Nearly one in five Americans ages 55 and older have no local pathway to investigational cancer therapies because 70% of U.S. counties have no active cancer treatment trials. Yet 85% of cancer patients receive care at community-based practices, not academic medical centers where most clinical trials are concentrated. A new system called Right-In-Time (RIT) is designed to change that by embedding trial matching directly into the molecular profiling process and deploying trials to community oncology sites .

Why Are Cancer Patients Missing Out on Cutting-Edge Treatments?

The disconnect between available science and what patients actually receive is stark. A study of more than 295,000 real-world cancer patients, published in Nature Communications, examined the FDA's eight tissue-agnostic cancer approvals and found that for one of the most promising targets, NTRK fusion genes, roughly one-third to nearly half of eligible patients with advanced disease never receive the approved therapy . The problem isn't that patients refuse trials; a meta-analysis in the Journal of the National Cancer Institute found that 55% of cancer patients offered a trial agree to participate, suggesting the core barrier is access and infrastructure, not patient willingness .

Many oncologists simply don't encounter rare mutations frequently enough to become familiar with them or know which trials might be a match. Geographic isolation compounds the problem. Patients in rural or underserved areas often face impossible choices: travel hundreds of miles to an academic medical center or stick with standard treatments that may not address their specific tumor's molecular profile.

How Does the Right-In-Time System Actually Work?

The RIT solution integrates three key components into a single workflow that moves from molecular profiling to patient enrollment in approximately two weeks, and in as few as five days . Here's what happens at each stage:

• Comprehensive Molecular Profiling: Every patient whose tumor specimen is sent to Caris receives profiling through Whole Exome Sequencing (WES) of DNA, Whole Transcriptome Sequencing (WTS) of RNA, and immunohistochemistry (IHC) analysis of proteins, covering more than 23,000 genes .
• Automated Trial Matching: A proprietary trial-matching platform cross-references each patient's molecular results against a portfolio of more than 30 clinical trials and more than 80 biopharmaceutical partners, identifying potential matches within 24 to 48 hours .
• Clinical Navigation and Site Activation: Clinical Trial Navigators, who are registered oncology nurses, notify treating physicians of matches, conduct preliminary eligibility assessments, and manage contracting, budgeting, site qualification, and institutional review board documentation, freeing physicians to focus on patient care .

Critically, patients remain under the care of their treating oncologist, preserving continuity of care and eliminating the burden of long-distance travel to academic centers .

What Scale Are We Talking About?

The network has grown substantially. The RIT program now spans more than 600 community and regional oncology sites, with 2,200 investigators across the United States and Puerto Rico, and more than 71,000 patients identified for potential trial participation . The system draws on one of the largest clinico-genomic databases in oncology; as of December 31, 2025, Caris surpassed 1,016,000 total molecular tumor profiles and 740,000 matched profiles linking molecular data with clinical outcomes . The company has published findings from this research base in more than 1,050 peer-reviewed publications, often in collaboration with members of the Caris Precision Oncology Alliance, which includes cancer centers and academic research institutions .

"Every patient diagnosed with cancer deserves a treatment plan informed by the molecular profile of their disease. We believe the field is approaching a point where comprehensive profiling will become standard practice for all patients and programs like Right-In-Time are designed to accelerate that transition by connecting molecular insights directly to clinical trial opportunities at the community level," said David Spetzler, President of Caris Life Sciences.

David Spetzler, President of Caris Life Sciences

Why Does This Matter for Patients Right Now?

The implications are significant. For decades, access to investigational cancer therapies has been a privilege of geography and proximity to major academic centers. This system aims to democratize that access by bringing trials to where patients actually receive care. It addresses a fundamental inequity: your ZIP code should not determine whether you can access a potentially life-changing investigational therapy. By embedding trial matching into the molecular profiling workflow, the RIT solution ensures that oncologists have real-time information about which trials their patients might be eligible for, eliminating the knowledge gap that has historically prevented patients from accessing targeted therapies for rare mutations.

The urgency is clear. As precision medicine becomes more sophisticated, the gap between what science can offer and what patients actually receive continues to widen. Systems like Right-In-Time are designed to close that gap by making advanced clinical trials accessible at the community level, ensuring that more patients have the opportunity to benefit from the latest investigational treatments .