By Clinical Research News Staff 

June 9, 2026 | Cancer clinical trials increasingly run on precision oncology, where biomarker testing guides targeted therapies, trial matching, and treatment decisions. But the promise of personalized cancer care breaks down when next-generation sequencing, liquid biopsy, or comprehensive molecular profiling is not offered equitably.  

In the latest episode of The Scope of Things, Eugene Manley, Jr., founder and CEO of the STEMM & Cancer Health Equity Foundation, explains how underrepresented populations, including Black, Hispanic, Indigenous, rural, low-income, immigrant, underinsured, and uninsured communities, are less likely to receive guideline-aligned biomarker testing and less likely to be asked about clinical trial participation at all.  

When access to advanced diagnostics depends on geography, insurance, and system capacity, precision medicine can widen healthcare disparities instead of closing them. A practical path forward starts with making equity measurable through specific, trackable steps across the care pathway. That means documenting who is diagnosed, who is eligible for biomarker testing, who is offered testing, what type of panel is used, whether samples fail, how long results take, and how quickly treatment decisions follow. It also means measuring clinical trial representation against disease incidence, not just reporting enrollment demographics. When organizations treat equity metrics as optional or siloed, progress stalls; leadership-level accountability, transparent dashboards, and operational ownership can turn “equity” into a performance expectation across cancer care and clinical research. 

The conversation also pushes the lens earlier than most discussions by focusing on the biomarker gap that begins upstream of clinical trials. If preclinical models and cancer cell lines are not diverse, discovery science can start from a skewed baseline, influencing target validation, drug development, and ultimately which therapies reach patients. Manley recalled in previous trials where, across 800 plus lung cancer cell lines, there were only 30 cell lines from Black patients and none from Hispanic patients, Native Americans, and Alaskan Natives. There were about 390 from Asian patients and 200 from white patients. 

Building representative datasets is not a branding exercise. It is a scientific requirement for accurate interpretation of tumor biology, toxicity risk, and treatment response across populations. 

To learn more about how master protocol trials and decentralized trials could help with bridging inequity, as well as new primary endpoints for cancer trials, trial disruptions threatening diversity, and more, listen to The Scope of Things podcast.