For more than a decade, Cancer Commons has helped patients and their care teams access the information and data they need to make informed decisions. Demand for this kind of help is only growing. Here, Curious Dr. George asks our very own Medical Director, DeLeys Brandman, MD, about her vision for expanding Cancer Commons’ services to help many more patients. In addition to her role at Cancer Commons, Dr. Brandman is CEO of All Ways Home.
Curious Dr. George: You are an internist with broad clinical and organizational experience in medicine. As the recently appointed Medical Director of Cancer Commons, you have a unique insight into the value of our approach to helping individual patients deal with their advanced cancers, as well as how those patients, Cancer Commons clinical scientists, and the broader medical community can learn from these experiences. You recently presented this vision to an audience at the 2025 Precision Medicine World Conference in Santa Clara, CA. What was the essence of your message?
DeLeys Brandman, MD: The reality is stark; access to personalized medicine is abysmal, and quality cancer care remains poorly distributed. Despite revolutionary advances in science, drug development, and diagnostics, far too many patients lack access to life-changing molecular testing and personalized treatments.
Cancer is not a single event—it’s a journey requiring personalized medicine at every step, from diagnosis through survivorship. Yet, oncology care still relies on one-size-fits-all treatments, failing to maximize outcomes for many. And survivorship care is missing for most.
More than a singular disease, every cancer is a complex, multivariant condition. When treatments fail, the right genetic and molecular insights can identify sequential treatments, changing cancer to a chronic disease, rather than a single treatment episode. Despite evidence that personalized medicine can be life-saving, the “sequential care” approach found in academic centers like UCLA is the exception, rather than a standard.
Each year, more than 2 million people are diagnosed with cancer in the U.S.—1.2 million with localized disease. Take breast cancer as an example: as many as 35% of newly diagnosed patients will experience treatment failure and progress to metastatic disease. Advanced genetic testing at diagnosis could identify these patients, allowing them to switch to potentially-life-saving therapies before first-line treatment fails.
However, only 25% of cancer patients receive early molecular testing, and that percentage is in the single digits for disadvantaged populations. Countless patients are left in the dark—unaware of options that could extend their lives or even lead to a cure.
An Oncology Crisis
Beyond testing disparities, a worsening oncologist shortage is exacerbating the problem. More than 60% of U.S. counties lack a single oncologist, forcing patients to travel long distances, delay diagnoses, and suffer substantial financial burdens—all while battling a life-threatening disease. The logistical and financial strain of cancer care is unbearable for many, making equitable access to cutting-edge treatments even more urgent.
A New Model for Change: Process and Technology
To close these gaps, we must start from the ground up and become patient centric. Every cancer case provides a puzzle piece. By bringing research together with clinical care, every community can contribute to a “Learning Health System.”
Cancer Commons has been at the forefront of this movement for over a decade, providing personalized insights, facilitating access to molecular tests, and guiding individuals to clinical trials and experimental therapies.
In 2025, Cancer Commons is proposing to scale up by expanding its services, building a network for action that brings together:
- Partners to expand testing
- Expanded-access treatments
- A new platform—CRO-LITE—to support fast, FDA-grade, n-of-1 clinical trials
CRO-LITE Technology Will Democratize Access and Drive Scale
N-of-1 trials are individualized studies based on molecular profiling and targeted treatments, bridging the gap between patient care and long-term scientific discovery. In an n-of-1 trial, patients needing care beyond the standard can access cutting edge treatments, effectively participating in “personalized trials.” At Cancer Commons, we are putting together a new way to manage these small trials, which we call CRO-LITE.
CRO-LITE is a digital, AI-driven, SaaS technology platform that manages small research trials and integrates critical services as needed for community-based small trials, either virtual or hybrid. The name CRO-LITE comes from “contract research organization,” a type of organization that manages various aspects of running clinical trials. CRO-LITE will provide:
- A virtual molecular tumor board
- Just-in-time institutional review board (IRB) services
- Molecular test access
- Matching patients with providers willing to treat
- Principal investigators as needed
- Payer negotiation
CRO-LITE will enable many more patients to access the critical services we provide. In the future, we look forward to sharing more about this powerful platform.
Dr. Brandman can be reached at deleys.brandman@cancercommons.org.
Related links:
- The Personalized Power of the “N-of-1” Approach
- Cancer Commons’ Services for Patients and Caregivers
- The Cancer Commons Team
A message from Curious Dr. George:
The goal of Cancer Commons is to help patients identify and access their best possible treatments, one patient at a time, while moving the field forward. If you have advanced cancer, let our molecular oncology scientists provide personalized information about your options.
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Copyright: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
