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Cancer Network Aims to Expand Precision Cancer Care Analytics to Community Oncologists

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NEW YORK (GenomeWeb) – A newly launched consortium, called the Oncology Precision Network (OPN), is aiming to bring big data analytics to cancer doctors in the community so they can provide personalized care.

OPN involves Syapse, a software company focused on enabling precision medicine programs, academic research center Stanford Cancer Institute, and two non-profit health systems: Providence Health & Services, which serves underserved populations across five states, and Utah-based Intermountain Healthcare. The community-based health systems will use Syapse's platform to share aggregate data on cancer patients, including molecular tumor profiles and how they fared after receiving treatments based on these disease characteristics. 

"This is a really unique data-sharing consortium," said Gary Stone, operations officer at Intermountain Precision Genomics. "We're not just doing this for academic purposes and giving a few people access. We're really trying to make it easy for the front-line oncologists who query data as they're thinking about the problems they're facing in treating cancer."

Stanford, Intermountain, and Providence will use Syapse's Precision Medicine Platform, which enables healthcare systems to integrate a variety of patient data, including genomic information; access and connect data that are typically siloed in electronic health records and registries; and link directly with molecular testing labs to incorporate patients' molecular profiles. Using Syapse's platform, which OPN members will customize to their needs, oncologists will contribute and gain access to previously un-tapped, real-world data on cancer patients.

The network members at first will have access to 100,000 data sets, but eventually they will be able to draw on information from 1.5 million cancer cases. OPN will provide access to this data to physicians working in 11 states, 79 hospitals, and 800 clinics, and will add other health systems later this year. The information will be shared in a way that maintains patients' privacy, as well as security rights to the data, OPN members said in a statement.

As a side project, Stone noted that Intermountain and its collaborators are thinking about creating a platform that will allow cancer patients free access to tumor type and molecular profiles scrubbed of identifiable information. "We've found in working with cancer patients that they're very astute, and they really do understand what's going on in the cancer arena and in their molecular profile," he said. "There is interest among patients in being able to query a more public-facing database."

OPN, by increasing interoperability and data sharing between healthcare systems, is attempting to resolve the challenges necessary to bring to fruition national projects, such as the National Cancer Moonshot Initiative and the Precision Medicine Initiative. With similar objectives in mind, other groups are also trying to link patient data across health systems to spur personalized cancer care.

Last year, SAP and the American Society of Clinical Oncology announced plans to develop a health information technology platform based on Hana called CancerLinQ, aiming to combine de-identified data from millions of electronic health records, including molecular information, from different oncology practices and cancer centers. By collecting this data, they hope to improve doctors' ability to provide personalized cancer care and advance precision treatments.

Clifford Hudis, a member of the CancerLinQ board of governors and past ASCO president, said in December that the organization was shooting for 1 million patient records in the system by June 2016. As of late last year, the system included data from 500,000 patients collected by 350 physicians in 15 practices, and some 150 practices were interested in contributing patient data to CancerLinQ.

What makes OPN unique, said Stone, is that it is truly focused on increasing community oncologists' access to analytics that will help them deliver precision cancer care, while they themselves are contributing to the dataset. "An oncologist in a rural facility in Intermountain's system, for example, who wants to query this database and see how many patients have had this cancer with this type of molecular profile and received targeted therapy versus chemotherapy, is going to be able to see [patient data from] all the participating oncologists including their own patients' data," he explained.

The oft-cited statistic is that 80 percent of cancer patients receive treatment in the community setting. Precision cancer care, which often relies on next-generation sequencing technologies, access to genetics experts, and big data analytics for determining which therapies patients should receive, is practiced at most major cancer centers around the country and at academic institutions, but is usually out of reach for patients without access to these facilities.

Intermountain spokesperson Terri Draper added that major healthcare systems don't usually share genomic data at the level Stanford, Providence, and Intermountain have committed to.

Experts involved in the consortium are still figuring out the specific datasets that doctors will have access to. "Our first phase will focus on making sure we can see the data, easily share the data through the software platform, and make it easily queryable," said Stone.

Initially, oncologists will have access to deidentified data on patients' tumor types and the molecular tumor profiles. By year end or early 2017, doctors will be able to query patient outcomes on precision treatments. "That's what the oncologists are going to be most interested in querying," Stone said.

Intermountain was an early adopter of cancer genomics. Since 2013, the healthcare system has been offering all advanced cancer patients the chance to receive genomic profiling on a 100-gene panel it performs internally using Illumina's MiSeq. Last year, Intermountain conducted genomic testing for approximately 500 advanced cancer patients, and 80 percent received an "actionable result," meaning they had a genomic alteration that is targeted by a marketed drug or an investigational treatment in a clinical trial.

"We're actually taking care of patients, changing the course of care for these patients with stage IV cancer particularly, based on their molecular profile," Stone said. Intermountain and Syapse also conducted a study in which they found that precision cancer care strategies doubled progression-free survival in stage IV patients without increasing costs. The integrated healthcare system also applied to become a healthcare provider organization within the Precision Medicine Initiative.

Providence-affiliated Swedish Cancer Institute in Seattle, meanwhile, has developed an algorithm they're using to match patients to clinical trials based on the molecular profile of their cancers. The cancer institute will contribute to OPN genomic profiles and other data on 750 patients, and the other centers within the Providence system will contribute similar data from patients as they join the network. "We have a broader cohort of more than 58,000 cancer patients in Syapse with additional genomic, molecular profiles," a Providence spokesperson told GenomeWeb.

In the last 18 months, oncologists have tested more than 1,000 cancer patients in the Seattle area on a 68-gene NGS test performed by CellNetix, while more than 350 patients in the Portland, Oregon region have received testing on a 50-gene NGS panel. According to the Providence spokesperson, this summer, both sites and the broader system will begin testing cancer patients on an NGS panel that gauges more than 300 genes.

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