How Drug–Device Combinations Will Redefine Precision Medicine Over the Next Decade

Executive Summary

For years, precision medicine has been defined almost exclusively through the lens of genomic testing and targeted drugs. But as the field matures, a new reality is becoming clear: precision cannot be achieved through molecules alone. The next decade of innovation will belong to drug–device combinations — technologies that integrate therapeutic agents with delivery systems engineered to ensure the right dose reaches the right place at the right time.

From nebulizers to nasal delivery platforms to direct-to-tumor administration technologies, these devices represent one of the most under-recognized levers for improving real-world patient outcomes. This article outlines why drug–device combinations are poised to reshape oncology and broader precision medicine, enhancing efficacy, reducing toxicity, and transforming the patient experience.

Why Precision Medicine Has Hit a Delivery Bottleneck

While the industry has made extraordinary advances in biomarker-driven drug development, many approved precision therapies still face real-world barriers:

1. Targeted drugs often cannot reach the anatomical site where they are needed most

Poor tissue penetration, tumor architecture, and anatomical constraints often limit local exposure — even when the drug is biologically appropriate (Jain, Cancer Research, 2005).

2. Systemic delivery creates toxicities that limit dose intensity

Therapies with excellent mechanisms of action frequently fail in practice because they cannot be delivered safely at the concentrations required to be effective.

3. Older and frailer patients cannot tolerate modern systemic regimens

This is particularly evident in lung cancer and neurological diseases, where the median patient is elderly and managing multiple conditions (Hurria et al., JCO, 2014).

4. Precision is compromised when delivery is non-specific

A biologically precise drug still behaves like a blunt instrument when administered systemically.Delivery science is the missing link in precision medicine’s evolution.

The Rise of Drug–Device Combinations

Drug–device combinations represent a shift from systemic exposure to targeted administration, bringing therapy directly to the disease site or entry point. These approaches elevate delivery to the same status as the therapeutic agent itself.

Some of the most promising device categories include:

1. Nebulisers and Inhaled Platforms

Modern aerosol technologies have evolved far beyond traditional respiratory devices. Advanced vibrating mesh and smart nebulizer systems can generate precise particle sizes, enable deep-lung deposition, and support consistent dosing (Garg & Mathur, Adv Drug Deliv Rev, 2023).

Why it matters:

• The lung becomes a direct therapeutic gateway

• Reduced systemic exposure

• Alignment with outpatient and home-based care

• Relevance for oncology, infectious disease, and rare pulmonary disorders

2. Nasal Delivery Platforms for CNS Access

The nasal cavity provides a non-invasive route to access the brain via the olfactory and trigeminal nerve pathways, bypassing the blood–brain barrier (Lochhead & Thorne, Adv Drug Deliv Rev, 2012).

Clinical implications:

• Potential for higher CNS exposure

• Lower systemic burden

• Improved convenience versus invasive administration

• Expanding possibilities for GBM, neurodegeneration, and brain metastases

3. Direct-to-Tumor Delivery Devices

Whether via catheter-based systems, hydrogel depots, local infusions, or endoscopic-access platforms, direct-to-tumor devices represent one of the most powerful ways to deliver therapy exactly where disease resides.

Benefits include:

• High local concentrations with reduced systemic toxicity

• Opportunity to treat tumors in anatomically challenging regions

• Enhanced synergy with radiotherapy and surgery

• Lower dependence on high-dose systemic therapy

These platforms are still early in their evolution, but the direction of travel is clear: localization is the next frontier in precision.

Why Drug–Device Combinations Will Drive the Next Era of Precision Medicine

1. They Enable Therapies That Were Previously Considered Unfeasible

Many promising drug candidates have failed not because they were ineffective, but because they were delivered inefficiently or unsafely. Precise delivery resolves this bottleneck (Wong et al., Nat Rev Drug Discov, 2022).

2. They Transform the Therapeutic Index

By reducing systemic exposure and increasing concentration at the disease site, devices improve efficacy while lowering toxicity — a defining principle of precision medicine.

3. They Reduce Treatment Burden for Patients

Devices enable shorter visits, outpatient or home administration, and lower-impact regimens, dramatically improving the treatment experience.

4. They Unlock New Indications for Known Agents

Reformulation and delivery innovation can extend the reach of validated pharmacology into new therapeutic areas without the risk profile of novel molecules.

5. They Support Global Health Economics and Value-Based Care

Better-targeted delivery reduces hospitalizations, supportive care needs, and treatment discontinuations — directly supporting payer and health-system goals.

6. They Align with Regulatory Momentum

Regulators increasingly recognize the value of drug–device combinations and have created clear pathways — including the US 505(b)(2) framework — to accelerate their development.

Case Study Trends Across the Industry

The broader biotechnology landscape is already validating this shift:

• Inhaled oncology candidates entering clinical trials

• Intranasal CNS-targeted agents showing encouraging early signals

• Locally delivered immunotherapies achieving biologically meaningful exposure

• Device-enabled depots and implants supporting long-duration precision dosing

These examples reflect an industry-wide recognition that delivery is now a primary innovation driver, not a peripheral engineering exercise.

The Strategic Implications for the Next Decade

The next generation of precision therapeutics will be differentiated not only by what they target — but by how they are delivered.

Over the next 10 years, expect to see:

• A surge in drug–device combination approvals

• Growth of inhaled, nasal, and direct-to-tumor modalities

• Increasing integration of digital health, sensors, and smart delivery

• Major investment from biopharma into delivery-engineering partnerships

• More reformulated agents reaching market via accelerated pathways

• Precision delivery becoming a defining characteristic of successful oncology innovation

Delivery science is transitioning from “supportive technology” to a central pillar of therapeutic strategy.

Conclusion

For precision medicine to achieve its full potential, the industry must look beyond molecules and embrace delivery as a primary driver of therapeutic success. Nebulisers, nasal platforms, and direct-to-tumor devices are not incremental innovations — they represent a structural shift that will define the future of oncology and broader CNS care.

The future belongs to companies that can bridge the gap between validated pharmacology and intelligent delivery.Those that succeed will deliver therapies that are more effective, more tolerable, and more aligned with real patient needs.

The next era of precision medicine has already begun.Its defining innovations will come from delivery.

References

• Jain R., Cancer Research, 2005

• Hurria A. et al., Journal of Clinical Oncology, 2014

• Lochhead J., Thorne R., Advanced Drug Delivery Reviews, 2012

• Garg N., Mathur S., Advanced Drug Delivery Reviews, 2023

• Wong C. et al., Nature Reviews Drug Discovery, 2022

• SEER Cancer Statistics Review, 2023