For some advanced cancers, sequencing the tumor genome should be one of the first steps patients and physicians take. But a new study finds that many patients never receive genomic testing and so never get the chance to know if they might have benefitted from newer, more targeted therapies.

The study, published on Tuesday in JAMA Network Open, examined how many patients diagnosed with one of five different metastatic cancers received genetic sequencing for the cancers. For most cancers in the study, roughly half of patients in the cohort received genetic sequencing. Patients with low income, Medicare or Medicaid coverage, and Black or Hispanic race or ethnicity were also less likely to receive sequencing.

Cancer medicine and research have made enormous progress over the last few decades. The overall five-year survival rate has pushed up to 70% as of 2026, and the five-year survival rate for metastatic cancer has doubled since the 1960s. That’s in large part thanks to advances in medicines and technologies that can help treat cancer, like targeted therapies that work by exploiting key cancer mutations.

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Good morning. Amid all the tasks that demand to be addressed each day, are you having trouble finding your sense of wonder and awe re: the moon mission? I am too. Reading this and this yesterday helped me access it. 

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An experimental HIV prevention pill being developed by Merck could be mass produced for less than $5 per patient a year according to a new analysis. Advocates argue the low cost means the company should find it easier to license the drug so that low- and middle-income countries can gain easy access.

The pill, dubbed MK 8527, is currently undergoing a pair of late-stage clinical trials that are expected to determine whether the medicine can lower HIV transmission when given to people at high risk of infection. The results are due in the latter half of 2027, according to separate postings on ClinicalTrials.gov.

Already, the pill is generating considerable interest after Merck released mid-stage results last summer showing its drug holds promise. In addition to being safe and effective, the study found it could protect against infection, a form of prevention known as pre-exposure prophylaxis or PrEP, within 24 hours after being taken. Merck noted the pill works in a novel way.

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In medicine, we like to believe that progress is linear. That once a patient stabilizes, regains lost skills, and returns to work, the hardest part is behind them. But in addiction care, stability is fragile because the systems supporting patients are weak.

Recently, I sat with a patient who has done everything we ask of people in recovery. She has been abstinent for years. She attends visits. Her urine drug screens are consistently appropriate. She works. She parents. She plans for the future. And yet, halfway through our appointment, her voice changed, not when we discussed cravings or trauma, but when she told me her insurance premium was about to triple.

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