W. Kimryn Rathmell, MD, PhD, FASCO, urged a shift to integrated, tech-driven oncology models that prioritize equity and accessibility in a keynote address at the American Society of Clinical Oncology Gastrointestinal Cancers Symposium titled “Meeting Patients With Cancer Where They Are—The Role of Dyad Partnerships in Oncology.”
“It is really important that we lean into the ability to be connected,” Rathmell said, calling for new models of communication and care that expand clinical trial access and simplify the patient journey.
Rathmell is CEO of The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and served as director of the National Cancer Institute from December 2023 to January 2025.
She warned that scientific advances are outpacing the health system’s ability to deliver care, particularly in rural areas. About 19% of US households are rural, and those areas face a survival disadvantage, with roughly 180 deaths per 100,000 population compared with 157 per 100,000 in urban areas.
A major factor is the centralization of clinical research: more than 20% of trials occur at NCI-designated or academic centers, while only about 4% take place in community programs. That imbalance places patients who could benefit most from trials farthest from access, Rathmell said.
Rathmell advocated the dyad model, which pairs academic specialists with community oncologists in unified teams. The model establishes formal communication workflows, tracking mechanisms to prevent patients from “falling through the cracks,” and collaborative care plans that preserve the patient’s trusted relationship with their local physician. “You can’t play basketball if you don’t have guards and forwards,” she said, describing the coordinated roles of each partner with the patient as a full team member.
Technology is central to decentralizing research. Rathmell highlighted the NCI’s Virtual Clinical Trials Office, launched in 2024, which provides virtual staffing to smaller practices and has supported tens of thousands of patient screenings across multiple protocols. Nationwide telemedicine-enabled trials are also expanding access for rare mutations; in one example for FGFR-mutant pancreatic cancer, patients identified by genomic sequencing are screened remotely, receive oral medication by shipment, and are monitored locally by their physicians.
Rathmell noted the rise in early-onset gastrointestinal cancers among people aged 20 to 50 and described Ohio State’s Bridge Program, which uses the dyad model to coordinate specialized treatment, survivorship support, and research for younger patients coping with fertility, psychological, and work-related challenges.
Implementing these models will require policy changes, Rathmell said, including multistate or national medical licensure for telehealth, standardized approaches to managing complications at distant sites, and new financial strategies to sustain high-tech, high-touch care. The ultimate aim is to make clinical research part of standard care so that geography no longer dictates access to innovation or outcomes.
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