NEW YORK (GenomeWeb) – In partnership with SAP, the American Society of Clinical Oncology is hoping to develop and launch the first version of its health IT platform CancerLinQ by late 2015, the organization announced today.
In developing CancerLinQ, ASCO is aiming to build a big data framework that will enable doctors to harness real-world patient care data from "millions of electronic health records" – including patients' molecular information – to guide personalized cancer treatment decisions and improve research into precision treatments.
During a call to announce the partnership, ASCO President Peter Yu noted that 3 percent of cancer patients that participate in clinical trials currently inform how physicians practice medicine. Meanwhile, the potential knowledge from the treatments and experiences of the rest of the 97 percent of patients are "locked away in unconnected servers and patient files," he reflected.
"A key challenge physicians face today is that most treatment insights are inaccessible to us. It can't be used to improve future patient care," Yu said. "CancerLinQ promises to change that. Instead of learning from 3 percent of patients, we [would] learn from almost every patient."
ASCO has been planning the development of CancerLinQ for several years now, and even conducted a pilot effort using data from some 170,000 breast cancer patients. The organization is hoping that once fully developed by 2020, CancerLinQ will be able to provide real-time feedback to doctors about the treatments and strategies that are working and those that aren't.
By querying the data in CancerLinQ, physicians will be able to compare their practice against guidelines. Moreover, the data will uncover new patterns in patients' treatments and outcomes that can in turn improve care for other patients, and inform research. The system "will feed personalized insights to doctors offering individualized and unbiased decision support for every patient and for every type of cancer," Yu said.
This is where SAP Hana comes in. The in-memory database technology will power CancerLinQ. The platform will extract data from patients' records, anonymize and aggregate the data, and integrate information from other sources like physicians' notes, clinical guidelines, and biomarker repositories. Doctors will then be able to query this data to inform the care of their patients.
SAP's platform is already being used in 24 different sectors for real-time data management and analysis purposes. During the call, David Delaney, SAP's chief medical officer, highlighted several features of SAP Hana, that will be useful for CancerLinQ. For example, he noted that the platform can process and analyze data 10,000 times faster than standard technologies.
The main value of SAP Hana isn't as a database, Delaney noted, but in its computing and analysis power. "Once you get the data back, we're able to do natural-language processing, geo-spatial analyses, and all sorts of transformations all in real time, at massively accelerated speeds," he said. "Once we begin pulling the CancerLinQ data in from these practices, we'll have tremendous capabilities."
SAP unveiled a version of the SAP Hana system for oncology applications and made it available to early access customers last year. Additionally, SAP has worked with the National Center for Tumor Diseases in Heidelberg, Germany, to use real-time data analytics to speed research and match patients to clinical trials. Mitsui Knowledge Industry in Japan is also working with SAP to speed up the time it takes to analyze cancer patient's genomic data from 30 days to 20 minutes. "When CancerLinQ is complete, doctors will gain insights in seconds, not years," Yu said.
According to ASCO, CancerLinQ is the only HIT platform development effort being led by physicians. Currently eight oncology practices in the US have signed on to make patient records available to CancerLinQ and adopt the system. These include Inova Comprehensive Cancer & Research Institute; South Coast Centers for Cancer Care; New England Cancer Specialists; Medical Oncology Hematology Consultants, PA; Cancer Treatment Centers of America; Marin Cancer Care; Space Coast Cancer Center; and Michiana Hematology-Oncology.
Therese Mulvey, physician-in-chief at Southcoast Centers for Cancer Care in Massachusetts, noted during the call that in community settings like the one she practices in, the challenge is translating data from highly selected clinical trial participants to real-world situations in the clinic. After CancerLinQ is developed, she hopes that physicians in her cancer center will be able to query the system to learn how patients who are similar to the ones they're treating tolerated drugs. "There are over 13 million cancer survivors in the US," Mulvey said. "What happens to them after they complete their therapy will be an area of great interest to us practicing in the community."
Additionally, she said that the cancer center will use CancerLinQ to collect patterns of hospitalization rates, complications, and outcomes data that can in turn improve the center's processes. She and her colleagues also hope to use CancerLinQ to compare regimens between patients rather than relying on clinical trial data.
There is an acute need in oncology for a real-time data collection and analysis system. Burgeoning molecular knowledge of cancers is breaking up classifications of tumors into smaller and smaller subsets. Patients with tumors characterized by rare molecular markers often aren't studied in clinical trials. But a system like CancerLinQ could pick up data on such patients, which could help another cancer patient with the same rare marker.
Seven other big cancer centers are expected to sign on to CancerLinQ later this year, bringing the total number of patient records to be included in the project to 500,000. "We could have had more" participants, Yu said, noting that other practices have expressed interest and the effort will grow quickly. These early participants will help ASCO collate and analyze the initial crop of data that will be available for the inaugural version of CancerLinQ slated for launch later this year.
The ultimate aim, however, is to make CancerLinQ a resource that joins all cancer centers and oncology practices in the US. "We are developing CancerLinQ as part of ASCO's broader mission to improve cancer care for every patient no matter who they are and no matter where they live and no matter where they receive their care," Clifford Hudis, the immediate past-president of ASCO and chief of the Breast Cancer Medicine Service at Memorial Sloan Kettering Cancer Center, said during the call.
Hudis further noted that by collecting and analyzing data from "almost every cancer patient," and by using the data in CancerLinQ, researchers will be able to make drug development and research more efficient. Yu added that the system could positively impact healthcare spending by identifying cost-effective strategies that improve patient outcomes.
ASCO will not charge members and their practices to use CancerLinQ, and the raw aggregate data will remain within the cancer organization, which will pay a licensing fee to SAP to use its platform. Once CancerLinQ is developed, drug companies will have the option to pay CancerLinQ to run specific queries.
CancerLinQ LLC, a subsidiary of ASCO, will lead overall development of the eponymous HIT platform, with input from doctors, patients, and other experts along the way. The HIT platform is receiving support from ASCO's Conquer Cancer Foundation, and the CancerLinQ subsidiary will be in charge of the data, analysis, tools and services that are developed through this project. SAP will provide customized technologies based on SAP Hana, engineering knowhow, and technical support.
ASCO has been working with SAP for the past month on a production model for CancerLinQ. Yu noted that initially, ASCO had expected to develop the platform internally, but deciding not to reinvent the field, went with an established platform provider. He said that while ASCO has reduced its projected development costs by half by working with SAP, the organization expects to spend heavily in improving the platform and customizing it in the next couple of years.
SAP has dedicated a portion of its global development team to the CancerLinQ effort. According to Delaney, the patient data pulled in from oncology practices, aggregated and anonymized, will be stored in a highly compressed, simple format and "you don't really have to understand what the relationships are that are important in the data to be able to mine it and leverage it." He compared SAP Hana as a more agile and adaptable platform compared to standard technologies. It's "like working with clay," Delaney said.
ASCO has said that the fully developed version of CancerLinQ will launch in 2020. The organization is funding the effort through a combination of internal funding and philanthropic donations. Yu projected during the call that the effort will cost in the range of eight figures, and noted that fund-raising efforts have been going well. The society has thus far garnered funding from Susan G. Komen.