiron Health and the Community Oncology Alliance (COA). The study of more than 240,000 patients across more than 200 community oncology practices documents how these practices are translating advances in cancer science into testing and treatment that help tailor care to each patient’s cancer.
The findings will be presented at the 2026 American Society of Clinical Oncology (ASCO) Quality Care Symposium, taking place October 16–17 in Boston. The study, “Quality of care in US community oncology practices among patients with metastatic breast cancer and metastatic non-small cell lung cancer,” builds on the collaboration’s first analysis, announced in April 2026, which found longer survival among patients treated at participating community oncology practices compared with national benchmarks.
More than half of all patients with cancer in the United States receive treatment in the independent community oncology settings. Despite these practices’ central role in cancer care delivery, comprehensive national data evaluating their adoption of modern diagnostic testing and guideline-concordant treatments has been limited. This research helps address that gap by examining how advances in cancer care reach patients treated in the community.
Using the Flatiron Health Research Network, researchers evaluated biomarker testing, receipt of therapies aligned with National Comprehensive Cancer Network (NCCN) guidelines, and timeliness of treatment among more than 104,000 patients with metastatic breast cancer and nearly 139,000 patients with metastatic non-small cell lung cancer treated across more than 200 community oncology practices.
Key findings included:
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Substantial growth in advanced genomic testing: Among patients with metastatic non-small cell lung cancer, next-generation sequencing increased from 8% to 90% over the study period. This testing can help identify tumor alterations that inform treatment selection.
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Increased adoption of immunotherapy: Immunotherapy use among patients with metastatic non-small cell lung cancer increased from 15% to 77% over the study period.
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Timely treatment initiation: Approximately 80% of patients initiated treatment within six weeks of their first oncology visit.
Together, the findings support the ability of the community oncology practices studied to deliver high-quality, national clinical guideline-aligned care, with sustained adoption of complex diagnostics and novel therapies.
“These findings reinforce the quality of personalized cancer care available to patients in community oncology settings,” said Stephen Divers, MD, a member of COA’s board, and medical oncologist and hematologist at Genesis Cancer and Blood Institute in Hot Springs, Ark. “This means adopting advanced biomarker testing to help guide treatment choices, incorporating new therapies, and expediting patients into treatment. Protecting access to this care means helping patients benefit from advances in cancer treatment close to their families and support networks.”
This second phase of the Flatiron and COA collaboration extends the focus beyond survival outcomes to examine key measures of care delivery. By assessing testing, treatment selection and time to treatment, the research provides a more detailed view of how community oncology practices translate advances in cancer medicine into care for patients.
“As an oncologist, I’ve seen firsthand how advances in advances in testing and treatment have transformed care for patients with lung and breast cancer,” said Emily Castellanos, MD, MPH, Senior Medical Director and Head of Research Oncology at Flatiron Health. “What’s especially encouraging about these findings is how community oncology practices have embraced innovation, bringing new testing approaches and treatments into everyday care. Real-world data allows us to understand how these advances are reaching patients and provides greater visibility into the care delivered in community oncology settings.”
The initial phase of the COA and Flatiron collaboration examined survival among nearly 98,000 patients with metastatic breast cancer or non-small cell lung cancer. Compared with population-based estimates from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database, median survival among patients treated at participating Flatiron Health Research Network community oncology practices was eight months longer for metastatic breast cancer and two months longer for metastatic non-small cell lung cancer.
The new findings build on that work by documenting the adoption of diagnostics and therapies that have reshaped treatment for these diseases, adding to the evidence supporting community oncology’s role in delivering modern cancer care close to where patients live.
About the Community Oncology Alliance
The Community Oncology Alliance (COA) is a nonprofit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology where the majority of Americans with cancer are treated. The mission of COA is to ensure that patients with cancer receive quality, affordable, and accessible cancer care in their own communities. Learn more at www.communityoncology.org.
About Flatiron
Flatiron Health is a healthtech company expanding the possibilities for point of care solutions in oncology and using data for good to power smarter care for every person with cancer. Through machine learning and AI, real-world evidence, and breakthroughs in clinical trials, we continue to transform patients’ real-life experiences into knowledge and create a more modern, connected oncology ecosystem. Flatiron Health is an independent affiliate of the Roche Group.
Flatiron Health Media Contact
Nina Toor
press@flatiron.com
Community Oncology Alliance Media Contact
Julie McDowell
news@coacancer.org