Jerry Radich of the Fred Hutchinson Cancer Center, writing in the February 2026 edition of DIA’s Global Forum magazine, lays out a framework for taking cutting-edge cancer therapies – currently the preserve of the world’s wealthiest nations – to a broader global patient population.
It’s been said that geography is destiny. Should we accept this in medicine? Should the amazing advances in cancer therapy just be the sole property of those of us lucky enough to be born in wealthy countries? How do we get “precision medicine” to the millions worldwide who desperately need it?
Precision medicine is the merging of what we’ve learned from years of genetic discovery and functional biology with innovative drug design and manufacturing.
The “poster child” of precision medicine is chronic myeloid leukemia (CML), where the unique BCR::ABL1 fusion gene drives the disease, and tyrosine kinase inhibitors (TKIs) directly block the pathogenetic pathway. As a result, patients receiving TKI therapy now live a normal lifespan. By way of comparison, when I came into this field more than three decades ago, the average lifespan of a patient diagnosed with CML was only seven years. That kind of progress sets a very high bar but does demonstrate the potential power of a precision medicine approach.
So, what you need is sophisticated molecular diagnostic testing, advanced drug development pipelines, and wham!, a near-magical result that is the model for all cancer therapy. Of course, this all means little to the vast majority of cancer patients who live in areas without access to the diagnostics or medicines that make this near miracle possible.
What Made This Possible?
For CML, creativity, cross-discipline partnerships, and plain hard work forged fantastic advances in patient care in low-resource areas. This success was fueled by a unique collaboration of a nonprofit (Max), “big pharma” (Novartis, then others), biotech (Cepheid), and academia (the Fred Hutchinson Cancer Center).
The Max Foundation. Established in 1997 in memory of a young CML patient, this group is dedicated to facilitating access to treatment for CML and other malignancies for the world’s most neglected populations. The Max Foundation entered into a partnership with Novartis in 2001 and now supports access to imatinib and five other TKIs for CML patients in 78 low- and middle-income countries. The organization has helped over 60,000 CML patients gain access to imatinib and now works with several drug and diagnostics companies to support access to multiple lines of therapy for CML and other cancers and rare diseases. Altogether, the Max Foundation has helped over 100,000 people in resource-challenged settings worldwide gain access to life-saving treatments.
Cepheid is a diagnostic company that makes a portable, affordable, cartridge-based, automated polymerase chain reaction (PCR) system that allows the rapid quantification of molecular targets with minimal technician hands-on time. Initially, Cepheid was interested in the detection of critical pathogens (for example, the Cepheid platform is used to test for anthrax contamination of the mail, sparked by the post-9/11 attacks on politicians and media). We helped Cepheid develop their quantitative reverse transcription–polymerase chain reaction (RT-PCR) assay for the BCR::ABL1 fusion gene. This was Cepheid’s first cancer test.
Dried blood spots (DBS). If clinics and hospitals do not have a local assay (Cepheid or otherwise), shipping of the sample by air to a referral lab is often the next-best option. However, this is expensive and not scalable. Shipping a single fresh blood sample from Africa to Seattle can cost >$500, and since samples must be sent fresh, batching is not possible. As a workaround, we developed an RNA-based assay for BCR::ABL1 using DBS. (The main hurdle in this work was finding the right paper that would limit RNA degradation but still allow nucleic acid extraction from the paper. This was not trivial.) Samples can now be batched and will yield accurate results even after weeks of travel. Thus, a clinic can send scores of samples for BCR::ABL1 testing even by regular post if economically necessary.
