New cancer drugs can precisely target tumors and avoid chemotherapy. John Ebers, a 46-year-old beekeeper from Grand Rapids, Mich., learned he had Stage 3 colorectal cancer and was prescribed standard chemotherapy, which he could not tolerate. Dr. Christopher Lieu of the University of Colorado Anschutz Cancer Center says genetic testing could have revealed targeted therapies for his cancer.

Dr. Paul Mischel of Stanford notes that while molecular understanding is unprecedented, infrastructure is failing. Only 51 percent of patients are tested for the five mutations needed to guide treatment, according to recent studies. Financial barriers also block access, as drugs often cost over $10,000 monthly. Medicare caps co-pays, but uninsured and privately insured patients face bankruptcy-level bills. Dr. David Gerber of the University of Texas Southwestern says financial assistance programs exist but are slow or ineffective for metastatic patients.

Demographics worsen disparities: poor patients, Black or Hispanic individuals, uninsured, or Medicaid recipients are least likely to receive new therapies. The FDA has approved an average of one new cancer treatment per month, overwhelming doctors who may lack time or awareness of updated guidelines.

Targeted drugs offer hope for patients who reject or cannot handle chemotherapy, but systemic issues — biopsy limitations, lack of lab access, slow protocol updates, and high costs — prevent widespread use.