Early phase oncology research is often described as cutting edge. In practice, it is just as defined by logistics as by science. For Dr. Sankhala, the work of advancing new therapies has always been inseparable from a more practical question: how do patients outside large academic centers, who are often limited by cost, geography, or system barriers, gain timely access to clinical trials?
That question has shaped his career, from early training abroad to building a research dedicated site in one of the most complex healthcare markets in the United States.
A conversation with Dr. Kamalesh K. Sankhala on rare cancers, operational focus, and building access where it is needed most
Where the interest began
Dr. Sankhala did not initially set out to run a clinical research center. His entry into oncology drug development began during fellowship training in India in the early 2000s, a period when new cancer therapies and clinical trials were beginning to reshape treatment expectations. Seeing experimental therapies move from development into real patient care sparked a deeper curiosity about how drugs are built, tested, and ultimately delivered.
That curiosity brought him to the University of Texas, where he entered the world of early phase oncology and translational research. Many of the patients referred to him for Phase 1 trials had rare cancers, particularly sarcomas. What stood out was not only the rarity of the diagnoses, but the variability from one patient to the next. Each case required an individualized approach, often without a clear roadmap.
Over time, that combination of early phase drug development, rare disease, and direct patient care became the center of his professional focus. It also revealed the structural challenges that make early phase research harder than it needs to be.
Why early phase trials slow down in major medical centers
Los Angeles is home to some of the most advanced medical institutions in the country. Dr. Sankhala has worked within several of them, including Cedars Sinai, and serves as faculty and staff at USC and UCLA. From a scientific standpoint, the capabilities are unquestionable.
The challenge, he explains, is operational.
"Large academic medical centers are designed to manage scale, complexity, and risk. Each institution has its own processes, review committees, and administrative layers. While those systems serve important purposes, they are rarely aligned across institutions. For early phase oncology trials, where timing and flexibility matter, that fragmentation becomes a bottleneck."
From Dr. Sankhala’s perspective, the result is predictable. Trials take longer to open. Sponsors face delays that have little to do with science. Patients wait while approvals move through parallel systems that were never designed to work together.
The access gap hiding in plain sight
Operational delay is one part of the problem. Access is the other.
Southern California includes dense urban centers alongside large populations living on the outskirts of Los Angeles or in underserved areas. Many patients are covered through managed care. Others face barriers related to transportation, time away from work, or limited referral pathways. For these patients, repeated travel to major academic hospitals is often unrealistic.
The result is a disconnect. Highly specialized trials may exist within the city, but remain out of reach for the very patients who could benefit from them. In Dr. Sankhala’s view, access to early phase oncology research should not depend on geography, institutional affiliation, or a patient’s ability to navigate complex systems.
That gap is what ultimately drove him to build something different.
A research dedicated model tailored for rare cancers
Dr. Sankhala founded Precision Action Oncology and Research Center with the specific purpose of supporting early phase oncology trials, particularly in rare cancers, without the friction that slows execution in larger institutions.
Rather than layering research onto broad clinical priorities, the site was designed around drug development from the start. The goal was to remove unnecessary barriers, shorten the path from sponsor to site activation, and ensure that eligible patients actually have access to trials that match their disease.
In his view, a research dedicated site should be able to move quickly, communicate clearly with sponsors and CROs, and focus its resources on execution rather than administrative repetition.
Why partnership determines whether the model works
Early phase oncology trials demand close coordination between sponsors, CROs, and sites. Protocols evolve. Timelines are tight. Decisions need to be made quickly and with context.
Dr. Sankhala describes the sponsor site relationship as inherently collaborative but often slowed by layers that sit between intent and execution. For him, the value of partnership is measured in outcomes: whether the right trials are identified, whether startup moves efficiently, and whether issues can be resolved without prolonged handoffs.
That is how he characterizes his work with Precision for Medicine. From the outset, the focus was clear. Phase 1 and early phase trials. Rare cancers, including sarcoma. A shared understanding of what the site could support and what sponsors needed.
The practical difference, he notes, was accessibility. Being able to reach the right people directly. Resolve questions quickly. Move studies forward without unnecessary escalation. That efficiency benefits sponsors through smoother execution, and patients through earlier access.
Who the system is ultimately built for
Dr. Sankhala consistently returns to the same group when he talks about why this work matters. Patients who live outside traditional research corridors. Patients for whom early phase oncology may represent a last option rather than an abstract opportunity.
For many of them, participation in a clinical trial feels distant, or impossible. When access is delayed or denied, the consequences are immediate and personal.
His objective is straightforward. Build a system where clinical care and drug development are tightly integrated. Where sites are dedicated to research execution. Where partnerships reduce friction instead of adding to it. In that system, early access to investigational therapies becomes less of a privilege and more of a realistic option.
That, in his view, is how progress reaches the patients who need it most.