Precision medicine clinic boosts access for patients with rare cancers

People with rare or complex cancers can face barriers to specialist care. UNSW’s Precision Care Clinic helps connect them to expert advice and treatment options.

Australians living with rare or hard-to-treat cancers – particularly outside major cities – often struggle to access specialist expertise.

But now a clinic run by UNSW Sydney at Prince of Wales Hospital – the Precision Care Clinic – is working to address this gap. The clinic is part of UNSW's Precision Care Initiative, which uses genetic information about tumours to guide treatment decisions through a field of medicine known as genomics. A team of specialists reviews each case in detail and provides evidence-based treatment recommendations. Since launching in 2023, the Clinic has guided treatment decisions for more than 200 patients across Australia, including 22% from regional and remote areas.

Professor Natalie Taylor says the clinic was designed to improve timely access to specialist cancer expertise.

“Precision oncology is evolving rapidly, and for clinicians managing complex cancer cases, it can be challenging to stay across all available treatment options and emerging evidence,” she says.

“It’s about ensuring patients can receive informed, evidence-based treatment guidance, from wherever they live in Australia.”

How it works

If an oncologist is treating a patient with a rare or particularly complex cancer, they can refer the case to the Precision Care Clinic for additional specialist input.

The clinic’s team meets to review the patient’s medical information, working through the evidence and available treatment options before sending recommendations back to the treating oncologist.

“In this way, the patient can continue to receive care from their treating oncologist, but with additional guidance from our clinic,” Prof. Taylor says.

Closing the gap

While genomics and molecular testing are becoming more common in cancer care, interpreting these results and turning them into treatment decisions is not always straightforward. And for busy oncologists – especially those outside major metropolitan centres – keeping up with rapidly evolving evidence and clinical trial options can add complexity and pressure.

“This is where the Precision Care Clinic really comes into its own,” says Prof. Taylor.

“We can provide a more detailed review of complex cases and can help translate results into practical treatment options that clinicians may not otherwise have time or access to explore.”

So far the Clinic has received referrals from more than 100 oncologists across 76 national cancer centres of all states and territories, spanning metropolitan, regional and remote areas. It has also provided one-off follow-up consultations for more than 100 patients seeking to better understand the clinic’s findings.

Working closely with not-for-profit precision oncology organisation Omico, the Clinic helps connect patients with advanced cancers to genomic testing and clinical trial opportunities.

In some cases, the review has identified clinical trial options that may not have been considered, or which clinicians weren't aware of. In others, it has confirmed or refined existing care management plans.

“The clinic has contributed to valuable changes in the trajectory of care for some patients based on the latest evidence in precision oncology,” Prof. Taylor says.

As the service is designed to support clinicians, not replace them, referring doctors are invited to join case discussions, which Prof. Taylor describes as strengthening the quality of decision-making and creating an opportunity for shared learning.

“The referring clinicians are invited to be part of the discussion, not only to provide information about their case, but also to engage with emerging evidence,” she says.

Sustainability and routine care

While the clinic is now operating in the public health system, its development has been supported through funding from the Australian Government’s Medical Research Future Fund.

The recent federal budget included $71 million to continue Omico’s Precision Oncology Screening Platform Enabling Clinical Trials (PrOSPeCT) program, which helps patients with advanced cancers access genomic profiling and be matched to treatments and clinical trials.

But the long-term future of services such as the Precision Care Clinic depends on how precision oncology is funded in Australia.

“For this to be sustainable, we need to see this kind of care recognised and funded as part of routine publicly funded healthcare,” Prof. Taylor says.

She says success will ultimately mean that services like this are embedded as a routine part of cancer care, rather than relying on time-limited research funding.

Looking ahead

The team is exploring how the model could be scaled and adapted to other complex diseases.

“We think this clinic could offer a blueprint for how specialised expertise is shared more evenly across Australia – ensuring that where a person lives does not determine the care they receive,” Prof. Taylor says.