Emerging Trends: Time Toxicity in Oncology
Why time continues to be the most precious outcome
Authored by Dane Lund, Jorge Durand
What you’ll learn:
Time toxicity, the cumulative time burden of cancer treatment, is a critical yet under-recognized factor that can significantly impact patient and care partner quality of life.
Vulnerable populations, including women, racial and ethnic minorities, and those with limited resources, are disproportionately affected by time toxicity and deserve tailored solutions.
By addressing time toxicity through evidence generation, innovative care models, and patient-centric support programs, oncology brands have a powerful opportunity to differentiate and deliver more meaningful value.
As cancer treatments continue to evolve with the dual goals of prolonging survival and preserving quality of life, a new look at the dimension of time is emerging. This new re-dimensionalized time may soon play a defining role in how we assess the true benefit of cancer therapies. Moving forward, it will shift how manufacturers and marketing teams should be planning evidence generation, clinical assessment, and patient support programs.
At the center of this emerging paradigm is time toxicity, the cumulative time that care partners, clinicians, and patients spend preparing, administering, monitoring, and managing cancer therapies. While pharmacologic innovations, such as combination regimens and novel mechanisms, have transformed cancer care, the time required to deliver these therapies remains a critical but often overlooked burden. Time toxicity is embedded in the treatment journey, yet it is frequently deprioritized, despite its significant impact on patient and care partner quality of life (QoL). Addressing it will require not only new formulations and delivery methods, but also technological innovation focused on reducing the time burden of care.
What Is Time Toxicity?
“The price of anything is the amount of life you exchange for it.” ∼ Henry David Thoreau
Time toxicity refers to the time-related burdens patients experience during cancer treatment, including time spent on medical appointments, treatment administration, and recovery, which can significantly impact their QoL.
The oncology universe is familiar with the notion of toxicity. Most commonly we discuss a specific product’s toxicity profile, financial toxicity, or even the toxic burnout oncologists face from long hours, lack of resources, and emotional stress. However, it’s time to elevate our understanding and discussions around the time-related burden patients and their families experience.
Importantly, the impact of time toxicity associated with a specific treatment or intervention is a very personal experience for each patient. Women, racial and ethnic minority patients, individuals from lower socioeconomic backgrounds, and those living in resource-limited areas are more likely to be “time poor” and may experience a greater burden from time toxicity than others.
Breaking Down the Burden of Time
While routine lab work may only take 15 minutes, it could be a three-hour burden difference for someone in a rural vs. urban area based on travel times. To personalize care, it is important to discuss what a “time-toxic day” might mean to an individual patient.
Time should be a critical factor in risk/benefit assessments of oncology treatments. The time toxicity associated with a therapy may, in some cases, outweigh its marginal survival benefits. Yet, when we look at one of the most widely used QoL instruments (EORTC QLQ-C30), we find that time burden is not explicitly addressed. While QoL patient-reported outcomes (PROs) are embedded in nearly all oncology trials, why hasn’t time burden become equally entrenched? Time is, after all, central to the goals of cancer treatment. Incorporating metrics like the number of “home days” patients experience on novel therapies versus standard of care could offer a more complete picture of a treatment’s clinical viability and real-world impact.
"I would want to weigh length of time before the cancer comes back against length of treatment and reduction in quality of life." - Oncology Patient
Reflection on ASCO 2024, Looking Forward to ASCO 2025
Our Klick oncology experts are at the forefront of the emerging focus on time toxicity in cancer care. A central question driving our discussions: How are new approaches prioritizing more home days for patients and minimizing the burden of treatment on their lives? And how can oncology brands develop new tactics and patient support programs to help address this? As we prepare for this year’s congress, here is a summary of last year’s insights on time toxicity:
Palliative Care: In 2024, ASCO updated its guidelines to recommend the early integration of specialized interdisciplinary palliative care alongside active cancer treatment. This recommendation should ultimately lead to better symptom management and potentially reduced hospitalizations. Importantly, the guideline update encouraged the use of telehealth appointments, which can significantly cut down travel and waiting times. However, the update presents challenges, such as increased appointments and potential coordination complexities. Balancing these factors is crucial to enhance patient QoL and minimize time toxicity.
Innovative New Treatments & Practice-Changing Studies: Non-invasive or less-invasive diagnostic and monitoring tools, like ctDNA, ultimately reduce the number of biopsies and imaging appointments patients need. Personalized medicine approaches often involve complex and time-intensive procedures, potentially elevating time toxicity. While these therapies offer promising outcomes, some may require more frequent administration, safety monitoring, and/or have a higher rate of ARs.
Continuous Integration of Artificial Intelligence (AI) in Oncology: AI gained traction at last year’s congress, where much of the attention was geared around its effective impact on diagnostics, treatment, decisions, and trial enrollment.
Telehealth and remote monitoring: AI-powered telehealth solutions and wearable technology can help reduce unnecessary in-person visits by enabling remote symptom monitoring and virtual consultations, ensuring patients only travel to healthcare facilities when absolutely necessary.
"I don’t have to go to the hospital all that often, and it makes a big difference, it makes a big difference to me." - Oncology Patient
The Real Value of Time
Time is important to everyone. Bringing a novel oncology treatment to market often means entering later-line or facing an aggressive cancer, where patients endure time-intensive therapies with minimal survival gains. As the community and payers weigh cost and QoL impact, time toxicity must take center stage. This critical yet often overlooked factor should shape not only clinical decisions but also marketing efforts, ensuring they serve the goal of minimizing time toxicity.
For drug developers and marketers in oncology, recognizing and addressing time toxicity presents an opportunity to differentiate products through targeted clinical evidence generation and patient-centric support programs. Incorporating measures like “home days” into clinical trials can deliver compelling data that resonates with HCPs, patients, and payers. Strategically elevating the benefit of reduced time burden associated with a specific treatment and ensuring cross-functional collaboration early in brand planning stages and communication strategy will help position the brand as a champion of optimal care, ultimately driving increased engagement and trust within the oncology community. We’ll continue to watch how this concept evolves—ideally with “home days” emerging as a key clinical benefit metric.
Are you interested in how the idea of time toxicity can help differentiate your brand? Let's connect. Klick has played a pivotal role in the commercialization of cell and gene therapies, RNA therapeutics, and precision oncology, we understand how to construct scientific stories that resonate with HCPs and patients.
Bibliography
Ray et al. Disparities in Time Spent Seeking Medical Care in the United States. 2015 (link)
Johnson et al. The unequal burden of time toxicity. 2023 (link)
Samuel et al. Racial differences in employment and cost-management behaviors in patients with metastatic breast cancer. 2020 (link)
Gupta et al. Time-related burdens of cancer care. 2021 (link)
Gupta et al. Patients’ considerations of time toxicity when assessing cancer treatments with marginal benefit. 2024 (link)
Gupta et al. The Time Toxicity of Cancer Treatment. 2022 (link)
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Authors
Dane Lund
Medical Strategist
Dane brings deep experience in oncology and rare diseases, with a focus on lung, breast, prostate, gastric, and hematologic cancers, as well as autoimmune and genetic conditions. He is passionate about translating complex science into clear, compelling stories that resonate with both healthcare providers and patients. Prior to entering medical strategy, Dane completed a PhD in molecular biology and a postdoctoral fellowship at Memorial Sloan Kettering Cancer Center, where he conducted research on cancer-related muscle wasting and AI-driven drug discovery to perturb cancer cell growth and metastasis.
Jorge Durand
Executive Director, Medical Strategy
With over 15 years of medical strategy experience, Jorge has helped build healthcare brands across oncology, immunology, rare disease, and more. He is passionate about practice-changing ideas grounded in deep scientific and market analysis, especially for brands significantly impacting the lives of patients.. He’s led marketing and medical affairs efforts, helped develop new messaging platforms and campaigns, optimized omnichannel strategy, and collaborated with thought leaders and patient-advocate organizations. Since joining Klick in 2017, Jorge has expanded the medical strategy department tenfold and grown the overall brand portfolio. He holds a BS and an MS in nuclear engineering from Balseiro Institute and a PhD/MS in biomedical sciences from Albert Einstein College of Medicine.
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