Oncology’s Next Challenge Isn’t Innovation—It’s Delivery

After two decades of rapid scientific breakthroughs—from immunotherapies and targeted medicines to antibody-drug conjugates (ADCs)—oncology is entering a new phase. The challenge is no longer simply developing innovative cancer treatments, but ensuring healthcare systems can deliver them sustainably and equitably through timely diagnostics, reimbursement, and patient access. “Cancer isn’t a death sentence anymore—or it doesn’t have to be,” said Tina Graves, Vice President and General Manager of GSK Taiwan. “If we focus on therapies that improve long-term outcomes and quality of life, our goal at GSK is to make cancer a curable disease.” Echoing that vision, Graves and Tony Pao, Country Medical Director at GSK Taiwan, emphasized that scientific innovation has little value without access. “We’re in the industry of patient care,” Graves said. “Patients are 100% at the center of everything we do.”

Precision Medicine Is Redefining What “Best-in-Class” Means

Historically, oncology success was measured through endpoints such as tumor response, progression-free survival, and overall survival. While those metrics remain fundamental, advances in precision medicine are changing how clinicians, developers, and healthcare systems evaluate therapeutic value.

“When we think about oncology, we have moved beyond traditional systemic therapies (like chemotherapy),” said Pao. “We are now very much focused on precision.”

That shift reflects one of the most significant changes in modern cancer care. What was once treated as a single disease can now be divided into multiple biologically distinct subtypes, each driven by different molecular pathways and potentially requiring different therapeutic approaches. In lung cancer for instance, treatment decisions increasingly depend on genetic mutations, biomarker expression, histological classification, and characteristics of the tumor microenvironment. As a result, two patients with the same diagnosis of lung cancer may ultimately receive entirely different treatments based on the biology of their disease.

“Even for the same tumor type, different patients respond very differently,” Pao explained. “Taking precision to the next level means looking at the subtype of the cancer and the genotype.”

For GSK, precision medicine is not simply about developing innovative therapies. It is about identifying which patients are most likely to benefit from those therapies and ensuring treatment decisions are informed by the best available scientific evidence. The company’s approach incorporates multiple layers of information, including genetic mutations, protein expression patterns, immune biomarkers, and tumor-specific characteristics that may influence response.

“It’s not just lung cancer,” Graves said. “It’s matching the right patient to the right medicine at the right time in their therapy.”

This philosophy is also changing how the company defines therapeutic success. As patients live longer and treatment becomes increasingly personalized, traditional measures such as survival are being supplemented by broader considerations around patient experience.

“It’s not just about being the best because the overall survival is there, but the patients can’t tolerate it,” Graves said. “The onus is on us as a developer of innovative medicines to do better.”

Factors such as treatment tolerability, convenience, quality of life, and the ability to remain on therapy are becoming increasingly important. A medicine may demonstrate impressive clinical efficacy, but if patients struggle to tolerate treatment or face significant disruptions to their daily lives, the overall benefit can be diminished. Increasingly, “best-in-class” means balancing efficacy with the realities of long-term patient care.

Key Oncology Priorities Highlighted by GSK

• Focus on three major therapeutic modalities: immuno-oncology, ADCs, and targeted small molecules.
• Emphasis on meaningful efficacy alongside quality of life and treatment convenience.
• Precision medicine strategies incorporating genetic mutations, protein expression, and immune biomarkers.
• Focus on areas of unmet medical need rather than simply pursuing the largest patient populations.

Tina Graves (featured), Vice President and General Manager of GSK Taiwan, says the future of oncology depends not only on scientific innovation, but also on ensuring patients can access the therapies designed to improve and extend lives. Image: GeneOnline.

Why ADCs Are Becoming a Defining Oncology Platform

Few areas of oncology have generated as much interest in recent years as antibody-drug conjugates. By combining the targeting capabilities of monoclonal antibodies with highly potent anti-cancer payloads, ADCs aim to solve one of oncology’s oldest challenges: how to maximize efficacy while minimizing damage to healthy tissue.

“The payload is not something we can typically use in a chemotherapy setting,” Pao explained. “With the advantage of ADCs, we can specifically target those toxins to the tumor cells.”

Traditional chemotherapy remains an important treatment modality, but its systemic nature often results in significant toxicity because healthy cells are exposed alongside cancer cells. ADCs attempt to address this challenge by functioning as highly selective delivery systems, transporting potent therapies directly to tumor cells while reducing off-target exposure.

“That means we can increase the toxicity because we’re more selective,” Pao said. “And that means the potency is stronger. It kills the cancer cells better.”

This combination of potency and precision has made ADCs one of the fastest-growing segments within oncology. Developers are increasingly exploring new targets, payloads, and linker technologies in an effort to improve efficacy while maintaining manageable safety profiles.

However, Pao emphasized that innovation in this field remains far from complete.

“Even if we have ADCs in the market, tumors develop resistance,” he said. “That means we need to think about what we do with this type of patient.”

Like many cancer therapies, ADCs face the challenge of tumor adaptation. Cancer cells can develop resistance through multiple mechanisms, including alterations in target expression, changes in drug uptake, or activation of alternative pathways. As a result, developers are already focused on next-generation ADCs and new targets that can extend the benefits of this therapeutic approach.

For GSK, one area of particular interest is small cell lung cancer, where outcomes remain poor despite existing treatment options.

“We’re focusing on small cell lung cancer because there’s remaining unmet medical need in that area,” said Pao. “There remains an opportunity to improve patient outcomes beyond existing chemotherapy treatment”

The company’s broader ADC strategy, including programs targeting B7-H3 and B7-H4, reflects a commitment to addressing difficult-to-treat cancers where significant unmet need remains.

Innovative Outcomes for Oncology Patients Through Smarter Reimbursement

While scientific innovation dominated much of the discussion, one theme repeatedly resurfaced: access.

Precision medicine depends on identifying which patients are most likely to benefit from a specific therapy. Achieving that goal often requires biomarker testing, genomic analysis, and increasingly sophisticated diagnostics. While these tools improve treatment selection and clinical outcomes, they also introduce additional costs and complexity into healthcare systems.

“When we think about precision medicine, it’s getting the right product to the right patient at the right time,” said Pao. “A smarter reimbursement environment can help us streamline how we bring these products to patients.“

The challenge is not just scientific. The science already exists. The challenge is ensuring healthcare systems can effectively support it.

“Biomarkers are one very important aspect to make sure that for every product we put on the patient, we’re putting it on the right patient,” Pao explained.

As oncology becomes increasingly personalized, reimbursement frameworks are being asked to evaluate not only the value of the medicine itself, but also the infrastructure required to support its use. Diagnostic testing, treatment sequencing, eligibility requirements, and duration of therapy all influence whether patients ultimately gain access to innovative treatments.

“The innovation is there,” Pao said. “The challenge is how policy and reimbursement keep up with the innovation.”

This challenge becomes particularly visible in areas such as ADCs, where physician awareness and clinical enthusiasm may already be strong, yet reimbursement limitations continue to influence how therapies are used in practice.

One of the most striking observations from the discussion centered on patients who respond well to treatment but are nevertheless required to discontinue therapy due to reimbursement restrictions rather than clinical considerations.

“Sometimes we have a very good product. The patient responds really well, but the continuation isn’t always possible,” Pao said. “I sympathize.”

Such examples highlight a broader reality facing healthcare systems worldwide. Innovation is accelerating, but healthcare budgets are not. New oncology therapies are becoming increasingly precise, personalized, and clinically effective, yet they are also introducing new demands on reimbursement systems that were designed for a different era of medicine.

For healthcare providers, policymakers, and industry alike, the challenge is no longer simply bringing innovation to market—it is determining how to sustain access once that innovation arrives.

Key Access Challenges Discussed

• Biomarker testing improves treatment selection but introduces additional cost and complexity.
• Reimbursement criteria influence treatment sequencing and patient eligibility.
• Therapy duration limits can affect long-term patient access.
• Healthcare systems must balance innovation with sustainability.
• Smarter reimbursement models may be required as precision medicine expands.

Dr. Tony Pao, Country Medical Director at GSK Taiwan, highlights how precision medicine, biomarker-driven care, and next-generation antibody-drug conjugates are reshaping cancer treatment. Image: GeneOnline

Taiwan’s Future Contribution May Extend Beyond Treatment

One of the more unexpected themes to emerge from the discussion was the role of prevention in shaping the future of oncology.

While much of the conversation focused on advanced therapeutics, Graves repeatedly returned to the importance of preventing cancer before treatment becomes necessary. For all the excitement surrounding precision medicine, immunotherapies, and next-generation targeted therapies, she argued that reducing disease burden at the population level will ultimately require a broader approach—one that begins long before a patient enters an oncology clinic.

“We hope not only to bring innovative medicines for oncology to Taiwan, but also to help prevent cancer from happening in the first place,” Graves said.

That perspective reflects a growing recognition across healthcare systems that treatment alone cannot solve the global cancer burden. Early detection, disease monitoring, risk reduction, and prevention strategies often have a greater impact on population health than any single therapeutic breakthrough. While they may not attract the same attention as new oncology drugs, they remain among the most powerful tools available to healthcare systems.

For Graves, Taiwan’s experience with hepatitis B provides a compelling example of this principle in action.

“When we look at chronic hepatitis B, it’s one of the main risk factors for liver cancer,” she explained. “As a result, Taiwan has faced a relatively high burden of liver cancer.”

What was once a significant public health challenge has also generated decades of practical expertise. Taiwan’s efforts in hepatitis B vaccination, screening, disease monitoring, and long-term management have produced valuable insights into prevention and early intervention—insights that extend well beyond liver disease alone.

The relationship between chronic hepatitis B and hepatocellular carcinoma has made Taiwan one of the world’s most experienced healthcare systems in understanding how prevention strategies can influence long-term cancer outcomes. This experience has helped shape approaches to surveillance, risk stratification, and disease management that continue to inform both clinical practice and public health policy.

“The clinical data is highly valuable on a global scale because of all this experience,” Graves noted. “Taiwan’s insights into cancer prevention, diagnosis, and treatment can be shared globally.”

That opportunity is amplified by one of Taiwan’s greatest healthcare assets: its integrated healthcare data infrastructure. Through the National Health Insurance system and comprehensive population-level datasets, researchers have access to longitudinal information that can help track disease progression, treatment patterns, outcomes, and healthcare utilization across large populations.

As real-world evidence becomes increasingly important in regulatory decision-making, health economics, and clinical practice, Taiwan’s ability to generate meaningful long-term data may become one of its most valuable contributions to global oncology.

Importantly, Graves does not view Taiwan solely as a market for innovative medicines. Instead, she sees an opportunity for the country to contribute knowledge, experience, and evidence that can influence healthcare strategies well beyond its borders.

That perspective aligns closely with Taiwan’s broader ambitions to reduce age-standardized cancer mortality by one-third by 2030. Achieving that goal will require more than breakthrough therapies alone. It will depend on coordinated efforts spanning prevention, screening, diagnosis, treatment, and long-term disease management.

Taiwan’s Oncology Advantage Beyond Treatment

• Decades of experience managing hepatitis B and liver cancer.
• Strong expertise in prevention, screening, and disease monitoring.
• Access to integrated healthcare datasets and real-world evidence.
• Ability to generate globally relevant clinical and public health insights.
• Opportunity to contribute knowledge, not just consume innovation.

Taiwan’s Competitive Advantage in Clinical Research Is Evolving

Beyond patient care and prevention, both leaders identified clinical research as another area where Taiwan has the potential to play an increasingly important global role.

According to Pao, Taiwan already contributes significantly across GSK’s development portfolio, including oncology, vaccines, respiratory medicine, HIV, immunology, and infectious diseases. The country has built a strong reputation for study execution, investigator quality, and patient recruitment, making it a reliable partner for multinational clinical development programs.

“Taiwan is actually very capable in terms of conducting clinical trials,” said Pao. “A lot of our portfolio, if you look at our pipeline for oncology and many other therapeutic areas, we actually have Taiwan as part of the global trial.”

The country’s strengths extend beyond scientific expertise. Taiwan benefits from a highly trained medical workforce, a well-developed healthcare system, and patients who are often willing to participate in clinical research. These factors have helped establish a strong foundation for global trial participation.

“In terms of recruitment, execution and site initiation, Taiwan is actually ranking top five, at least within GSK,” Pao noted.

Those achievements are particularly noteworthy given the increasing competition among countries seeking to attract clinical research investment. As pharmaceutical pipelines become more global, sponsors have more options than ever when selecting research sites and study locations.

Yet throughout the discussion, both leaders suggested that Taiwan’s next challenge is not scientific credibility. That battle has already been won. Instead, the conversation repeatedly returned to operational efficiency.

“We don’t have a problem with scientific credibility,” Graves said. “The urgency is demonstrating we can mobilize at speed for global R&D hubs.”

Increasingly, sponsors evaluate potential research locations not only on scientific capability, but also on how quickly studies can be activated, contracts can be executed, and patients can be enrolled. In an environment where timelines are becoming increasingly compressed, administrative efficiency is becoming a competitive advantage in its own right.

Graves pointed to ongoing discussions around streamlining clinical trial infrastructure and reducing complexity in study activation. She also highlighted examples from neighboring markets that have successfully strengthened their position through coordinated national strategies.

“I know already that Taiwan has its eyes on how Korea has done it and how we can do it better,” she said. For Taiwan, the opportunity is substantial.

The combination of experienced clinicians, strong healthcare infrastructure, extensive patient datasets, and a strategically important Han Chinese population provides a foundation few markets can replicate. These strengths create opportunities not only for multinational studies, but also for generating evidence that may be relevant across broader Asian populations.

The next challenge is ensuring that operational systems evolve quickly enough to capitalize on those advantages.

Why Taiwan Matters to Global Development

• Top-performing market within GSK for recruitment and study execution.
• Extensive experience across oncology, vaccines, HIV, respiratory medicine, and immunology.
• Highly trained investigators and strong clinical research infrastructure.
• Access to valuable real-world evidence and longitudinal healthcare data.
• Significant Han Chinese patient population with regional relevance.
• Opportunity to strengthen competitiveness through greater operational efficiency.

GSK Taiwan leaders Tina Graves (right) and Tony Pao (left) shared how precision medicine, sustainable access, and clinical innovation must work together to improve outcomes for cancer patients. Image: GeneOnline

The Future of Oncology Will Depend on More Than Science

Taken together, the discussion revealed an industry entering a new phase of maturity.

Scientific innovation remains essential. Precision medicine continues to reshape treatment paradigms. ADCs are expanding therapeutic possibilities. Biomarker-driven care is improving treatment selection. Yet increasingly, the factors that determine patient outcomes extend far beyond the medicine itself.

Precision medicine depends on diagnostics. Diagnostics require reimbursement pathways. Reimbursement depends on sustainable healthcare financing. Healthcare financing depends on policy decisions. Policy decisions can play a critical role in enabling faster and more convenient patient access to innovations

That interconnected reality was one of the strongest themes to emerge throughout the conversation. The future of oncology will not be defined solely by scientific breakthroughs, but by how effectively healthcare systems adapt to support them.

For Pao, the objective remains straightforward. “It’s about bringing the right product to the right patient at the right time.”

That principle has become increasingly important as oncology grows more complex. Delivering precision medicine requires more than identifying the right target or developing the right therapy. It requires healthcare systems capable of supporting biomarker testing, treatment access, long-term monitoring, and sustainable reimbursement.

Graves offered a complementary perspective—one grounded not in products or pipelines, but in patients.“Growth isn’t just about numbers,” she said. “It’s about how do we help more patients today.”

That statement may ultimately capture the broader challenge facing oncology as a whole.

As scientific innovation continues to accelerate, success will no longer be measured solely by the next breakthrough therapy. It will depend on whether healthcare systems, clinical research infrastructure, reimbursement frameworks, and prevention strategies can evolve quickly enough to ensure those breakthroughs reach the patients they were designed to help. Because in the end, innovation only matters when it improves lives.

From precision medicine and ADCs to prevention and smarter reimbursement, GSK Taiwan outlines a vision for making the next generation of cancer care more effective, equitable, and accessible. Image: GeneOnline

Author

Bernice Lottering