Advancing the adoption of oncology decision support tools in Europe: insights from CAN.HEAL

Effective cancer care increasingly depends on digital decision support tools (DSTs) to interpret complex clinical, molecular, and genomic data and guide personalised treatment decisions. However, the oncology DST (oncDST) landscape remains fragmented, with limited interoperability, inconsistent standards, and uneven clinical adoption across healthcare systems. This fragmentation hinders routine clinical use and impedes the demonstration of robust clinical benefit. To address these challenges, the CAN.HEAL consortium proposes the EU-oncDST digital framework, a conceptual, harmonised, interoperable, and modular architecture designed to integrate existing oncDSTs across Europe. Developed through consortium-wide consultations, an EU-level survey and comprehensive mapping of both public and private solutions, the framework provides a practical pathway for implementing interoperable oncDSTs while fostering stakeholder collaboration and innovation. It also promotes the improvement of data-driven precision oncology, highlighting the integration of artificial intelligence, enabling continuous patient follow-up, and supporting the development of a learning cancer system. At its core, the framework empowers Molecular Tumour Boards (MTBs) to operate efficiently at institutional, national, and European levels. By offering a harmonised, interoperable, and modular architecture designed to integrate clinical, molecular and genomic data, the framework strengthens evidence-based and personalised treatment recommendations. A phased action plan links MTB deployment to the implementation of oncDSTs. Early phases focus on piloting and validating oncDST use within MTBs, optimising patient-centred consultations, harmonising variant annotation, and enhancing clinical trial matching. Overall, the EU-oncDST digital framework aims to provide a practical and collaborative pathway to strengthen oncology decision-making and accelerate the translation of precision medicine into clinical benefit across Europe.