Pharmaceutical Market Europe • July/August 2025 • 19
THOUGHT LEADER
Embracing uncertainty in precision medicine communications for lung cancer
‘What happens when breakthroughs arise from factors we previously never thought to question – let alone measure?’
By Jessica Hurley
An infusion in the morning versus the afternoon. That’s it. Yet this simple difference translated into a median progression-free survival (PFS) of 11.3 months versus 5.7 months for patients with non-small-cell lung cancer (NSCLC) receiving immunochemotherapy.1
When this data emerged from the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, it wasn’t just another clinical finding to file away – it challenged fundamental assumptions about what drives treatment outcomes in precision medicine.
The timing discovery: precision medicine’s unexpected result
These findings came from a phase 3 study of patients with advanced NSCLC receiving chemotherapy plus immunotherapy, randomised to receive their infusion either before or after 15:00. This simple timing switch led to a difference in PFS of 5.6 months, favouring patients receiving the earlier infusion.1
An effect size of this magnitude rivals those seen with other precision medicine contenders. After all, that same ASCO congress delivered the wins we expected: Zipalertinib hit a 35% response rate in patients with EGFR exon 20 mutations in the phase 2b REZILIENT1 study – exactly the kind of biomarker-driven success that validates our molecular targeting approach in patients progressing after platinum-based chemotherapy.2 Tarlatamab, a DLL3-targeting bispecific T-cell engager (BiTE), extended overall survival from 8.3 to 13.6 months versus chemotherapy in relapsed small-cell lung cancer (DeLLphi-304), another victory for targeted therapy.3
Preparing for the unpredictable
The ‘why’ behind the circadian effect is still unclear – the role of ‘clock’ genes in modulating immune system functional patterns is only beginning to be unpicked, but the precise mechanisms regarding timing of infusions are still vague.4
For pharma and medical communications professionals, this discovery exposes an uncomfortable truth. We’ve built entire scientific strategies around the assumption that we understand why our treatments work. But what happens when breakthroughs arise from factors we previously never thought to question – let alone measure?
The traditional approach – project confidence, avoid uncertainty – breaks down when impressive clinical data comes from unexpected variables. How do we create scientific strategies around the idea that ‘your appointment time might matter as much as your genetics’, even when we can’t predict which factors will surprise us next? Honesty is, perhaps, the most confident route of all.
Building what we don’t know into strategy
Most medical communications avoid uncertainty like the plague. But the circadian discovery suggests a different map for the road ahead: what if acknowledging the limits of current knowledge became a differentiator rather than a liability?
The organisations that will lead in precision medicine communications are those that prepare for discoveries they can’t predict. And with the pace of research and data generation increasing each year, there will inevitably be more. Take heart – there’s no need to overhaul messaging; instead, forward-thinking teams are building three core content approaches:
- Modular content frameworks that can rapidly integrate new science without starting from scratch. Instead of traditional campaign materials, these are content systems designed for evolution – educational slides with flexible sections for emerging data, clinical summaries that can accommodate both molecular and non-molecular factors, patient materials with ‘discovery zones’ for unexpected findings.
- Scenario planning for communications that goes beyond standard strategic planning. Rather than delivering a single communications strategy, sophisticated teams develop multiple strategic scenarios: what if environmental factors become as important as biomarkers? What if resistance patterns reshape treatment sequencing? What if simple interventions outperform complex ones? This approach transforms reactive scrambling into proactive preparation.
- Evolution narratives that position unexpected discoveries as evidence of scientific progress rather than narrative disruption. When the next circadian timing-type breakthrough emerges, teams with evolution narratives already have frameworks to integrate it seamlessly into existing therapeutic stories.
In short, no more ‘by implementing these biomarker-driven strategies, we achieve optimal patient outcomes’ That sentence says nothing while pretending to say everything.
Instead, use scientific strategies that acknowledge the elephants in the room: ‘We know molecular targeting works. We’re learning that timing matters too. Environmental factors are proving significant. We’re probably missing other variables entirely.’
The communications teams that thrive will be those that view each unexpected discovery not as a threat to existing narratives, but as validation that the field is advancing faster than anyone predicted. Because in precision medicine for oncology, the only certainty is that we still have a lot to learn.
References:
Jessica Hurley is Scientific Director at Synergy Vision
jessica.hurley@synergy-vision.com
Pharmaceutical Market Europe (PME)
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