The traditional view of the pathway from research to practice suggests linear development of interventions emerging from basic science insights, testing of those interventions through specific stages of investigative trials, publication of those results, and then consideration of how the interventions may be adopted, implemented and sustained in clinical and community systems of care. As implementation science has emerged to more systematically understand and improve the fit of research discoveries with service delivery, questions have arisen about the value of this pathway and the implications of the assumptions that an intervention can be fully “ready for implementation.” This presentation will critically examine the impact of these assumptions on the ultimate ability to optimize the use of research findings and evidence-based interventions and argue for a more dynamic, evolutionary consideration of the evidence base and the design, use and sustainment of cancer care interventions. Reviewing recent efforts in the field to reconsider this terrain, the author will discuss future directions for the field and research opportunities for advancing these ideas.