ASCO 2025: Oncology Pathway Tools Show Consistent Usage Across Patient Groups

Standardized treatment pathways are designed to support equitable, evidence-based oncology care, but questions remain about whether these tools are used consistently across diverse patient populations. At the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, Laura Momoko Asakura, PharmD, BCOP, BCSPS, presented findings from a study examining the equitable use of treatment pathway tools in oncology care.

In this interview with Pharmacy Times, Asakura, a lead clinical utilization and intelligence specialist for national drug use management and the national oncology pathways pharmacy lead at Kaiser Permanente, discussed how these treatment pathway tools—designed to guide clinicians toward evidence-based, cost-effective cancer therapies—are utilized across diverse patient populations. Asakura shares insights on the study’s findings, reflecting on how the study results may inform future efforts to enhance equity in cancer treatment.

Pharmacy Times: What were the primary metrics used to evaluate equity in treatment pathway tool utilization, and how were disparities defined in your study?

Laura Momoko Asakura, PharmD, BCOP, BCSPS, is a lead clinical utilization and intelligence specialist for national drug use management and the national oncology pathways pharmacy lead at Kaiser Permanente, in San Francisco, California.

Laura Momoko Asakura, PharmD, BCOP, BCSPS: The primary metrics used to evaluate equal care in treatment pathway utilization were the adjusted probability of using the pathway tool, and average marginal effects of differences in how the pathway tool was used across race/ethnicity groups and insurance types. Disparities were defined by statistically significant differences in adjusted usage rates across different patient groups. The absolute differences did not exceed 3%, suggesting the differences between patient populations were not clinically impactful.

Pharmacy Times: Can you describe how the integrated health system's pathways were originally developed and whether equity considerations were built into their design?

Asakura: These pathways were developed to guide physicians to standardized, evidence-based, and cost-effective treatment options for their patients based on their specific type of cancer. The pathways are regularly updated to reflect the latest scientific advancements and help ensure that all patients are receiving the best, evidence-based treatment for their type of cancer. Equity considerations were not explicitly in the original design but were examined in this analysis to ensure equal use across patient sociodemographic groups.

Pharmacy Times: What demographic factors (eg, race, ethnicity, insurance status, language, geography) were most strongly associated with variation in pathway tool usage?

Asakura: Our analysis focused on the effects of factors such as race, ethnicity, and type of insurance on use of the pathways tool. We did not look at geography or language in our analysis. We did not find that any one group received favorable treatment compared to another.

Pharmacy Times: Were there differences in pathways tool usage based on cancer type or stage, and how might these intersect with disparities in access or outcomes?

Asakura: The analysis did not specifically address differences in how the pathways tool was used based on cancer type or stage.

Pharmacy Times: Did your analysis identify any system-level barriers (eg, prior authorization requirements, formulary restrictions) that disproportionately affected certain populations?

Asakura: This analysis focused on the equal use of the pathway tool across different patient groups and did not analyze any specific system-level barriers.

Pharmacy Times: How do you see pharmacists playing a role in identifying or mitigating inequities in pathway adherence across the care continuum?

Oncology professional with patient with cancer. Image Credit: © Halfpoint - stock.adobe.com

Asakura: Pharmacists can encourage clinicians to utilize the pathways tool whenever possible to help deliver standardized cancer care. They can also ensure all patients receive appropriate, evidence-based medications and support regardless whether the pathways tool is utilized.

Pharmacy Times: What strategies or interventions were found to be most effective in improving pathway usage among historically underserved populations?

Asakura: The findings suggest that the use of the oncology pathways tool may facilitate equal, standardized cancer care.

Pharmacy Times: Were there any surprising findings regarding which patient groups experienced the most significant deviations from pathway-recommended care?

Asakura: The analysis found high usage of the pathway tool across all patient groups, with relatively small absolute differences.

Pharmacy Times: How do you plan to use these findings to inform revisions to existing clinical pathways or future equity-focused quality improvement initiatives?

Asakura: Since our findings indicated we are using the pathways tool equally across patient populations, we will continue to focus on encouraging clinician utilization of our pathways tool.

Pharmacy Times: What are the next steps for this research, and how might it inform national guidelines or policy around equitable oncology care delivery?

Asakura: We have not planned any further analysis on the equal application of our pathways tool. We hope our findings help to support use of pathways to continue to deliver equal oncology care.